Human Reproduction, Vol. 17, No. 2, 442-445,
February 2002
© 2002 European Society of Human Reproduction and Embryology
Factor V Leiden and recurrent miscarriage—prospective outcome of untreated pregnancies
1 Department of Reproductive Science, Faculty of Medicine, Imperial College of Science, Technology and Medicine and 2 Department of Haematology, St Mary's Hospital NHS Trust, London, UK
BACKGROUND: Some cases of recurrent miscarriage and later pregnancy complications have a thrombotic basis. Factor V Leiden is a common thrombophilic mutation. METHODS: The prospective outcome of untreated pregnancies amongst 25 women heterozygous for the Factor V Leiden allele who had a history of either recurrent early miscarriages only (three or more miscarriages at <12 weeks gestation; n = 19) or of late miscarriage (>12 weeks gestation; n = 9) was studied. Control groups of women with a similar pregnancy history but who had a normal Factor V genotype were also studied. RESULTS: The live birth rate was significantly lower amongst women with a history of recurrent early miscarriage who carried the Factor V Leiden allele (6/16; 37.5%) compared with that amongst those with a normal Factor V genotype (106/153; 69.3%; odds ratio 3.75, 95% confidence intervals 1.3–10.9). The live birth rate was 11.1% (1/9) amongst those with a history of late miscarriage carrying the Factor V Leiden allele and 48.9% (22/45) amongst those with a normal Factor V genotype. CONCLUSIONS: Attention should be directed at screening women with recurrent miscarriage associated with placental thrombosis for Factor V Leiden and a policy of targeted thromboprophylaxis during future pregnancies should be assessed in the form of a randomized controlled trial.
Key words: Factor V Leiden/pregnancy outcome/prospective study/recurrent miscarriage
3 To whom correspondence should be addressed at: Department of Reproductive Science and Medicine, Imperial College of Science, Technology and Medicine, Mint Wing, St Mary's Hospital, South Wharf Road, London W2 1PG, UK. E-mail: r.rai{at}ic.ac.uk
Submitted on May 29, 2001; resubmitted on July 30, 2001
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