Can we identify risk factors during pregnancy for thrombo-embolic events during the puerperium and later in life?

Abstract

OBJECTIVES:

To investigate parturients at risk to develop venous thrombo-embolic events (VTE) in the puerperium or later in life, during a follow-up of more than a decade and compare risk factors for VTE during the puerperium with VTE later in life.

METHODS:

A nested case-control study was conducted to profile parturients at risk for VTE and a secondary analysis to compare risk factors for VTE during or after puerperium. We used a cohort of 95 257 women who gave birth between the years 1988 and 1998.

RESULTS:

Independent risk factors to develop VTE were peripartum hysterectomy, stillbirth, cesarean delivery (CD), obesity, pregnancy-related hypertension, grandmultiparity and advanced maternal age. Women undergoing CD and those receiving blood transfusion were more likely to develop early versus late VTE (OR = 2.0, 95% CI = 1.15-3.5 and OR = 11.0, 95% CI = 2.25-55.5; respectively). Patients that encountered VTE during the puerperium had more pulmonary emboli and less deep vein thrombosis, compared with the late VTE group (p < 0.001).

CONCLUSIONS:

Maternal age, grandmultiparity, pregnancy-related hypertension, CD, obesity, stillbirth and peripartum hysterectomy are independent risk factors for the development of VTE. CD and blood transfusion were predictive of early versus late VTE.

• Authors: Maor Waldman, Eyal Sheiner, Ruslan Sergienko, Ilana Shoham-Vardi
• Journal: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians (J Matern Fetal Neonatal Med) Vol. 28 Issue 9 Pg. 1005-9 (Jun 2015) ISSN: 1476-4954 [Electronic] England
• PMID: 25012805 (Publication Type: Comparative Study, Journal Article)

Topics

• Adult
• Case-Control Studies
• Female
• Follow-Up Studies
• Humans
• Incidence
• Israel (epidemiology)
• Postpartum Period
• Pregnancy
• Regression Analysis
• Risk Factors
• Venous Thromboembolism (epidemiology)
• Young Adult