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Women with factor V Leiden (FVL) are usually advised to avoid oral contraceptives (OCs) because of the increased risk for venous thromboembolism (VTE). However, such advice does not take into account that pregnancy, itself, is a moderate risk factor for thrombosis in these women.
To compare the VTE risks associated with OC use versus pregnancy, investigators retrospectively studied female relatives of patients with both FVL and VTE. Of the 798 study participants, 251 had one thrombophilic mutation, 50 had more than one such mutation, and 497 had none. Most participants had a history of OC use (mean duration, 6–8 years), and about 70% had been pregnant at least once.
VTE episodes had occurred in 50 participants. Most were provoked by exogenous…