150955 20251017144550.0 doi 10.1080/14767058.2019.1611764 sideral 111593 ART-2021-111593 eng Lafalla, Olivia Clinical utility of thrombophilia, anticoagulant treatment and maternal variables as predictors of placenta-mediated pregnancy complications: an extensive analysis 2021 Access copy available to the general public Unrestricted Objective: 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. info:eu-repo/grantAgreement/ES/MINECO/MTM2017-83812-P info:eu-repo/semantics/openAccess by-nc https://creativecommons.org/licenses/by-nc/4.0/deed.es 2.323 2021 OBSTETRICS & GYNECOLOGY 61 / 85 = 0.718 2021 Q3 T3 0.61 2021 Pediatrics, Perinatology and Child Health 2021 Q2 Obstetrics and Gynecology 2021 Q2 4.0 2021 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Esteban Escaño, Luis Mariano (orcid)0000-0002-3007-302X Lou Mercade, Ana Cristina Universidad de Zaragoza (orcid)0000-0001-9058-1037 Cornudella, Rosa (orcid)0000-0002-9233-9065 Domínguez, Manuel Sanz Saiz, Gerardo Universidad de Zaragoza (orcid)0000-0002-6474-2252 Borque Fernando, Ángel Universidad de Zaragoza (orcid)0000-0003-0178-4567 2007 265 Universidad de Zaragoza Dpto. Métodos Estadísticos Área Estadís. Investig. Opera. 1013 645 Universidad de Zaragoza Dpto. Cirugía Área Obstetricia y Ginecología 1013 817 Universidad de Zaragoza Dpto. Cirugía Área Urología 34, 4 (2021), 588-598 J. matern.-fetal neonatal med. Journal of Maternal-Fetal and Neonatal Medicine 1476-7058 2187147 http://zaguan.unizar.es/record/150955/files/texto_completo.pdf Versión publicada 1232482 http://zaguan.unizar.es/record/150955/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:150955 articulos driver 2025-10-17-14:11:33 ARTICLE