title: Family history of venous thromboembolism and identifying factor V Leiden carriers during pregnancy.
abstract: OBJECTIVE
  To estimate whether there is a correlation between family history of venous thromboembolism and factor V Leiden mutation carriage in gravid women without a personal history of venous thromboembolism.
  
  
  METHODS
  This is a secondary analysis of a prospective observational study of the frequency of pregnancy-related thromboembolic events among carriers of the factor V Leiden mutation. Family history of venous thromboembolism in either first- or second-degree relatives was self-reported. Sensitivity, specificity, and positive and negative predictive values of family history to predict factor V Leiden mutation carrier status were calculated.
  
  
  RESULTS
  Women without a personal venous thromboembolism history and with available DNA were included (n=5,168). One hundred forty women (2.7% [95% confidence interval (CI) 2.3-3.2%]) were factor V Leiden mutation-positive. Four hundred twelve women (8.0% [95% CI 7.3-8.7%]) reported a family history of venous thromboembolism. Women with a positive family history were twofold more likely to be factor V Leiden mutation carriers than those with a negative family history (23 of 412 [5.6%] compared with 117 of 4,756 [2.5%], P<.001). The sensitivity, specificity, and positive predictive value of a family history of a first- or second-degree relative for identifying factor V Leiden carriers were 16.4% (95% CI 10.7-23.6%), 92.3% (95% CI 91.5-93.0%), and 5.6% (95% CI 3.6-8.3%), respectively.
  
  
  CONCLUSIONS
  Although a family history of venous thromboembolism is associated with factor V Leiden mutation in thrombosis-free gravid women, the sensitivity and positive predictive values are too low to recommend screening women for the factor V Leiden mutation based solely on a family history.
authors.affiliation: From the Departments of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina; University of Utah, Salt Lake City, Utah; University of Alabama at Birmingham, Birmingham, Alabama; University of Texas Southwestern Medical Center, Dallas, Texas; The Ohio State University, Columbus, Ohio; University of Tennessee, Memphis, Tennessee; University of Pittsburgh, Pittsburgh, Pennsylvania; Wayne State University, Detroit, Michigan; University of Cincinnati, Cincinnati, Ohio; University of Miami, Miami, Florida; University of Texas at San Antonio, San Antonio, Texas; Thomas Jefferson University, Philadelphia, Pennsylvania; and The George Washington University Biostatistics Center, Washington, DC; and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Horton
authors.forename: Valerija
authors.initials: V
authors.lastname: Momirova
authors.forename: Donna
authors.initials: D
authors.lastname: Dizon-Townson
authors.forename: Katharine
authors.initials: K
authors.lastname: Wenstrom
authors.forename: George
authors.initials: G
authors.lastname: Wendel
authors.forename: Philip
authors.initials: P
authors.lastname: Samuels
authors.forename: Baha
authors.initials: B
authors.lastname: Sibai
authors.forename: Catherine Y
authors.initials: CY
authors.lastname: Spong
authors.forename: Margaret
authors.initials: M
authors.lastname: Cotroneo
authors.forename: Yoram
authors.initials: Y
authors.lastname: Sorokin
authors.forename: Menachem
authors.initials: M
authors.lastname: Miodovnik
authors.forename: Mary J
authors.initials: MJ
authors.lastname: O'Sullivan
authors.forename: Deborah
authors.initials: D
authors.lastname: Conway
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Wapner
mesh_terms: D005165:Factor V / Q000235:genetics*; D005260:Female; D006580:Genetic Carrier Screening / Q000379:methods*; D006801:Humans; D008403:Mass Screening / Q000379:methods; D010375:Pedigree; D011237:Predictive Value of Tests; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000175:diagnosis* / Q000235:genetics; D011296:Prenatal Diagnosis / Q000379:methods*; D011446:Prospective Studies; D054556:Venous Thromboembolism / Q000235:genetics*
chemical_list: C095381:factor V Leiden; D005165:Factor V