Inherited thrombophilia and risk of venous thromboembolism in females in association with contraceptive use

Česká verzia

Authors: Petr Dulíček
Authors place of work: IV. interní hematologická klinika LF UK a FN Hradec Králové
Published in the journal: Ceska Gynekol 2024; 89(5): 424-428
Category: NEWS FROM A HEMATOLOGIST’S POINT OF VIEW
doi: https://doi.org/10.48095/cccg2024424

Summary

Venous thromboembolism is a multifactorial dis ease and major cause of morbidity and mortality. Absolute risk of venous thromboembolism is less than 1 per 10,000 per year in women of reproductive age. Hormonal contraception is a common risk situation for venous thromboembolism in this part of the population. The risk of venous thrombosis depends on many factors, mainly female characteristics and also the type of contraception. Hematologists can help with the choice of contraception in females with inherited thrombophilia and females experiencing thrombosis. Intrauterine devices with levonorgestrel seem to be the best option in these settings.

Keywords:

thrombophilia – hormonal contraceptives – LNG-IUS

Zdroje

1. Nordström M, Lindblad B, Bergqvist D et al. A prospective study of the incidence of deep – vein thrombosis within a defined urban population. J Intern Med 1992; 232 (2): 155–160. doi: 10.1111/j.1365-2796.1992.tb 00565.x.

2. Cohen AT, Agnelli G, Anderson FA et al. VTE Impact Assessment Group in Europe (VITAE). Venous thromboembolism (VTE) in Europe. The number of VTE events and associated morbidity and mortality. Thromb Haemost 2007; 98 (04): 756–764. doi: 10.1160/TH07-03- 0212.

3. Vinogradova Y, Coupland C, Hippisley-Cox J. Use of combined oral contraceptives and risk of venous thromboembolism: nested case-control studies using the OResearch and CPRD databases. BMJ 2015; 350: h2135.

4. Fruzzetti F, Cagnaci A. Venous thrombosis and hormonal contraception: what’s new with estradiol-based hormonal contraception? Open Access J Contracept 2018; 9: 75–79. doi: 10.2147/OAJC.S179673.

5. Herings RM, Urquhart J, Leufkens HG. Venous thromboembolism among new users of different oral contraceptives. Lancet 1999; 354 (9173): 127–128. doi: 10.1016/s0140-6736 (99) 0 1257-x.

6. Abdollahi M, Cushman M, Rosendaal FR. Obesity: risk of venous thrombosis and the interaction with coagulation factor and oral contraceptive use. Thromb Haemost 2003; 89 (3): 493–498.

7. Bloemenkamp KW, Rosendaal FR, Helmerhorst FM et al. Enhancement by factor V Leiden mutation of risk of deep‐vein thrombosis associated with oral contraceptives containing a third‐generation progestagen. Lancet 1995; 346 (8990): 1593–1596. doi: 10.1016/s0140-6736 (95) 91929-5.

8. Martinelli I, Taioli E, Bucciarelli P et al. Interaction between the G20210A mutation of the prothrombin gene and oral contraceptives use in deep vein thrombosis. Arterioscler Thromb Vasc Biol 1999; 19: 700–703. doi: 10.1161/01.atv.13.3.700.

9. Aznar J, Vayá A, Estellés A. Risk of venous thrombosis in carriers of the prothrombin G20210A variant and factor V Leiden and their interaction with oral contraceptives. Haematologica 2000; 85 (12): 1271–1276.

10. van Vlijmen EF, Wiewel-Verschueren S, Monster TB et al. Combined oral contraceptives, thrombophilia and the risk of venous thromboembolism: a systematic review and meta-analysis. J Thromb Haemost 2016; 14 (7): 1393–1403. doi: 10.1111/jth.13349.

11. Bergendal A, Persson I, Odeberg J et al. Association of venous thromboembolism with hormonal contraception and thrombophilic genotypes. Obstet Gynecol 2014; 124 (3): 600–609. doi: 10.1097/AOG.0000000000 000411.

12. Emmerich J, Rosendaal FR, Cattaneo M et al. Combined effect of factor F V Leiden and prothrombin 20210A on the risk of venous thromboembolism – pooled analysis of 8 case-control studies including 2310 cases and 3204 controls. Study group for Pooled-Analysis in Venous Thromboembolism. Thromb Haemost 2001; 86 (3): 809–816.

13. van Vlijmen EF, Brouwer JL,Veeger N et al. Oral contraceptives and the absolute risk of venous thromboembolism in women with single or multiple thrombophilic defects: results from a retrospective family cohort study. Arch Intern Med 2007; 167 (3): 282–289. doi: 10.1001/archinte.167.3.282.

14. Pabinger I, Schneider B. Thrombotic risk of women with hereditary antithrombin III, protein C‐ and protein S- deficiency taking oral contraceptive medication. The GTH Study Group on Natural Inhibitors. Thromb Haemos 1994; 71 (5): 548–552.

15. Martinelli I, De Mannucci PM, De Stefano V et al. Different risk of thrombosis in four coagulation defects associated with inherited thrombophilia: a study of 150 families. Blood 1998; 92 (7): 2353–2356.

16. Rintelen C, Mannhalter C, Ireland H et al. Oral contraceptives enhance the risk of clinical manifestation of venous thrombosis at a young age in females homozygous for factor V Leiden. Br J Haematol 1996; 93 (2): 487–489. doi: 10.1046/j.1365-2141.1996.5712013.x.

17. Rosendaal FR, Koster T, Vandenbroucke JP et al. High risk of thrombosis in patients homozygous for factor V Leiden (Activated Protein C Resistance). Blood 1995; 85 (6): 1504–1508.

18. Rott H. Hormonal contraception in thrombophilic adolescents: risk of thrombosis and recommendations. Hamostaseologie 2012; 32 (1): 15–21. doi: 10.5482/ha-1177.

19. Dulicek P, Maly J, Pecka M et al. Venous thromboembolism in young female while on oral contraceptives: high frequency of inherited thrombophilia and analysis of thrombotic events in 400 Czech women. Clin Appl Thromb Hemost 2009; 15 (5): 567–573. doi: 10.1177/1076029608325544.

20. Dulicek P, Ivanova E, Kostal M et al. Analysis of risk factors of stroke and venous thromboembolism in females with oral contraceptives use. Clin Appl Thromb Hemost 2018; 24 (5): 797–802. doi: 10.1177/1076029617727857.

21. Culwell KR, Curtis KM. Use of contraceptive methods by women with current venous thrombosis on anticoagulant therapy: a systematic review. Contraception 2009; 80 (4): 337–345. doi: 10.1016/j.contraception.2009.04.008.

22. Moustafa F, Fernández S, Fernández-Capitán C et al. Uterine bleeding during anticoagulation in women with venous thromboembolism. Thromb Res 2017; 151 (Suppl 1): S1–S5. doi: 10.1016/S0049-3848 (17) 30058-0.

23. Kingman CE, Kadir RA, Lee CA et al. The use of levonorgestrel-releasing intrauterine system for treatment of menorrhagia in women with inherited bleeding disorders. BJOG 2004; 111 (12): 1425–1428. doi: 10.1111/j.1471-0528.2004.00305.x.

24. Schaedel ZE, Dolan G, Powell MC. The use of the levonorgestrel-releasing intrauterine system in the management of menorrhagia in women with hemostatic disorders. Am J Obstet Gynecol 2005; 193 (4): 1361–1363. doi: 10.1016/j.ajog.2005.05.002.

25. Parsons SJ, Olson SR, DeLoughery TG. Inappropriate testing and treatment of factor V Leiden and other heritable thrombophilias. Am J Med 2019; 132 (9): e712–e713. doi: 10.1016/j.amjmed.2019.03.039.

26. Middeldorp S, Nieuwlaat R, Baumann Kreuziger L et al. American Society of Hematology 2023 guidelines for management of venous thromboembolism: thrombophilia testing. Blood Adv 2023; 28 (7): 7101–7138. doi: 10.1182/bloodadvances.2023010177.

27. Sammaritano LR. Which hormones and contraception for women with APS? Exogenous hormone use in women with APS. Curr Rheumatol Rep 2021; 23 (6) : 44. doi: 10.1007/ s11926-021-01006-w.

ORCID autora

P. Dulíček 0000-0002-4899-760X

prof. MU Dr. Petr Dulíček, Ph.D.

IV. interní hematologická klinika

LF UK a FN Hradec Králové

Sokolská 581

500 05 Hradec Králové

petr.dulicek@fnhk.cz