The prevalence of thrombophilia in women with recurrent fetal loss and outcome of anticoagulation therapy for the Prevention of Miscarriages

Abstract

Objective: To estimate the prevalence of thrombophilia in women with recurrent miscarriages and to assess the effect of antithrombotic therapy. Design: A retrospective cohort study between the years 2004 and 2010. Setting: A hypercoagulation community clinic in northern Israel. Patients: Four hundred ninety pregnant women referred for thrombophilia screening. Main Outcome Measures: Screening results for thrombophilia and antithrombotic treatment with enoxaparin, aspirin, or both and pregnancy outcomes. Results: The most common thrombophilia in our study group was factor V Leiden mutation with a prevalence of 20.9% followed by protein S deficiency with a prevalence of 19%. Live birth rate was higher in the group of women who received enoxaparin regardless of whether a specific thrombophilia could be found. This finding was more pronounced in women who had ≥4 miscarriages. Conclusion: The prevalence of thrombophilia was higher in our study group than in the general population. Furthermore, treatment with enoxaparin might improve the rate of live births in women with or without evidence of thrombophilia, especially in women with ≥4 miscarriages.