The full content of Annals is available to subscribers

Subscribe/Learn More  >
Brief Communications |

Factor V Leiden Mutation as a Risk Factor for Recurrent Pregnancy Loss

Paul M. Ridker, MD; Joseph P. Miletich, MD; Julie E. Buring, ScD; Abraham A. Ariyo, MD; Daniel T. Price, MD; JoAnn E. Manson, MD; and Joseph A. Hill, MD
[+] Article, Author, and Disclosure Information

From Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; and Washington University Medical Center, St. Louis, Missouri. Grant Support: Dr. Ridker is supported by an Established Investigator Award from the American Heart Association, Dallas, Texas. The Women's Health Study is supported by grants from the National Heart, Lung, and Blood Institute and the National Cancer Institute. Requests for Reprints: Paul M. Ridker, MD, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115. Current Author Addresses: Drs. Ridker, Buring, Manson, and Hill: Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1998;128(12_Part_1):1000-1003. doi:10.7326/0003-4819-128-12_Part_1-199806150-00007
Text Size: A A A

Background: Recurrent pregnancy loss may result from hypercoagulability.

Objective: To determine whether women with factor V Leiden mutation, a common inherited defect of coagulation, are at increased risk for recurrent pregnancy loss.

Design: Case-control study.

Setting: University hospital.

Patients: 113 consecutive women referred for evaluation of recurrent spontaneous abortion (case-patients) and 437 postmenopausal women with at least one successful pregnancy and no history of pregnancy loss (controls). An additional survey of 387 postmenopausal women with at least one pregnancy loss was also conducted.

Measurements: Prevalence of factor V Leiden mutation determined by a second-generation screening test for resistance to activated protein C with genetic confirmation of all borderline and low-value results.

Results: Prevalence of the factor V Leiden mutation was greater among case-patients (8.0%) than among controls (3.7%) (odds ratio, 2.3 [95% CI, 1.0 to 5.2]; P = 0.050). In the subgroup of case-patients with three or more pregnancy losses and no successful pregnancies, prevalence of the mutation was 9.0% (odds ratio, 2.6 [CI, 1.0 to 6.7]; P = 0.048). Among the additional women surveyed, the prevalence of the mutation in those with three or more pregnancy losses (7.5%) was almost identical to that in case-patients. Thus, in all evaluated women with several pregnancy losses, the prevalence of factor V Leiden was increased 2.2-fold (P = 0.026).

Conclusion: These data are compatible with the hypothesis that factor V Leiden mutation may play a role in some cases of unexplained recurrent pregnancy loss.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $32.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.