Predicting Thrombophilia in Preeclampsia: Is Universal Testing Necessary?

Area of Science:

• Obstetrics and Gynecology
• Hematology
• Reproductive Medicine

Background:

• Preeclampsia (PE) association with thrombophilia (TP) lacks consensus, necessitating further investigation.
• Identifying specific patient profiles linked to acquired and hereditary TP in PE is crucial.
• Developing a predictive model for TP probability in PE patients is a key research gap.

Purpose of the Study:

• To determine conditions associated with acquired and hereditary thrombophilia in preeclampsia patients.
• To develop a predictive model for thrombophilia probability in women with preeclampsia.
• To clarify the role of thrombophilia in preeclampsia and identify high-risk groups for screening.

Main Methods:

• Retrospective analysis of 95 women diagnosed with preeclampsia undergoing thrombophilia testing.
• Data collected between May 2019 and May 2024 at a single center.
• Multivariate analysis to identify independent predictors of thrombophilia.

Main Results:

• 19% of preeclampsia patients tested positive for thrombophilia, including antiphospholipid syndrome and genetic factors.
• Intrauterine growth retardation (IUGR) and prior abortions were negatively associated with thrombophilia.
• TP prevalence was 0% with both factors, 15% with one, and 32% with neither; higher TP prevalence correlated with lower placental insufficiency and prematurity.

Conclusions:

• History of abortions and IUGR are independent predictors of the absence of thrombophilia in preeclampsia.
• Preeclampsia patients without these risk factors may benefit from hematology consultation and thrombophilia screening.
• A standardized multinational framework for thrombophilia screening in preeclampsia is recommended for future research.