Familial Thrombophilia as a Warning Flag for Pregnancy-Associated VTE

Pregnancy and the postpartum state significantly raise risk for venous thromboembolism (VTE; NEJM JW Womens Health Jun 2014 and Obstet Gynecol 2014; 123:987). To inform guidelines on prophylactic anticoagulation for women with hereditary thrombophilias, researchers conducted a systematic review and meta-analysis of 36 observational studies.

Hereditary thrombophilias identified as high-risk for a first pregnancy-associated VTE included antithrombin deficiency (antepartum and postpartum absolute risks for VTE, 7.3% and 11.1, respectively), protein C deficiency (3.2% and 5.4%), protein S deficiency (0.9% and 4.2%), and homozygous factor V Leiden (2.8% and 2.8%). In contrast, the overall antepartum plus postpartum absolute risks were <3% in wome…