RISK FACTORS OF VENOUS THROMBOEMBOLISM
IN SUDANESE PREGNANT WOMEN
Abdalhabib EK, Alfeel A, Ali EI, Ibrahim IK, Mobarki AA, Dobie G, Hamali HA, Saboor M,
*Corresponding Author: Dr. Muhammad Saboor, Department of Medical Laboratory Technology,
Faculty of Applied Medical Science, Jazan University, Jazan, Saudi Arabia. Tel.: +966-54-495-9029.
E-mail: msaboor@ jazanu.edu.sa
page: 49
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RESULTS
Among the 396 study participants, 198 were pregnant
women with VTE (VTE group) and the remaining 198
were healthy pregnant women (control group), with the
mean (±SD) age being 28.21 ± 7.69 and 28.42 ± 5.93 years
(p >0.05), respectively (data not shown in table). Among
the VTE group, DVT was the most common clinical feature
(n = 156, 78.8%), followed by pulmonary thromboembolism
(n = 20, 10.1%). The frequencies of venous
thrombosis of the upper limbs, portal vein, and cerebral
vein were 5.1, 4.0 and 2.0%, respectively (Table 1).
A total of 161 patients (81.3%) showed an association
with various known risk factors of VTE, whereas 37
patients (18.6%) had no known risk factor of VTE (Table
2). Patients with a history of contraceptive use were more
susceptible to developing VTE (33.8%). Moreover, high
BMI (12.6%), termination (11.6%) and family history
(10.1%), were the most common risk factors of VTE in the study population. The frequencies of other risk factors
are shown in Table 2.
Thrombophilia profiles revealed highly significant
differences in the VTE group compared with those in the
control group (p <0.05). The VTE group had significantly
lower levels of PC (74.93 ± 40.8 vs. 97.83 ± 23.75 ng/mL)
and PS (87.47 ± 25.24 vs. 102.46 ± 22.73 ng/mL) than
those in the control group (p <0.01). Although, AT levels
were slightly lower in the VTE group (80.19 ± 30.33 ng/
mL) than in the control group (85.46 ± 18.23 ng/mL), the
differences were statistically significant (p <0.05) (Table
3). The frequency of PC deficiency was 6.7% in the VTE
group compared with 1.01% in the control group. The
frequency of PS deficiency in patients with VTE was also
higher than that in the control group (Table 3). Moreover,
AT deficiency was the most common abnormality among
patients with VTE (11.6%) and controls (5.1%) (Table 3).
Regarding FVL G1691A, the frequency of the homozygous
normal genotype (G/G) was lower in the VTE
group (96.0%) than in the control group (100.0%). Heterozygous
(G/A) and homozygous (A/A) mutations were
detected in the VTE group, with frequencies of 3.5% (n
= 7) and 0.5% (n = 1), respectively (Table 4). The prothrombin
G20210A mutation exhibited a statistically insignificant
difference between the VTE and control groups
(p = 0.499). Heterozygous (G/A) prothrombin G20210A
mutation was found in only one patient (0.5%), and none of the study participants had the homozygous (A/A) mutation
(Table 4).
The FVL G1691A mutation was detected in 4.49% of
patients (n = 7/156) with DVT and in 5.0% (n = 1/20) of
those with pulmonary thromboembolism (Table 5). Patients
with other conditions, such as venous thrombosis of the upper
limb, cerebral vein thrombosis, and portal vein thrombosis
did not exhibit the FVL G1691A mutation. Similarly,
11 (7.05%) patients with DVT had PC deficiency, one patient
had pulmonary thromboembolism, and another patient
had portal vein thrombosis. Furthermore, PS deficiency
was found in 25.0% (n = 1/4) of patients with cerebral vein
thrombosis and 10.26% (n = 16/156) of patients with DVT,
as shown in Table 5. Details regarding AT deficiency in the
observed cases are also presented in Table 5.
Table 6 depicts the correlation of DVT, FVL G1691A
polymorphism, and PC and PS deficiencies with risk factors,
including age, family history, high BMI, contraceptive
use and termination. In the study population, DVT was
found to be correlated negatively with age (r = –0.122, p
<0.05) but positively with contraceptive use, high BMI,
and history of termination (p <0.05). Age, high BMI, and
termination showed negative correlation with the FVL
G1691A polymorphism, but these findings were statistically
insignificant. Contraceptive use showed a statistically
significant (p <0.05) positive correlation with the
FVL G1691A polymorphism. Similarly, PC deficiency
positively correlated (r = 0.227, p <0.05) with high BMI.
The PS deficiency also showed a statistically significant
(p <0.05) positive correlation with age and termination.
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