title: Pregnancy-Related Venous Thromboembolism Risk in Asymptomatic Women With Antithrombin Deficiency: A Systematic Review.
abstract: OBJECTIVE
  To evaluate the risk of pregnancy-associated venous thromboembolism in women with asymptomatic antithrombin deficiency.
  
  
  METHODS
  The search was performed on MEDLINE (Ovid and PubMed databases) for the period 1966 to June 2012 and ClinicalTrials.gov as of December 15, 2015.
  
  
  METHODS
  A systematic review including randomized controlled trials, cohort studies, and case-control studies was conducted. Selection criteria included objectively diagnosed venous thromboembolism or venous thromboembolism treated with 3 months of anticoagulation before the availability of objective testing. The study population consisted of pregnant women with asymptomatic antithrombin deficiency.
  
  
  RESULTS
  Seven publications were included in the review. No randomized controlled trials were identified. The best available data consist of three retrospective cohort studies and four case-control studies. Pooled results from case-control studies yielded an estimated odds ratio for venous thromboembolism of 6.09 (95% confidence interval 1.58-23.43). No pooled estimates could be obtained for cohort studies. Data on use of thromboprophylaxis were scarce.
  
  
  CONCLUSIONS
  Despite the small number of patients included, and the variation in study designs, pooled results from case-control studies show a significant association between asymptomatic antithrombin deficiency and pregnancy-associated venous thromboembolism. Thromboprophylaxis during pregnancy and postpartum should be considered in these women.
authors.affiliation: Departments of Medicine, Divisions of Internal Medicine, Hôpital du Sacré-Coeur de Montréal, and Centre Hospitalier de l'Université de Montréal Hôpital Saint-Luc, Montréal, Quebec, Canada.
authors.forename: Maxime
authors.initials: M
authors.lastname: Rhéaume
authors.forename: Florence
authors.initials: F
authors.lastname: Weber
authors.forename: Madeleine
authors.initials: M
authors.lastname: Durand
authors.forename: Michèle
authors.initials: M
authors.lastname: Mahone
mesh_terms: D000328:Adult; D020152:Antithrombin III Deficiency / Q000150:complications*; D058070:Asymptomatic Diseases; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016017:Odds Ratio; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000209:etiology* / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000209:etiology* / Q000517:prevention & control