Postpartum maternal thrombophilia workup value in pregnancies with severe small for gestational age
Abstract Introduction In the absence of prenatal etiology explaining small for gestational age (SGA), a blood workup may be performed postpartum to look for maternal thrombophilia if a newborn is confirmed to be growth‐restricted at birth. The literature regarding thrombophilia factors and fetal gro...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-07-01
|
| Series: | Acta Obstetricia et Gynecologica Scandinavica |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/aogs.15108 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850212174274756608 |
|---|---|
| author | Maëlig Abgral Céline Desconclois Sophie Prevot Isabelle Monier Raluca Sterpu Alexandra Benachi Alexandre J. Vivanti |
| author_facet | Maëlig Abgral Céline Desconclois Sophie Prevot Isabelle Monier Raluca Sterpu Alexandra Benachi Alexandre J. Vivanti |
| author_sort | Maëlig Abgral |
| collection | DOAJ |
| description | Abstract Introduction In the absence of prenatal etiology explaining small for gestational age (SGA), a blood workup may be performed postpartum to look for maternal thrombophilia if a newborn is confirmed to be growth‐restricted at birth. The literature regarding thrombophilia factors and fetal growth restriction is discordant. The main objective was to assess the prevalence and type of maternal thrombophilia among women delivering newborns of birthweight below the 3rd percentile and undergoing a postpartum thrombophilia workup and placental analysis. Material and Methods This was a single‐center retrospective observational cohort study in a tertiary care French maternity. The study population included all women delivering a liveborn infant with severe SGA, defined as a birthweight below the 3rd percentile according to French charts between January 2014 and December 2018. Data from thrombophilia workups (antiphospholipid antibodies, protein C assay, protein S assay, antithrombin assay, factor V Leiden mutation, and factor II G 20210A mutation search) were collected from medical records. Placental pathology analysis, if available, was also collected. The primary endpoint was the prevalence of positive expanded thrombophilia workup (inherited or acquired). Results A total of 733 patients were included in our study, 401 of whom (54.7%) underwent a postpartum thrombophilia workup. The overall prevalence of hereditary thrombophilia was 6.7%, 95% confidence interval (4.3 to 9.2) and of acquired thrombophilia was 2.0%, 95% confidence interval (0.6 to 3.4). Among hereditary anomalies, heterozygous factor V mutation and heterozygous factor II mutation were the most frequently observed, respectively, 4% and 1.7%. Concerning the presence of antiphospholipid antibodies, triple positivity was present in one patient (0.2%). The presence of a single antiphospholipid antibody was more frequently observed in 3 patients (0.7%). Conclusions Among patients with a severe SGA infant and postpartum investigation of maternal thrombophilia, an extensive workup of postpartum thrombophilia contributed to a low proportion of positive findings. This suggests that the prescription of such a workup should be targeted, based on personal and family medical history. In fact, testing for inherited thrombophilia should be reserved for patients with a personal or family history of thrombosis. Testing for antiphospholipid antibodies should follow ACR/EULAR criteria. |
| format | Article |
| id | doaj-art-c72c1ff3423e4ea8a601b4285993ff96 |
| institution | OA Journals |
| issn | 0001-6349 1600-0412 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Acta Obstetricia et Gynecologica Scandinavica |
| spelling | doaj-art-c72c1ff3423e4ea8a601b4285993ff962025-08-20T02:09:24ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122025-07-0110471318132710.1111/aogs.15108Postpartum maternal thrombophilia workup value in pregnancies with severe small for gestational ageMaëlig Abgral0Céline Desconclois1Sophie Prevot2Isabelle Monier3Raluca Sterpu4Alexandra Benachi5Alexandre J. Vivanti6Department of Obstetrics and Gynecology, DMU Santé des Femmes et des Nouveau‐nés, Antoine Béclère Hospital Paris Saclay University Clamart FranceDepartment of Biological Hematology, Antoine Béclère Hospital Paris Saclay University Clamart FranceDepartment of Pathology, Bicêtre Hospital Paris Saclay University Le Kremlin Bicêtre FranceObstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Université de Paris, Epidemiology and Statistics Research Center (CRESS), Institut national de la santé et de la recherche médicale (INSERM) Institut national de la recherche agronomique (INRA) Paris FranceDepartment of Internal Medicine, Antoine Béclère Hospital Paris Saclay University Clamart FranceDepartment of Obstetrics and Gynecology, DMU Santé des Femmes et des Nouveau‐nés, Antoine Béclère Hospital Paris Saclay University Clamart FranceDepartment of Obstetrics and Gynecology, DMU Santé des Femmes et des Nouveau‐nés, Antoine Béclère Hospital Paris Saclay University Clamart FranceAbstract Introduction In the absence of prenatal etiology explaining small for gestational age (SGA), a blood workup may be performed postpartum to look for maternal thrombophilia if a newborn is confirmed to be growth‐restricted at birth. The literature regarding thrombophilia factors and fetal growth restriction is discordant. The main objective was to assess the prevalence and type of maternal thrombophilia among women delivering newborns of birthweight below the 3rd percentile and undergoing a postpartum thrombophilia workup and placental analysis. Material and Methods This was a single‐center retrospective observational cohort study in a tertiary care French maternity. The study population included all women delivering a liveborn infant with severe SGA, defined as a birthweight below the 3rd percentile according to French charts between January 2014 and December 2018. Data from thrombophilia workups (antiphospholipid antibodies, protein C assay, protein S assay, antithrombin assay, factor V Leiden mutation, and factor II G 20210A mutation search) were collected from medical records. Placental pathology analysis, if available, was also collected. The primary endpoint was the prevalence of positive expanded thrombophilia workup (inherited or acquired). Results A total of 733 patients were included in our study, 401 of whom (54.7%) underwent a postpartum thrombophilia workup. The overall prevalence of hereditary thrombophilia was 6.7%, 95% confidence interval (4.3 to 9.2) and of acquired thrombophilia was 2.0%, 95% confidence interval (0.6 to 3.4). Among hereditary anomalies, heterozygous factor V mutation and heterozygous factor II mutation were the most frequently observed, respectively, 4% and 1.7%. Concerning the presence of antiphospholipid antibodies, triple positivity was present in one patient (0.2%). The presence of a single antiphospholipid antibody was more frequently observed in 3 patients (0.7%). Conclusions Among patients with a severe SGA infant and postpartum investigation of maternal thrombophilia, an extensive workup of postpartum thrombophilia contributed to a low proportion of positive findings. This suggests that the prescription of such a workup should be targeted, based on personal and family medical history. In fact, testing for inherited thrombophilia should be reserved for patients with a personal or family history of thrombosis. Testing for antiphospholipid antibodies should follow ACR/EULAR criteria.https://doi.org/10.1111/aogs.15108antiphospholipid syndromefetal growth restrictionplacentasmall for gestational agethrombophilia |
| spellingShingle | Maëlig Abgral Céline Desconclois Sophie Prevot Isabelle Monier Raluca Sterpu Alexandra Benachi Alexandre J. Vivanti Postpartum maternal thrombophilia workup value in pregnancies with severe small for gestational age Acta Obstetricia et Gynecologica Scandinavica antiphospholipid syndrome fetal growth restriction placenta small for gestational age thrombophilia |
| title | Postpartum maternal thrombophilia workup value in pregnancies with severe small for gestational age |
| title_full | Postpartum maternal thrombophilia workup value in pregnancies with severe small for gestational age |
| title_fullStr | Postpartum maternal thrombophilia workup value in pregnancies with severe small for gestational age |
| title_full_unstemmed | Postpartum maternal thrombophilia workup value in pregnancies with severe small for gestational age |
| title_short | Postpartum maternal thrombophilia workup value in pregnancies with severe small for gestational age |
| title_sort | postpartum maternal thrombophilia workup value in pregnancies with severe small for gestational age |
| topic | antiphospholipid syndrome fetal growth restriction placenta small for gestational age thrombophilia |
| url | https://doi.org/10.1111/aogs.15108 |
| work_keys_str_mv | AT maeligabgral postpartummaternalthrombophiliaworkupvalueinpregnancieswithseveresmallforgestationalage AT celinedesconclois postpartummaternalthrombophiliaworkupvalueinpregnancieswithseveresmallforgestationalage AT sophieprevot postpartummaternalthrombophiliaworkupvalueinpregnancieswithseveresmallforgestationalage AT isabellemonier postpartummaternalthrombophiliaworkupvalueinpregnancieswithseveresmallforgestationalage AT ralucasterpu postpartummaternalthrombophiliaworkupvalueinpregnancieswithseveresmallforgestationalage AT alexandrabenachi postpartummaternalthrombophiliaworkupvalueinpregnancieswithseveresmallforgestationalage AT alexandrejvivanti postpartummaternalthrombophiliaworkupvalueinpregnancieswithseveresmallforgestationalage |