Venous Thromboembolism Clinical Trial
Official title:
Venous Thromboembolism and Intrauterine Fetal Death in Pregnancy - Epidemiology and Pathogenic Mechanisms
The purpose of this study is to investigate clinical, biochemical and genetic risk factors for venous thromboembolism in pregnancy and pregnancy related vascular complications, and the long-term outcome of such complications including implications for quality of life.
Background: Venous thromboembolism (VTE) in pregnancy is a serious, but rare condition.
There is no epidemiological data on this patient group from Norway, and there is generally
little literature on the immediate and long-term outcome after such pregnancies.
Approximately 50% of the women with VTE in pregnancy have known thrombophilia. These women
also carry a considerably increased risk for intrauterine fetal death (IUFD). In this
project we want to identify new thrombophilias as risk factors for VTE and IUFD in
pregnancy.
Aims:
Using a case-control design we will investigate the following issues:
- Risk factors for VTE in pregnancy and IUFD
- Association between thrombophilia, VTE, and other vascular pregnancy complications
including IUFD
- Association between thrombophilia and IUFD
- Long term effects of VTE in pregnancy and IUFD on future health including quality of
life
- Association between "single nucleotide polymorphisms" (SNP) in genes coding for
specific coagulation-, fibrinolysis-, inflammatory, and other relevant proteins and
their phenotypic expression
- Association between relevant phenotypes of coagulation, fibrinolysis, inflammation, and
other relevant pathways and their risk of disease
- Association between the frequency of specific SNPs that codes for coagulation-,
fibrinolysis-, inflammatory, and other relevant proteins and risk for VTE
Materials and Methods:
- 300 women with a history of VTE in their pregnancy and 150 women with IUFD will be
identified by the Norwegian patient registry (NPR) and the Medical Birth Registry
(MFR). The medical records of these patients will be checked. The epidemiological data
will be collected with the help of questionnaires that the patients will fill out and
blood samples will be collected. Blood samples will be analyzed with the aim to check
for known coagulation factors and thrombophilias as well as new gene polymorphisms.
- 600 control women, from the maternity wards at Ullevål/Aker University Hospitals in the
same time period, matched for age and ethnicity, will also answer questionnaires and
donate blood samples. The medical records for these women will be checked.
Ethical problems: This study raises no new ethical problems. The study is based on voluntary
participation from the invited and informed consent for all analyzes of biological test
material. The study design, data procedures and storing of biological material, will use
methods that assure the patients privacy at all levels.
The participants are invited to fill out a questionnaire concerning information of
thrombosis in pregnancy and take one simple blood test. Women with symptoms of post
thrombotic syndrome (PTS) will be offered a clinical examination of their lower extremities
to verify the condition. The data will be de-identified and the individuals will not be able
to be identify by other than those that have concession to the patient register established
for this study.
Blood tests will be stored in a biobank at Ullevål University Hospital (UUS) established for
this study, and will only be used for research related problems that have to do with this
study.
Some patients could have a psychological reaction of the illness they experienced many years
ago. The project leader or co-workers from the Hematology Department/Research Laboratory
will handle this problem. These patients will be offered additional information on
thrombosis in pregnancy.
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Observational Model: Case Control, Time Perspective: Retrospective
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