title: Pregnancy complications predict thrombotic events in young women with essential thrombocythemia.
abstract: Although Philadelphia-negative myeloproliferative neoplasms (MPNs) occur typically in middle to advanced age, any age group may be affected, posing a challenge for their management during pregnancy when they occur in young females. There is a high incidence of thromboembolic events and pregnancy complications in patients with myeloproliferative neoplasms, and a possible relationship between these complications is a matter of concern. The aim of this article was to correlate thrombosis and pregnancy outcome in 158 females with ET experiencing 237 pregnancies. Seven patients had a thrombotic event before their first pregnancy, one of them ended (14.3%) in a miscarriage. Among the 151 patients with no history of thrombosis before they became pregnant, 40 (26.5%) had a miscarriage (P = NS). Eighteen patients (11.4%) developed major thrombotic complications (12 splanchnic vein, 1 cerebral vein, 2 coronary syndromes, and 3 strokes) after at least one pregnancy (4 uneventful and 14 complicated). The occurrence of thrombosis was significantly more frequent (P < 0.001) in patients with a history of pregnancy complications (28%) than in those experiencing a normal pregnancy and delivery (3.7%). Pregnancy complications in women with ET are associated with a higher risk of subsequent thromboses, so pregnant women with this neoplasm who miscarry need to be carefully monitored.
authors.affiliation: Dept of Medicine -DIMED, Internal Medicine, University of Padua, Padua, Italy.
authors.forename: Maria Luigia
authors.initials: ML
authors.lastname: Randi
authors.forename: Irene
authors.initials: I
authors.lastname: Bertozzi
authors.forename: Elisa
authors.initials: E
authors.lastname: Rumi
authors.forename: Chiara
authors.initials: C
authors.lastname: Elena
authors.forename: Guido
authors.initials: G
authors.lastname: Finazzi
authors.forename: Nicola
authors.initials: N
authors.lastname: Vianelli
authors.forename: Nicola
authors.initials: N
authors.lastname: Polverelli
authors.forename: Marco
authors.initials: M
authors.lastname: Ruggeri
authors.forename: Alessandro Maria
authors.initials: AM
authors.lastname: Vannucchi
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Antonioli
authors.forename: Federico
authors.initials: F
authors.lastname: Lussana
authors.forename: Alessia
authors.initials: A
authors.lastname: Tieghi
authors.forename: Alessandra
authors.initials: A
authors.lastname: Iurlo
authors.forename: Elena
authors.initials: E
authors.lastname: Elli
authors.forename: Marco
authors.initials: M
authors.lastname: Ruella
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Fabris
authors.forename: Mario
authors.initials: M
authors.lastname: Cazzola
authors.forename: Tiziano
authors.initials: T
authors.lastname: Barbui
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D015897:Comorbidity; D005260:Female; D006470:Hemorrhage / Q000453:epidemiology; D006801:Humans; D053614:Janus Kinase 2 / Q000235:genetics; D020125:Mutation, Missense; D017354:Point Mutation; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011250:Pregnancy Complications, Hematologic / Q000453:epidemiology*; D011256:Pregnancy Outcome; D011379:Prognosis; D012189:Retrospective Studies; D050497:Stillbirth / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology; D013920:Thrombocythemia, Essential / Q000150:complications* / Q000235:genetics; D019851:Thrombophilia / Q000188:drug therapy / Q000209:etiology; D013927:Thrombosis / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult
chemical_list: D000925:Anticoagulants; C507924:JAK2 protein, human; D053614:Janus Kinase 2