Hematology Department, IBSAL-Hospital Universitario de Salamanca, Salamanca, Spain.
Eur J Haematol. 2012 Sep;89(3):250-5. doi: 10.1111/j.1600-0609.2012.01809.x. Epub 2012 Jun 29.
Few studies have evaluated the risk of pregnancy-related adverse events in asymptomatic relatives of probands for VTE and factor V Leiden or the G20210A variant. The antepartum management of this population ranges from antepartum anticoagulation therapy to clinical surveillance.
To evaluate the risk of placenta-mediated pregnancy complications and pregnancy-related VTE in VTE-asymptomatic families of probands with VTE and who are heterozygous carriers of either factor V Leiden or PT-G20210A mutation.
One hundred and fifty-eight relatives, who had 415 pregnancies, were retrospectively evaluated. Odds ratios and 95% confidence intervals were calculated to compare pregnancy outcomes between women with and without thrombophilia.
In the factor V Leiden group, 22 placenta-mediated pregnancy events of 152 pregnancies (14.4%) were reported, compared with 25 adverse events of 172 pregnancies in the G20210A prothrombin group (14.5%) and 13 adverse events of 91 pregnancies in the non-carrier group (14.2%). Carriers of factor V Leiden or G20210A prothrombin were not associated with a higher risk of pregnancy-adverse outcomes compared with non-carriers: OR 1.02 (95% CI, 0.40-2.25) and 1.25 (95% CI, 0.48-3.24), respectively. Four episodes of pregnancy-associated VTE of 415 pregnancies (0.96%) were recorded. Two episodes of VTE in the G20210A group, one in the factor V Leiden group, and one episode in the non-carrier group were noted.
In VTE-asymptomatic relatives of probands with VTE, the presence of factor V Leiden or the G20210A prothrombin mutation in heterozygosis should not lead to a decision to instigate antepartum prophylaxis.
很少有研究评估无症状静脉血栓栓塞症（VTE）患者一级亲属和 V 因子 Leiden 或 G20210A 变体杂合子携带者的妊娠相关不良事件的风险。该人群的产前管理范围从产前抗凝治疗到临床监测。
评估 VTE 无症状一级亲属中 VTE 患者和 V 因子 Leiden 或 PT-G20210A 突变杂合子携带者的胎盘介导妊娠并发症和妊娠相关静脉血栓栓塞症的风险。
回顾性评估了 158 名亲属的 415 次妊娠。计算比值比和 95%置信区间，以比较血栓形成倾向女性和非血栓形成倾向女性的妊娠结局。
在 V 因子 Leiden 组中，152 次妊娠中有 22 次胎盘介导的妊娠事件（14.4%），而在 G20210A 凝血酶原组中，172 次妊娠中有 25 次不良事件（14.5%），在非携带者组中，91 次妊娠中有 13 次不良事件（14.2%）。与非携带者相比，携带 V 因子 Leiden 或 G20210A 凝血酶原的患者妊娠不良结局的风险没有增加：比值比分别为 1.02（95%CI，0.40-2.25）和 1.25（95%CI，0.48-3.24）。在 415 次妊娠中记录了 4 次妊娠相关 VTE。在 G20210A 组中有 2 次 VTE 事件，在 V 因子 Leiden 组中有 1 次 VTE 事件，在非携带者组中有 1 次 VTE 事件。
在 VTE 无症状一级亲属中，杂合子携带 V 因子 Leiden 或 G20210A 凝血酶原突变不应导致决定进行产前预防。
