Objective: To determine whether there is an association between early recurrent miscarriage (before 10 weeks of pregnancy) and Factor V Leiden and G20210A prothrombin mutations. Design: A prospective study. Setting: Department of Gynaecology and Obstetrics, Saint Antoine Hospital, Paris, France. Population: Two groups of women: those with early unexplained recurrent miscarriage before 10 weeks of pregnancy (n = 260) and control healthy women without a previous history of thromboembolism (n = 240). Methods: Screening for defects in the protein C anticoagulant pathway was performed using the anticoagulant response to agkistrodon confortrix venom (ACV test). Protein C and Factor V Leiden mutation testing was performed for each low ACV level. Each sample was tested for the G20210A prothrombin mutation. Results: Factor V Leiden and G20210A mutations were found to be associated with early recurrent spontaneous miscarriage before 10 weeks of pregnancy, the odds ratios being 2.4 (95% CI 1-5) and 2.7 (95% CI 1-7), respectively. Similar results were found whether or not women had had a previous live birth. Conclusions: Early recurrent miscarriage before 10 weeks of pregnancy is significantly associated with Factor V or G20210A prothrombin mutations. These results indicate a possible role for anticoagulant prevention in these early miscarriages.
Reznikoff-Etiévant, M. F., Cayol, V., Carbonne, B., Robert, A., Coulet, F., & Milliez, J. (2001). Factor V Leiden and G20210A prothrombin mutations are risk factors for very early recurrent miscarriage. British Journal of Obstetrics and Gynaecology, 108(12), 1251–1254. https://doi.org/10.1016/S0306-5456(01)00298-4