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Recurrent miscarriage is not associated with a higher prevalence of inherited and acquired thrombophilia
Author(s) -
Vomstein Kilian,
Herzog Anna,
Voss Pauline,
Feil Katharina,
Goeggl Tamara,
Strowitzki Thomas,
Toth Bettina,
Kuon RubenJeremias
Publication year - 2021
Publication title -
american journal of reproductive immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.071
H-Index - 97
eISSN - 1600-0897
pISSN - 1046-7408
DOI - 10.1111/aji.13327
Subject(s) - thrombophilia , medicine , recurrent miscarriage , antiphospholipid syndrome , factor v , miscarriage , factor v leiden , protein s deficiency , obstetrics , pregnancy , gastroenterology , thrombosis , venous thrombosis , genetics , biology
Problem Although not being recommended in guidelines, many physicians perform routine screening for thrombophilia in RM patients suspecting a higher prevalence in these patients. The aim of this study was to analyze the prevalence of inherited and acquired thrombophilia in a large cohort of RM patients. Method of study Within a multicenter case‐control study, n = 820 RM patients and n = 141 controls were included. The prevalence of inherited and acquired thrombophilia including deficiency of protein C/S and antithrombin, elevation of factor VIII activity, APC resistance including mutation in the factor V Leiden gene, mutation in the prothrombin gene and antiphospholipid antibodies were assessed. Further, we performed a meta‐analysis of the prevalence of thrombophilia in RM patients including studies between 01/2000 and 01/2020. Results An antiphospholipid syndrome (APLS) was only present in RM patients. Increased factor VIII concentration was significantly more prevalent in controls (RM vs controls: 5.8% vs 11.0%). None of the other thrombophilia did differ significantly between RM patients and controls. The meta‐analysis revealed no significant difference in the occurrence of these thrombophilia between RM patients and controls. Conclusion The prevalence of inherited thrombophilia does not differ between RM patients and controls. When analyzing rare events like thrombophilia, a high number of patients are needed to obtain reliable results, which might explain contradictory findings in previous studies analyzing small cohorts of RM patients. Despite being less prevalent than previously described, we still recommend screening for APLS as it is associated with severe pregnancy complications.