Maternal and paternal thrombophilia: risk factors for perinatal mortality

Background Although some paternal components to the predisposition to pre‐eclampsia have been demonstrated recently, it is not known whether such paternal factors play a role to thrombophilia‐related perinatal mortality. Objective To compare the paternal and maternal contribution to perinatal mortality. Study design Data from a prospective registry of perinatal mortality in a Dutch healthcare region were used. Between December 1999 and May 2000, the prevalence of thrombophilia was studied in 74 women with a history of perinatal mortality (female cases) and 54 of their male partners (male cases). Seventy‐one healthy unrelated women after uneventful pregnancies only and 66 of their male partners were used as controls. Setting Obstetric outpatient clinic in a regional hospital (Remierde Graaf Group, Deflt). Methods Presence of various coagulation abnormalities, hyperhomocysteinaemia and anticardiolipins was investigated. Results The frequency of antithrombin deficiency (12% vs 0%), increased activated protein C (APC) resistance (32% vs 6%), total protein S deficiency (11% vs 1%) and elevated factor VIII:C activity (43% vs 17%) was significantly higher in female cases compared with controls. In male cases, the frequency of increased APC resistance was significantly higher compared with controls (22% vs 0%). In 30 of the 54 couples with a history of perinatal mortality, more than one thrombophilic abnormality was found (55%) compared with 10 of the 62 control couples (17%). Conclusion The risk of having thrombophilia is doubled in men who have fathered pregnancies which ended in perinatal death as well as in the mothers of such pregnancies.