Differences in thrombotic risk factors in black and white women with adverse pregnancy outcome.
BACKGROUND
Black women have an increased risk of adverse pregnancy outcomes and the characteristics of thrombotic risk factors in this population are unknown. The objective of this study was to examine the racial differences in thrombotic risk factors among women with adverse pregnancy outcomes.


METHODS
Uniform data were collected in women with adverse pregnancy outcomes (pregnancy losses, intrauterine growth restriction (IUGR), prematurity, placental abruption and preeclampsia) referred to Thrombosis Network Centers funded by the Centers for Disease Control and Prevention (CDC).


RESULTS
Among 343 white and 66 black women seen for adverse pregnancy outcomes, protein S and antithrombin deficiencies were more common in black women. The prevalence of diagnosed thrombophilia was higher among whites compared to blacks largely due to Factor V Leiden mutation. The prevalence of a personal history of venous thromboembolism (VTE) did not differ significantly by race. A family history of VTE, thrombophilia, and stroke or myocardial infarction (MI) was higher among whites. Black women had a higher body mass index, and a higher prevalence of hypertension, while the prevalence of sickle cell disease was approximately 27 fold higher compared to the general US black population.


CONCLUSIONS
Thrombotic risk factors differ significantly in white and black women with adverse pregnancy outcomes. Such differences highlight the importance of considering race separately when assessing thrombotic risk factors for adverse pregnancy outcomes.
Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA. Electronic address: philipp@rutgers.edu.
Claire S
CS
Philipp
Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
Ambarina S
AS
Faiz
Division of Blood Disorders, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Michele G
MG
Beckman
Division of Blood Disorders, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Althea
A
Grant
Department of Medicine, University of Michigan, Ann Arbor, MI, USA.
Paula L
PL
Bockenstedt
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
John A
JA
Heit
Department of Obstetrics and Gynecology, Duke University, Durham, NC, USA.
Andra H
AH
James
Department of Pediatrics and Human Development, Michigan State University, East Lansing, MI, USA.
Roshni
R
Kulkarni
Department of Pediatrics, University of Colorado, Denver and the Children's Hospital, Aurora, CO, USA.
Marilyn J
MJ
Manco-Johnson
Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.
Stephan
S
Moll
Departments of Medicine and Pathology, Duke University, Durham, NC, USA.
Thomas L
TL
Ortel
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood* / Q000453:epidemiology / Q000208:ethnology*; D012307:Risk Factors; D013927:Thrombosis / Q000097:blood* / Q000453:epidemiology / Q000208:ethnology*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
Thrombotic risk factors; adverse pregnancy outcomes; racial disparities; thrombophilia