000150955 001__ 150955 000150955 005__ 20251017144550.0 000150955 0247_ $$2doi$$a10.1080/14767058.2019.1611764 000150955 0248_ $$2sideral$$a111593 000150955 037__ $$aART-2021-111593 000150955 041__ $$aeng 000150955 100__ $$aLafalla, Olivia 000150955 245__ $$aClinical utility of thrombophilia, anticoagulant treatment and maternal variables as predictors of placenta-mediated pregnancy complications: an extensive analysis 000150955 260__ $$c2021 000150955 5060_ $$aAccess copy available to the general public$$fUnrestricted 000150955 5203_ $$aObjective: The objective of this study is to analyze the usefulness of thrombophilia and antithrombotic drugs in combination with materno-fetal characteristics to generate a predictive model of placenta-mediated pregnancy complications (PMPC) for counseling treatment. Methods: A retrospective analysis was performed in women with singleton pregnancy that required a thrombophilia study, including 222 patients with unknown cause PMPC and 151 women with no complications at current pregnancy in Hospital Clínico Universitario, Lozano, Blesa, Zaragoza, Spain. Chi-squared and Mann–Whitney test were applied to analyze univariate risk factors. Multivariate analysis was performed using logistic regression model with candidate variables: maternal characteristics, obstetric history, thrombophilia, and treatment with low-molecular-weight heparin (LMWH) and/or with acid acetylsalicylic (ASA). The calibration, discrimination, and best cutoff point for the clinical application of the model was analyzed. Results: Maternal characteristics showed differences in median body mass index (BMI), odds ratio (OR): 0.4, smoking habit, OR: 8.5, and hypertension, OR: 11.4, appearing all of them as risk factors. In our study, a prior pregnancy that ended in a child alive was a protective factor OR: 0.02–0.4, and having a previous preterm child was a strong risk factor OR: 4.2. Thrombophilia was not a risk factor. Patients under LMWH treatment (15%) and/or ASA (6.2%) had better pregnancy outcomes, showing both as protective factors: ASA OR: 0.32 and LMWH OR: 0.16. The model has an AUC value of 0.847, with good calibration. A nomogram and an app is provided for this adjusted model with high discrimination ability in internal validation (AUC = 0.833). Our clinical utility analysis guide us to choose 40% as the best threshold probability. Conclusions: We found risk and protective factors associated with PMPC, but our data were not conclusive to demonstrate its relation with maternal thrombophilia. However, the challenger finding is the clinical utility of antithrombotic drugs as a protective factors in PMPC prevention. It is possible to identify patients with high risk of PMPC through a combined predictive model, for counseling treatment. 000150955 536__ $$9info:eu-repo/grantAgreement/ES/MINECO/MTM2017-83812-P 000150955 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc$$uhttps://creativecommons.org/licenses/by-nc/4.0/deed.es 000150955 590__ $$a2.323$$b2021 000150955 591__ $$aOBSTETRICS & GYNECOLOGY$$b61 / 85 = 0.718$$c2021$$dQ3$$eT3 000150955 592__ $$a0.61$$b2021 000150955 593__ $$aPediatrics, Perinatology and Child Health$$c2021$$dQ2 000150955 593__ $$aObstetrics and Gynecology$$c2021$$dQ2 000150955 594__ $$a4.0$$b2021 000150955 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion 000150955 700__ $$0(orcid)0000-0002-3007-302X$$aEsteban Escaño, Luis Mariano 000150955 700__ $$0(orcid)0000-0001-9058-1037$$aLou Mercade, Ana Cristina$$uUniversidad de Zaragoza 000150955 700__ $$0(orcid)0000-0002-9233-9065$$aCornudella, Rosa 000150955 700__ $$aDomínguez, Manuel 000150955 700__ $$0(orcid)0000-0002-6474-2252$$aSanz Saiz, Gerardo$$uUniversidad de Zaragoza 000150955 700__ $$0(orcid)0000-0003-0178-4567$$aBorque Fernando, Ángel$$uUniversidad de Zaragoza 000150955 7102_ $$12007$$2265$$aUniversidad de Zaragoza$$bDpto. Métodos Estadísticos$$cÁrea Estadís. Investig. Opera. 000150955 7102_ $$11013$$2645$$aUniversidad de Zaragoza$$bDpto. Cirugía$$cÁrea Obstetricia y Ginecología 000150955 7102_ $$11013$$2817$$aUniversidad de Zaragoza$$bDpto. Cirugía$$cÁrea Urología 000150955 773__ $$g34, 4 (2021), 588-598$$pJ. matern.-fetal neonatal med.$$tJournal of Maternal-Fetal and Neonatal Medicine$$x1476-7058 000150955 8564_ $$s2187147$$uhttps://zaguan.unizar.es/record/150955/files/texto_completo.pdf$$yVersión publicada 000150955 8564_ $$s1232482$$uhttps://zaguan.unizar.es/record/150955/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada 000150955 909CO $$ooai:zaguan.unizar.es:150955$$particulos$$pdriver 000150955 951__ $$a2025-10-17-14:11:33 000150955 980__ $$aARTICLE