Amanda L Horton1, Valerija Momirova, Donna Dizon-Townson, Katharine Wenstrom, George Wendel, Philip Samuels, Baha Sibai, Catherine Y Spong, Margaret Cotroneo, Yoram Sorokin, Menachem Miodovnik, Mary J O'Sullivan, Deborah Conway, Ronald J Wapner. 1. From the Departments of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina; University of Utah, Salt Lake City, Utah; University of Alabama at Birmingham, Birmingham, Alabama; University of Texas Southwestern Medical Center, Dallas, Texas; The Ohio State University, Columbus, Ohio; University of Tennessee, Memphis, Tennessee; University of Pittsburgh, Pittsburgh, Pennsylvania; Wayne State University, Detroit, Michigan; University of Cincinnati, Cincinnati, Ohio; University of Miami, Miami, Florida; University of Texas at San Antonio, San Antonio, Texas; Thomas Jefferson University, Philadelphia, Pennsylvania; and The George Washington University Biostatistics Center, Washington, DC; and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
Abstract
OBJECTIVE: To estimate whether there is a correlation between family history of venous thromboembolism and factor V Leiden mutation carriage in gravid women without a personal history of venous thromboembolism. METHODS: This is a secondary analysis of a prospective observational study of the frequency of pregnancy-related thromboembolic events among carriers of the factor V Leiden mutation. Family history of venous thromboembolism in either first- or second-degree relatives was self-reported. Sensitivity, specificity, and positive and negative predictive values of family history to predict factor V Leiden mutation carrier status were calculated. RESULTS: Women without a personal venous thromboembolism history and with available DNA were included (n=5,168). One hundred forty women (2.7% [95% confidence interval (CI) 2.3-3.2%]) were factor V Leiden mutation-positive. Four hundred twelve women (8.0% [95% CI 7.3-8.7%]) reported a family history of venous thromboembolism. Women with a positive family history were twofold more likely to be factor V Leiden mutation carriers than those with a negative family history (23 of 412 [5.6%] compared with 117 of 4,756 [2.5%], P<.001). The sensitivity, specificity, and positive predictive value of a family history of a first- or second-degree relative for identifying factor V Leiden carriers were 16.4% (95% CI 10.7-23.6%), 92.3% (95% CI 91.5-93.0%), and 5.6% (95% CI 3.6-8.3%), respectively. CONCLUSION: Although a family history of venous thromboembolism is associated with factor V Leiden mutation in thrombosis-free gravid women, the sensitivity and positive predictive values are too low to recommend screening women for the factor V Leiden mutation based solely on a family history.
OBJECTIVE: To estimate whether there is a correlation between family history of venous thromboembolism and factor V Leiden mutation carriage in gravid women without a personal history of venous thromboembolism. METHODS: This is a secondary analysis of a prospective observational study of the frequency of pregnancy-related thromboembolic events among carriers of the factor V Leiden mutation. Family history of venous thromboembolism in either first- or second-degree relatives was self-reported. Sensitivity, specificity, and positive and negative predictive values of family history to predict factor V Leiden mutation carrier status were calculated. RESULTS:Women without a personal venous thromboembolism history and with available DNA were included (n=5,168). One hundred forty women (2.7% [95% confidence interval (CI) 2.3-3.2%]) were factor V Leiden mutation-positive. Four hundred twelve women (8.0% [95% CI 7.3-8.7%]) reported a family history of venous thromboembolism. Women with a positive family history were twofold more likely to be factor V Leiden mutation carriers than those with a negative family history (23 of 412 [5.6%] compared with 117 of 4,756 [2.5%], P<.001). The sensitivity, specificity, and positive predictive value of a family history of a first- or second-degree relative for identifying factor V Leiden carriers were 16.4% (95% CI 10.7-23.6%), 92.3% (95% CI 91.5-93.0%), and 5.6% (95% CI 3.6-8.3%), respectively. CONCLUSION: Although a family history of venous thromboembolism is associated with factor V Leiden mutation in thrombosis-free gravid women, the sensitivity and positive predictive values are too low to recommend screening women for the factor V Leiden mutation based solely on a family history.
Authors: Donna Dizon-Townson; Connie Miller; Baha Sibai; Catherine Y Spong; Elizabeth Thom; George Wendel; Katharine Wenstrom; Philip Samuels; Margaret A Cotroneo; Atef Moawad; Yoram Sorokin; Paul Meis; Menachem Miodovnik; Mary J O'Sullivan; Deborah Conway; Ronald J Wapner; Steven G Gabbe Journal: Obstet Gynecol Date: 2005-09 Impact factor: 7.661
Authors: John A Heit; Catie E Kobbervig; Andra H James; Tanya M Petterson; Kent R Bailey; L Joseph Melton Journal: Ann Intern Med Date: 2005-11-15 Impact factor: 25.391
Authors: A Gerhardt; R E Scharf; M W Beckmann; S Struve; H G Bender; M Pillny; W Sandmann; R B Zotz Journal: N Engl J Med Date: 2000-02-10 Impact factor: 91.245
Authors: L Robertson; O Wu; P Langhorne; S Twaddle; P Clark; G D O Lowe; I D Walker; M Greaves; I Brenkel; L Regan; I A Greer Journal: Br J Haematol Date: 2006-01 Impact factor: 6.998