Should Genotype Guide Thromboprophylaxis in Pregnant Women With Antithrombin Deficiency? – RPTH Journal
RPTH Journal shared a post on LinkedIn about a recent article by Björn Diemer et al., adding:
“Antithrombin deficiency and obstetric complications: should genotype guide thromboprophylaxis decisions for ?
Hereditary antithrombin (AT) deficiency increases the risk of both VTE and obstetric complications during pregnancy. But not all subtypes carry the same risk; and whether genotyping can help personalise treatment decisions has remained unclear.
A new retrospective cohort study in RPTH Journal followed 43 women with AT deficiency across 106 pregnancies at Karolinska Institutet University Hospital (1990–2022):
- Women were stratified into low-risk (type IIHBS; n=26) and high-risk (types I, IIPE, IIRS; n=17) groups based on genotype
- In the low-risk group, 24% of untreated women developed pre-eclampsia vs none among treated women (P = .005)
- Intrauterine fetal death occurred in 20% of untreated women in the low-risk group vs none among treated women (P = .014)
No statistically significant difference in VTE incidence between high-risk and low-risk groups
Women with the ‘low-risk’ IIHBS subtype may still face significant obstetric complications when untreated. Genotyping alone may not be sufficient to withhold thromboprophylaxis, and a broader view of pregnancy risk beyond VTE is essential in this population.
This is a small retrospective single-centre study spanning over 30 years, with inherent limitations in consistency of management and data completeness. Larger prospective studies are needed to confirm these findings.”
Title: Risk stratification according to genotype and effect of thromboprophylaxis on obstetric outcomes in women with antithrombin deficiency
Authors: Björn Diemer, Nina Iversen, Lana Othman, Eva-Lotta Hempel, Roza Chaireti, Katarina Bremme
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