Cost-effectiveness of screening for the factor V Leiden mutation in pregnant women

The factor V Leiden (FVL) mutation is associated with vascular complications in pregnancy, and routine screening of all pregnant women has been suggested. We did a prospective, unselected study in 967 pregnant women to evaluate the cost-effectiveness of screening all women, or only those with a personal or family history of venous thrombosis (n=113). When anticoagulant prophylaxis was assumed to effect a 50% reduction in vascular complications, we recorded an additional management cost of 3768 pounds sterling with selective screening and 39,841 pounds sterling with universal screening. This additional cost would result in prevention of less than one and three vascular events,respectively. Our findings, therefore, suggest that screening of pregnant women for the FVL mutation is not cost-effective.