Yonsei Med J.  2016 Sep;57(5):1230-1235. 10.3349/ymj.2016.57.5.1230.

The Impact of Inherited Thrombophilia Types and Low Molecular Weight Heparin Treatment on Pregnancy Complications in Women with Previous Adverse Outcome

• Aracic N
• Roje D
• Jakus IA
• Bakotin M
• Stefanovic V

• KMID: 2374170
• DOI: http://doi.org/10.3349/ymj.2016.57.5.1230

Abstract

PURPOSE
To assess the distribution of births and spontaneous abortions, first-trimester abortion (FTA) and mid-trimester abortion (MTA), in untreated (n=128) and low molecular weight heparin (LMWH) treated pregnancies (n=50) of the same women with inherited thrombophilias and adverse pregnancy outcome (APO) in previous pregnancies. We particularly investigated the impact of LMWH on reducing the pregnancy complications in two thrombophilia types, "Conventional" and "Novel".
MATERIALS AND METHODS
50 women with inherited thrombophilia (26 Conventional and 24 Novel) and APO in previous pregnancies were included in the study. Conventional group included factor V Leiden (FVL), prothrombin G20210A (PT) mutations and antithrombin (AT), protein S (PS), and protein C (PC) deficiency, while the Novel group included methylentetrahydrofolate-reductase (MTHFR), plasminogen activator inhibitor-1 (PAI-1), and angiotensin converting enzyme (ACE) polymorphism. APO was defined as one of the following: preterm birth (PTB), fetal growth restriction (FGR), preeclampsia (PE), intrauterine fetal death (IUFD), placental abruption (PA) and deep venous thrombosis (DVT).
RESULTS
There was no difference in distribution of births and spontaneous abortions between Conventional and Novel thrombophilia in untreated pregnancies (χ2=2.7; p=0.100) and LMWH treated pregnancies (χ2=0.442; p=0.506). In untreaed pregnancies thrombophilia type did not have any impact on the frequency of FTA and MTA (χ2=0.14; p=0.711). In birth-ended pregnancies LMWH treatement reduced the incidence of IUFD (p=0.011) in Conventional and FGR, IUFD, and PTB in Novel thrombophilia group.
CONCLUSION
The equal impact of two thrombophilia types on the pregnancy outcomes and a more favorable effect of LMWH therapy on pregnancy complications in Novel thrombophilia group point the need for Novel thrombophilias screening and the future studies on this issue should be recommended.

Keyword

Thrombophilia; pregnancy outcome; LMWH

MeSH Terms

Adult
Anticoagulants/*therapeutic use
Female
Heparin, Low-Molecular-Weight/*therapeutic use
Humans
Infant, Newborn
Polymorphism, Genetic
Pregnancy
Pregnancy Complications/*drug therapy/genetics
*Pregnancy Outcome
Thrombophilia/*drug therapy/genetics
Young Adult
Anticoagulants
Heparin, Low-Molecular-Weight

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