Pregnancy loss in women with von Willebrand disease: a single-center pilot study

被引:12
作者
Skeith, Leslie [1 ]
Rydz, Natalia [2 ]
O'Beirne, Maeve [3 ]
Goodyear, Dawn [2 ]
Li, Haocheng [4 ,5 ]
Poon, Man-Chiu [2 ]
机构
[1] Univ Ottawa, Div Hematol, Dept Med, Ottawa, ON, Canada
[2] Univ Calgary, Div Hematol & Hematol Malignancies, Dept Med, Calgary, AB, Canada
[3] Univ Calgary, Dept Family Med, Calgary, AB, Canada
[4] Univ Calgary, Dept Community Hlth Sci, Calgary, AB, Canada
[5] Univ Calgary, Dept Oncol, Calgary, AB, Canada
关键词
placental complications; pregnancy loss; von Willebrand disease; MOLECULAR-WEIGHT HEPARIN; COMPLICATIONS; METAANALYSIS; CHILDBIRTH; VWD;
D O I
10.1097/MBC.0000000000000620
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The risk of pregnancy loss in von Willebrand disease (VWD) has been inconsistently reported. Von Willebrand factor (VWF) is a known regulator of angiogenesis, so has the potential to affect placental function. We sought to determine the risk of pregnancy loss and placenta-mediated pregnancy complications in women with VWD, compared with women without VWD. Women with VWD followed in the Southern Alberta Rare Blood and Bleeding Disorders Clinic were invited to participate in a questionnaire (February-June 2014). The same questionnaire was sent to women without VWD identified in a low-risk obstetrical clinic in Calgary, Alberta, Canada. The primary outcome was the proportion of pregnancies that ended in pregnancy loss. Secondary outcomes were preeclampsia, fetal growth restriction, placental abruption, and preterm labor less than 37 weeks gestation. Of the 30 (31.6%) VWD participants that responded, 26 (86.7%) were diagnosed with Type 1 VWD, of which 11 (42.3%) had VWF antigen or activity levels less than 30%. In women with VWD, there were 20 pregnancy losses out of 80 pregnancies [25.0%, 95% confidence interval (CI), 16.81-35.48], compared with eight losses out of 50 pregnancies in the control group (16.0%, 95% CI, 8.34-28.51; P=0.28). There was no difference in the risk of preeclampsia (1.7 versus 0%, P=1.00) or preterm labor (16.7 versus 7.1%, P=0.23) among VWD and control groups. There were no other placenta-mediated pregnancy complications reported. There is no significant difference in pregnancy loss between women with and without VWD; however, a large multicenter study is needed to clarify the risk of pregnancy loss in women with VWD. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
引用
收藏
页码:393 / 397
页数:5
相关论文
共 23 条
  • [1] Prevalence and risk factors of severe obstetric haemorrhage
    Al-Zirqi, I.
    Vangen, S.
    Forsen, L.
    Stray-Pedersen, B.
    [J]. BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 2008, 115 (10) : 1265 - 1272
  • [2] Maternal age and fetal loss: population based register Linkage study
    Andersen, AMN
    Wohlfahrt, J
    Christens, P
    Olsen, J
    Melbye, M
    [J]. BRITISH MEDICAL JOURNAL, 2000, 320 (7251) : 1708 - 1712
  • [3] Generation and validation of the Condensed MCMDM-1VWD Bleeding Questionnaire for von Willebrand disease
    Bowman, M.
    Mundell, G.
    Grabell, J.
    Hopman, W. M.
    Rapson, D.
    Lillicrap, D.
    James, P.
    [J]. JOURNAL OF THROMBOSIS AND HAEMOSTASIS, 2008, 6 (12) : 2062 - 2066
  • [4] ALIFE2 study: low-molecular-weight heparin for women with recurrent miscarriage and inherited thrombophilia - study protocol for a randomized controlled trial
    de Jong, Paulien G.
    Quenby, Siobhan
    Bloemenkamp, Kitty W. M.
    Braams-Lisman, Babette A. M.
    de Bruin, Jan Peter
    Coomarasamy, Arri
    David, Michele
    DeSancho, Maria T.
    van der Heijden, Olivier W. H.
    Hoek, Annemieke
    Hutten, Barbara A.
    Jochmans, Kristin
    Koks, Carolien A. M.
    Kuchenbecker, Walter K. H.
    Mol, Ben Willem J.
    Torrance, Helen L.
    Scheepers, Hubertina C. J.
    Stephenson, Mary D.
    Verhoeve, Harold R.
    Visser, Jantien
    de Vries, Johanna I. P.
    Goddijn, Mariette
    Middeldorp, Saskia
    [J]. TRIALS, 2015, 16
  • [5] Increased placental angiogenesis in late and early onset pre-eclampsia is associated with differential activation of vascular endothelial growth factor receptor 2
    Escudero, C.
    Celis, C.
    Saez, T.
    San Martin, S.
    Valenzuela, F. J.
    Aguayo, C.
    Bertoglia, P.
    Roberts, J. M.
    Acurio, J.
    [J]. PLACENTA, 2014, 35 (03) : 207 - 215
  • [6] Clinical and laboratory variability in a cohort of patients diagnosed with type 1 VWD in the United States
    Flood, Veronica H.
    Christopherson, Pamela A.
    Gill, Joan Cox
    Friedman, Kenneth D.
    Haberichter, Sandra L.
    Bellissimo, Daniel B.
    Udani, Rupa A.
    Dasgupta, Mahua
    Hoffmann, Raymond G.
    Ragni, Margaret V.
    Shapiro, Amy D.
    Lusher, Jeanne M.
    Lentz, Steven R.
    Abshire, Thomas C.
    Leissinger, Cindy
    Hoots, W. Keith
    Manco-Johnson, Marilyn J.
    Gruppo, Ralph A.
    Boggio, Lisa N.
    Montgomery, Kate T.
    Goodeve, Anne C.
    James, Paula D.
    Lillicrap, David
    Peake, Ian R.
    Montgomery, Robert R.
    [J]. BLOOD, 2016, 127 (20) : 2481 - 2488
  • [7] FRESSINAUD E, 1993, THROMB HAEMOSTASIS, V70, P546
  • [8] Disrupted Balance of Angiogenic and Antiangiogenic Signalings in Preeclampsia
    Furuya, Mitsuko
    Kurasawa, Kentaro
    Nagahama, Kiyotaka
    Kawachi, Kae
    Nozawa, Akinori
    Takahashi, Tsuneo
    Aoki, Ichiro
    [J]. JOURNAL OF PREGNANCY, 2011, 2011 : 123717
  • [9] Henkel-Klene A, ISTH C 2013
  • [10] HERTZPICCIOTTO I, 1988, NEW ENGL J MED, V319, P1483