Pulmonary embolism and deep venous thrombosis during pregnancy or oral contraceptive use: prevalence of factor V Leiden.
Activated protein C resistance caused by factor V Leiden mutation is the most common inherited cause of an underlying predisposition to pulmonary embolism (PE) and deep venous thrombosis (DVT). We studied the frequency of the factor V Leiden mutation in 50 women who had PE and/or DVT during or after pregnancy or during oral contraceptive use. Ten (20%; 95% CI 10% to 34%) of the 50 women were heterozygous for the mutation. First-trimester PE or DVT developed in 6 (60%; 95% CI, 26% to 88%) of the 10 women with the mutation compared with 3 (8%; 95% CI 2% to 20%) of 40 women without the mutation (p = 0.0009). These data indicate that the factor V Leiden mutation is an important risk factor for PE or DVT during pregnancy (especially the first trimester), after pregnancy, or during oral contraceptive use.
Hirsch
D R
DR
Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
Mikkola
K M
KM
Marks
P W
PW
Fox
E A
EA
Dorfman
D M
DM
Ewenstein
B M
BM
Goldhaber
S Z
SZ
D000293:Adolescent; D000328:Adult; D003276:Contraceptives, Oral / Q000009:adverse effects*; D004789:Enzyme Activation; D005165:Factor V / Q000235:genetics / Q000378:metabolism*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009154:Mutation; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood*; D011486:Protein C / Q000378:metabolism; D011655:Pulmonary Embolism / Q000097:blood* / Q000139:chemically induced / Q000235:genetics; D012307:Risk Factors; D013924:Thrombophlebitis / Q000097:blood* / Q000139:chemically induced / Q000235:genetics
D003276:Contraceptives, Oral; D011486:Protein C; C095381:factor V Leiden; D005165:Factor V