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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2001;21:874.)
© 2001 American Heart Association, Inc.

Thrombosis

Preeclampsia and Fetal Loss in Women With a History of Venous Thromboembolism

Ingrid Pabinger; Helga Grafenhofer; Alexandra Kaider; Adriana Ilic; Sabine Eichinger; Peter Quehenberger; Peter Husslein; Christine Mannhalter; Klaus Lechner

From the Department of Internal Medicine I, Division of Hematology and Blood Coagulation (I.P., H.G., S.E., K.L.), the Department of Medical Computer Sciences, Section of Clinical Biometrics (A.K.), the Department of Obstetrics and Gynecology (A.I., P.H.), the Department of Laboratory Medicine (P.Q.), and the Division of Molecular Biology (C.M.), University of Vienna, Medical School, Vienna, Austria.

Correspondence to Prof Ingrid Pabinger, MD, Department of Internal Medicine I, Division of Hematology and Blood Coagulation, Waehringer Guertel 18-20, A-1090 Vienna, Austria. E-mail ingrid.pabinger{at}akh-wien.ac.at

Abstract—A higher prevalence of risk factors for venous thromboembolism (VTE) has been found in women with preeclampsia and fetal loss. We investigated whether women with a history of VTE have a higher prevalence of pregnancy-associated complications compared with control subjects. In 395 patients with a history of VTE and in 313 control women, the prevalence of complications during pregnancy and the mean birth weight of viable infants were evaluated. The prevalence of pregnancy-induced hypertension and preeclampsia was higher in patients (5.1% and 3.0%, respectively) compared with control subjects (1.3% each). The odds ratio was 4.13 for pregnancy-induced hypertension (95% CI 1.4 to 12.22, P=0.0058) and 2.43 for preeclampsia (95% CI 0.78 to 7.6, P=0.133). Stillbirth was slightly more frequent in patients (4.3%) than in control subjects (3.2%); the difference was not statistically significant. Miscarriage was equally frequent in patients (21.8%) and control subjects (21.3%). The birth weight of viable infants born to patients was, on average, 109 g lower than that of the infants born to the control subjects (P=0.014) after adjustment for the mother’s body mass index. Our study demonstrates that women with a predisposition to VTE have, overall, a good chance for a successful pregnancy outcome. However, the findings from our study support the assumption that a predisposition to venous thrombosis is associated with a higher risk for complications during pregnancy and lower infant birth weight.

Key Words: venous thromboembolism • pregnancy • preeclampsia • fetal loss • birth weight

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