Pregnancy loss in individuals with von Willebrand disease and unspecified mucocutaneous bleeding disorders: a multicenter cohort study.

IF 5.5 2区 医学 Q1 HEMATOLOGY Journal of Thrombosis and Haemostasis Pub Date : 2024-10-23 DOI:10.1016/j.jtha.2024.09.037
Leslie Skeith, Paula James, Peter Kouides, Kelsey Uminski, Lisa Duffett, Shannon Jackson, Michelle Sholzberg, Margaret V Ragni, Adam Cuker, Maeve O'Beirne, Julia Hews-Girard, Natalia Rydz, Dawn M Goodyear, Jill Baxter, Andra James, David Garcia, Sara K Vesely, Man-Chiu Poon
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Abstract

Background: While bleeding around pregnancy is well described in von Willebrand disease (VWD), the risk of pregnancy loss is less certain.

Objectives: We aimed to describe the frequency of pregnancy loss in females with VWD compared with those with a similar mucocutaneous bleeding phenotype and no VWD or compared with nonbleeding disorder controls.

Methods: Female patients were consecutively approached in 8 specialty bleeding disorder clinics between 2014 and 2023. The VWD group was defined as having von Willebrand factor (VWF) antigen and VWF activity levels, each <0.50 IU/mL on ≥2 occasions, and a condensed MCMDM-1 score of ≥4. The non-VWD mucocutaneous bleeding disorder group had VWF levels ≥ 0.50 IU/mL on ≥2 occasions and an MCMDM-1 score ≥ 4. A nonbleeding disorder control group was recruited in pregnancy from a low-risk maternity clinic.

Results: There were 150 females in the VWD group, 145 in the non-VWD mucocutaneous bleeding disorder group, and 137 in the control group. There was a similar frequency of individuals with ≥1 loss in the VWD group (45.3%, 68/150), the non-VWD group (56.6%; 82/145; -11.2%; 97.5% CI, -24.2%, 1.8%), and the nonbleeding disorder control group (37.2%; 51/137; 8.1%; 97.5% CI, -4.9%, 21.1%). Using a logistic regression, the odds ratio of pregnancy losses in the VWD group vs the non-VWD group was 0.94 (95% CI 0.65, 1.36). All groups experienced more recurrent losses compared with the literature.

Conclusion: There was no statistically significant difference in risk of pregnancy loss between females with VWD, females with a similar mucocutaneous bleeding phenotype, and nonbleeding disorder controls.

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冯-威廉氏病和不明皮肤黏膜出血性疾病患者的妊娠损失:一项多中心队列研究。
背景:von-Willebrand病(VWD)患者妊娠期出血的情况已得到充分描述,但妊娠失败的风险却不太确定。我们旨在描述 VWD 女性患者的妊娠损失频率,并与具有相似粘膜出血表型但无 VWD 的女性患者进行比较,或与非出血性疾病对照组进行比较:2014-2023年间,8家出血性疾病专科门诊连续接诊了女性患者。VWD组被定义为具有VWF:抗原(Ag)和VWF:活性(Act)水平的患者:VWD组有150名女性,非VWD粘膜出血性疾病组有145名女性,对照组有137名女性。在 VWD 组(45.3%,68/150)、非 VWD 组(56.6%,82/145)(-11.2%,97.5% CI -24.2,1.8%)和非出血性疾病对照组(37.2%,51/137)(8.1%,97.5% CI -4.9%,21.1%)中,≥1 项损失的人数频率相似。通过逻辑回归,VWD 组与非 VWD 组的妊娠损失几率比为 0.94(95% CI 0.65,1.36)。与文献相比,所有组别都经历了更多的复发性流产:患有 VWD 的女性、具有相似粘膜出血表型的女性以及非出血障碍对照组的女性在妊娠损失风险方面没有明显的统计学差异。
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来源期刊
Journal of Thrombosis and Haemostasis
Journal of Thrombosis and Haemostasis 医学-外周血管病
CiteScore
24.30
自引率
3.80%
发文量
321
审稿时长
1 months
期刊介绍: The Journal of Thrombosis and Haemostasis (JTH) serves as the official journal of the International Society on Thrombosis and Haemostasis. It is dedicated to advancing science related to thrombosis, bleeding disorders, and vascular biology through the dissemination and exchange of information and ideas within the global research community. Types of Publications: The journal publishes a variety of content, including: Original research reports State-of-the-art reviews Brief reports Case reports Invited commentaries on publications in the Journal Forum articles Correspondence Announcements Scope of Contributions: Editors invite contributions from both fundamental and clinical domains. These include: Basic manuscripts on blood coagulation and fibrinolysis Studies on proteins and reactions related to thrombosis and haemostasis Research on blood platelets and their interactions with other biological systems, such as the vessel wall, blood cells, and invading organisms Clinical manuscripts covering various topics including venous thrombosis, arterial disease, hemophilia, bleeding disorders, and platelet diseases Clinical manuscripts may encompass etiology, diagnostics, prognosis, prevention, and treatment strategies.
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