The risk of pregnancy‐related venous thromboembolism in women who are homozygous for factor V Leiden

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Abstract
The risk of venous thromboembolism (VTE) is increased in pregnancy and during the post‐partum period. The absolute risk for pregnancy‐related VTE in heterozygous women with the factor V Leiden mutation is approximately 2%, but studies on this risk for homozygous women show conflicting results. In a retrospective family study, we found that the risk of pregnancy‐related VTE in women with a symptomatic first‐degree relative was 17% per pregnancy (95%CI 4·7–37·4). Anticoagulant prophylaxis during the post‐partum period appears to be indicated in asymptomatic homozygous women from symptomatic kindred, whereas this could be decided on an individual basis during pregnancy.