The risk of abortion and stillbirth in antithrombin-, protein C-, and protein S-deficient women.
Hereditary deficiencies of the naturally occurring anticoagulants are well recognized conditions predisposing to recurrent venous thromboembolism. Since thrombotic phenomena have been implied as a cause of abortion and stillbirth, we hypothesized that these deficiencies increase the risk of fetal demise. A group of 129 female subjects who had been pregnant at least once and who had a family member with documented venous thrombosis associated with a deficiency of AT, PC or PS were studied. We first assessed the obstetric history and subsequently determined the deficiency status. In the 60 deficient subjects 42 (22.3%) of the 188 pregnancies resulted in miscarriage or stillbirth as compared to 23 (11.4%) of the 202 pregnancies in the 69 non-deficient subjects. The relative risk of abortion and stillbirth per pregnancy for deficient women as compared to non-deficient women was 2.0 (95% C.I. 1.2-3.3).
Sanson
B J
BJ
Department of Clinical Epidemiology and Biostatistics, Academic Medical Centre, Amsterdam, The Netherlands.
Friederich
P W
PW
Simioni
P
P
Zanardi
S
S
Hilsman
M V
MV
Girolami
A
A
ten Cate
J W
JW
Prins
M H
MH
D000022:Abortion, Spontaneous / Q000097:blood* / Q000209:etiology; D020152:Antithrombin III Deficiency; D005260:Female; D005313:Fetal Death / Q000097:blood* / Q000209:etiology; D006801:Humans; D011247:Pregnancy; D020151:Protein C Deficiency; D018455:Protein S Deficiency / Q000150:complications*; D012307:Risk Factors