The association between inherited thrombophilia, antiphospholipid antibodies and lipoprotein a levels with obstetrical complications in pregnancy.

摘要

Objectives: To evaluate the association between obstetrical complications in pregnancy and thrombophilic factors.Study Design: 75 pregnant women with obstetrical complications and 66 controls with live births without obstetrical complications were tested for thrombophilia. All subjects were negative for thromboembolic disease.Results: The obstetrical complications in the study group were unexplained oligohydramnios = 16 (21%), IUGR = 17 (23%), preeclampsia <32 weeks = 15 (20%), recurrent abortions = 42 (56%), fetal demise = 14 (19%), abruption = 8 (11%). Comparing women with obstetrical complications versus controls, factor V Leiden mutation was present in 7 (10%) versus 1 (2%) P =.064, odds ratio (OR) = 7, 95%, CI = 0.8-58.5, antiphospholipid antibody syndrome in 14 (19%) versus 2 (3%) P =.003, OR = 7, 95% CI = 1.7-35, high lipoprotein A levels 13 (30%) versus 6 (10%) P =.019, OR = 3.8, 95% CI = 1.3-11. In the study group, there was a case each of prothrombin gene mutation, elevated homocysteine level, antithrombin III, protein S&C deficiencies. Major thrombophilia diagnosis was present in 24 (32%) versus 3 (5%) of controls p =.001, OR = 9.8. No association was found with the methylenetetrahydrofolate reductase gene mutation. In 22 women who subsequently became pregnant, prophylactic anticoagulant therapy compared to pretreatment control pregnancies showed 22 versus 11 live births P =.001, 95% CI = 0.3-0.7 and obstetrical complications of 2 (9%) versus 22 (100%) P =.001, OR = 11, 95% CI = 2.9-41.2.Conclusion: An association is suggested between non-thromboembolic pregnancy complications and hypercoagulable disorders. Prophylactic anticoagulant therapy may be associated with improved pregnancy outcome.