Women with von Willebrand disease (VWD) have a 10-fold greater risk of ante-partum bleeding (bleeding before delivery or during pregnancy) than women without VWD, reports a study of 16,824,897 deliveries in the US between 2000 and 2003, led by Dr. Andra James of the Department of Obstetrics and Gynecology at Duke University Medical Center in Durham, North Carolina. Despite the increased risk for premature delivery and stillbirth due to ante-partum bleeding, women with VWD were no more likely to experience preterm labor or intrauterine demise (fetal death).
The study also reported that women with VWD are five times more likely to have post-partum hemorrhage, excessive bleeding in the mother after delivery, than their non-VWD peers.
In the study population, of the 4,067 pregnant women diagnosed with VWD, five died. This represents a 10-fold increase in maternal mortality rate of pregnant women with VWD relative to women without the disorder. Despite the increased risk of death, this rate is still considered very low, translating to about 1 death per 1,000 women.
The study also reported that women with VWD are less likely to develop pregnancy-related deep vein thrombosis. In the group of 4,067 women, six cases of pregnancy-related deep vein thrombosis would be expected statistically. However, none was observed in the study.
"There is no obvious explanation why women with VWD would be less likely to experience deep vein thrombosis, yet no less likely to experience pulmonary embolism...," said Dr. James. "We were better able to ascertain that women with VWD do not appear to be at an increased risk of poor fetal outcomes..."
The Study, "Bleeding Events and Other Complications During Pregnancy and Childbirth in Women with von Willebrand Disease" was published in the June 2007 issue of the Journal of Thrombosis and Haemostasis.