A Retrospective Assessment of Thrombophilia in Pregnant Women with First and Second Trimester Pregnancy Loss
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Settings
2.2. Participants and Definitions
2.3. Variables and Data Sources
2.4. Laboratory Analysis
2.5. Statistical Analysis
3. Results
3.1. Background Characteristics
3.2. Obstetrical Characteristics
3.3. Laboratory Analysis
3.4. Risk Factor Analysis
4. Discussion
4.1. Important Findings
4.2. Study Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | First Trimester (n = 157) | Second Trimester (n = 54) | p-Value * |
---|---|---|---|
Age (≥ 35 years) | 71 (45.2%) | 22 (40.7%) | 0.567 |
BMI (>25 kg/m2) ** | 34 (21.7%) | 9 (16.7%) | 0.432 |
Area of residence (urban) | 112 (71.3%) | 33 (61.1%) | 0.162 |
Relationship status (married) | 136 (86.6%) | 46 (85.2%) | 0.791 |
Level of income (average or higher) | 98 (62.4%) | 33 (61.1%) | 0.864 |
Level of education (higher education) | 92 (58.6%) | 36 (66.7%) | 0.295 |
Occupation (employed) | 157 (80.3%) | 42 (77.8%) | 0.696 |
Substance use behavior | |||
Frequent alcohol consumption | 7 (4.5%) | 3 (5.6%) | 0.743 |
Frequent smoker | 22 (14.0%) | 9 (16.7%) | 0.634 |
Chronic comorbidities | |||
Cardiovascular | 5 (3.2%) | 2 (3.7%) | 0.854 |
Metabolic | 6 (3.8%) | 4 (7.4%) | 0.284 |
Autoimmune | 1 (0.6%) | 2 (3.7%) | 0.100 |
Respiratory | 5 (3.2%) | 1 (1.9%) | 0.611 |
Other | 2 (1.3%) | 1 (1.9%) | 0.756 |
History of depression | 11 (7.0%) | 5 (9.3%) | 0.589 |
History of COVID-19 | 16 (10.2%) | 9 (16.7%) | 0.204 |
Variables | First Trimester (n = 157) | Second Trimester (n = 54) | p-Value * |
---|---|---|---|
Gravidity | 0.179 | ||
1 | 28 (17.8%) | 7 (13.0%) | |
2 | 44 (28.0%) | 10 (18.5%) | |
≥3 | 85 (54.1%) | 37 (68.5%) | |
Parity (1 or more) | 16 (10.2%) | 5 (9.3%) | 0.843 |
History of pregnancy loss | 0.336 | ||
1 | 8 (5.1%) | 4 (7.4%) | |
2 | 41 (26.1%) | 9 (16.7%) | |
≥3 | 108 (68.8%) | 41 (75.9%) | |
Spontaneous abortion (n = 496) | 0.003 | ||
Threatened | 34 (10.1%) | 17 (10.6%) | |
Inevitable | 107 (31.7%) | 55 (34.2%) | |
Complete | 132 (39.1%) | 79 (49.1%) | |
Missed | 62 (18.5%) | 10 (6.2%) | |
History of induced abortion (n = 37) | 0.077 | ||
Medical | 14 (66.7%) | 6 (37.5%) | |
Surgical | 7 (33.3%) | 10 (62.5%) | |
High obstetrical risk | 33 (21.0%) | 21 (38.9%) | 0.009 |
Pregnancy-related complications | |||
Preeclampsia | 9 (5.7%) | 3 (5.6%) | 0.961 |
Anemia | 23 (14.6%) | 9 (16.7%) | 0.721 |
Peripartum infection | 12 (7.6%) | 6 (11.1%) | 0.431 |
Other maternal infections | 24 (15.3%) | 15 (27.8%) | 0.041 |
Deep venous thrombosis | 23 (14.6%) | 12 (22.2%) | 0.196 |
Pulmonary embolism | 5 (3.2%) | 2 (3.7%) | 0.854 |
Other episodes of thrombosis | 17 (10.8%) | 8 (14.8%) | 0.434 |
Female infertility | |||
Assisted reproductive techniques | 39 (24.8%) | 11 (20.4%) | 0.505 |
History of STDs | 18 (11.5%) | 9 (16.7%) | 0.323 |
Pelvic infections | 25 (15.9%) | 12 (22.2%) | 0.293 |
Variables | First Trimester (n = 157) | Second Trimester (n = 54) | p-Value * |
---|---|---|---|
FVL heterozygous | 36 (22.9%) | 10 (18.5%) | 0.498 |
FVL homozygous | 17 (10.8%) | 1 (1.9%) | 0.041 |
PT heterozygous | 11 (7.0%) | 6 (11.1%) | 0.339 |
FVL and PT (compound heterozygous) | 15 (9.6%) | 4 (7.4%) | 0.634 |
Antithrombin deficiency | 13 (8.3%) | 4 (7.4%) | 0.838 |
Protein C deficiency | 9 (5.7%) | 8 (14.8%) | 0.034 |
Protein S deficiency | 14 (8.9%) | 6 (11.1%) | 0.634 |
Free protein S deficiency | 7 (4.5%) | 5 (9.3%) | 0.188 |
PAI-1 deficiency | 2 (1.3%) | 1 (1.9%) | 0.756 |
ACE deletion | 9 (5.7%) | 3 (5.6%) | 0.961 |
Factor VII deficiency | 16 (10.2%) | 4 (7.4%) | 0.546 |
Factor XIII deficiency | 13 (8.3%) | 7 (13.0%) | 0.310 |
β-fibrinogen polymorphism | 29 (18.5%) | 9 (16.7%) | 0.765 |
Glycoprotein Ia polymorphism | 31 (19.7%) | 18 (33.3%) | 0.041 |
tPA deficiency | 10 (6.4%) | 4 (7.4%) | 0.791 |
APCR | 4 (2.5%) | 1 (1.9%) | 0.771 |
APS antibodies ** | 28 (17.8%) | 3 (5.6%) | 0.027 |
MTHFR gene mutation | 32 (20.4%) | 12 (22.2%) | 0.774 |
Risk Factors * | First Trimester Pregnancy Loss (OR–95% CI) | p-Value | Second Trimester Pregnancy Loss (OR–95% CI) | p-Value |
---|---|---|---|---|
FVL heterozygous | 2.54 (1.33–4.96) | 0.036 | 1.82 (1.24–3.25) | 0.049 |
FVL homozygous | 3.66 (1.85–6.11) | 0.001 | 2.27 (1.51–3.88) | 0.007 |
PT heterozygous | 2.79 (1.27–3.82) | 0.022 | 2.81 (1.58–4.33) | 0.001 |
FVL and PT compound | 3.11 (1.89–6.18) | 0.001 | 3.24 (1.80–5.76) | 0.001 |
Protein C deficiency | 2.15 (1.32–3.93) | 0.009 | 2.98 (1.75–5.04) | 0.001 |
Protein S deficiency | 2.25 (1.46–3.23) | 0.001 | 1.93 (1.16–2.83) | 0.012 |
APS antibodies | 4.47 (2.03–6.32) | 0.001 | 3.85 (1.83–5.41) | 0.001 |
MTHFR gene mutation | 2.02 (1.24–3.32) | 0.017 | 2.48 (1.37–4.29) | 0.001 |
Glycoprotein Ia polymorphism | 1.97 (1.08–3.40) | 0.033 | 3.61 (1.22–4.94) | 0.001 |
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Iordache, O.; Anastasiu-Popov, D.M.; Anastasiu, D.M.; Craina, M.; Dahma, G.; Sacarin, G.; Silaghi, C.; Citu, C.; Daniluc, R.; Hinoveanu, D.; et al. A Retrospective Assessment of Thrombophilia in Pregnant Women with First and Second Trimester Pregnancy Loss. Int. J. Environ. Res. Public Health 2022, 19, 16500. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph192416500
Iordache O, Anastasiu-Popov DM, Anastasiu DM, Craina M, Dahma G, Sacarin G, Silaghi C, Citu C, Daniluc R, Hinoveanu D, et al. A Retrospective Assessment of Thrombophilia in Pregnant Women with First and Second Trimester Pregnancy Loss. International Journal of Environmental Research and Public Health. 2022; 19(24):16500. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph192416500
Chicago/Turabian StyleIordache, Olivera, Diana Maria Anastasiu-Popov, Doru Mihai Anastasiu, Marius Craina, George Dahma, Geanina Sacarin, Carmen Silaghi, Cosmin Citu, Razvan Daniluc, Denisa Hinoveanu, and et al. 2022. "A Retrospective Assessment of Thrombophilia in Pregnant Women with First and Second Trimester Pregnancy Loss" International Journal of Environmental Research and Public Health 19, no. 24: 16500. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph192416500