Risk factors for venous thromboembolism during pregnancy

Thomas Bo Jensen; Thomas Alexander Gerds; Randi Grøn; Ditte-Marie Bretler; Michelle Dalgas Schmiegelow; Charlotte Andersson; Aziza Azimi; Gunnar Gislason; Christian Torp-Pedersen; Jonas Bjerring Olesen

doi:10.1002/pds.3536

Risk factors for venous thromboembolism during pregnancy

Thomas Bo Jensen, Thomas Alexander Gerds, Randi Grøn, Ditte-Marie Bretler, Michelle Dalgas Schmiegelow, Charlotte Andersson, Aziza Azimi, Gunnar Gislason, Christian Torp-Pedersen, Jonas Bjerring Olesen

15 Citationer (Scopus)

Abstract

Background: Pregnant women are at an increased risk of venous thromboembolism (VTE). Risk factors for VTE among pregnant women are not sufficiently investigated. Purpose: To examine pharmacological and non-pharmacological VTE risk factors during pregnancy (antepartum). Methods: The population comprised all pregnant women in Denmark aged 15-50 giving birth 2003-2010. Pregnancies were linked on an individual level with national registers for hospital admissions and drug dispenses from pharmacies. Risk of first occurring VTE antepartum was examined with Cox regression models. Results: Out of 299810 pregnancies, 337 experienced a VTE, incidence rate 1.1 (95% confidence interval [CI] 1.0-1.3) per 1000 pregnancies. Being underweight (body mass index [BMI]<18.5 kg/m²) was associated with a decreased risk of VTE (hazard ratio [HR] 0.53 [CI 0.29-0.98]) compared to normal weight (18.5≤BMI<25 kg/m²). Overweight (25≤BMI<30 kg/m²) increased VTE risk (HR 1.30 [CI 1.01-1.67]) but obesity (BMI≥30 kg/m²) was insignificant (HR 1.14 [CI 0.82-1.58]). A history of VTE was highly significant (HR 72.65 [CI 51.17-103.15]). The youngest (<20 years) and oldest (≥35 years) had insignificantly increased risks (HR 1.45 [CI 0.80-2.62] and HR 1.31 [CI 0.98-1.75], respectively) compared to those aged 20-30 years. Sixteen groups of medications, including anti-infectious medications, hormones, aminosalicylic acid, insulin, and benzodiazepine derivatives, were associated with VTE. Conclusion: The risk of antepartum VTE was increased in women with prior VTE. Compared to normal weight women, being underweight decreased the risk of VTE whereas being overweight increased the risk. Also, the use of several medications was associated with increased risk of VTE.

Originalsprog	Engelsk
Tidsskrift	Pharmacoepidemiology and Drug Safety
Vol/bind	22
Udgave nummer	12
Sider (fra-til)	1283-91
Antal sider	9
ISSN	1053-8569
DOI	https://doi.org/10.1002/pds.3536
Status	Udgivet - dec. 2013

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title = "Risk factors for venous thromboembolism during pregnancy",

abstract = "Background: Pregnant women are at an increased risk of venous thromboembolism (VTE). Risk factors for VTE among pregnant women are not sufficiently investigated. Purpose: To examine pharmacological and non-pharmacological VTE risk factors during pregnancy (antepartum). Methods: The population comprised all pregnant women in Denmark aged 15-50 giving birth 2003-2010. Pregnancies were linked on an individual level with national registers for hospital admissions and drug dispenses from pharmacies. Risk of first occurring VTE antepartum was examined with Cox regression models. Results: Out of 299810 pregnancies, 337 experienced a VTE, incidence rate 1.1 (95% confidence interval [CI] 1.0-1.3) per 1000 pregnancies. Being underweight (body mass index [BMI]<18.5 kg/m2) was associated with a decreased risk of VTE (hazard ratio [HR] 0.53 [CI 0.29-0.98]) compared to normal weight (18.5≤BMI<25 kg/m2). Overweight (25≤BMI<30 kg/m2) increased VTE risk (HR 1.30 [CI 1.01-1.67]) but obesity (BMI≥30 kg/m2) was insignificant (HR 1.14 [CI 0.82-1.58]). A history of VTE was highly significant (HR 72.65 [CI 51.17-103.15]). The youngest (<20 years) and oldest (≥35 years) had insignificantly increased risks (HR 1.45 [CI 0.80-2.62] and HR 1.31 [CI 0.98-1.75], respectively) compared to those aged 20-30 years. Sixteen groups of medications, including anti-infectious medications, hormones, aminosalicylic acid, insulin, and benzodiazepine derivatives, were associated with VTE. Conclusion: The risk of antepartum VTE was increased in women with prior VTE. Compared to normal weight women, being underweight decreased the risk of VTE whereas being overweight increased the risk. Also, the use of several medications was associated with increased risk of VTE.",

author = "Jensen, {Thomas Bo} and Gerds, {Thomas Alexander} and Randi Gr{\o}n and Ditte-Marie Bretler and Schmiegelow, {Michelle Dalgas} and Charlotte Andersson and Aziza Azimi and Gunnar Gislason and Christian Torp-Pedersen and Olesen, {Jonas Bjerring}",

note = "Copyright {\textcopyright} 2013 John Wiley & Sons, Ltd.",

year = "2013",

month = dec,

doi = "10.1002/pds.3536",

language = "English",

volume = "22",

pages = "1283--91",

journal = "Pharmacoepidemiology and Drug Safety",

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TY - JOUR

T1 - Risk factors for venous thromboembolism during pregnancy

AU - Jensen, Thomas Bo

AU - Gerds, Thomas Alexander

AU - Grøn, Randi

AU - Bretler, Ditte-Marie

AU - Schmiegelow, Michelle Dalgas

AU - Andersson, Charlotte

AU - Azimi, Aziza

AU - Gislason, Gunnar

AU - Torp-Pedersen, Christian

AU - Olesen, Jonas Bjerring

PY - 2013/12

Y1 - 2013/12

N2 - Background: Pregnant women are at an increased risk of venous thromboembolism (VTE). Risk factors for VTE among pregnant women are not sufficiently investigated. Purpose: To examine pharmacological and non-pharmacological VTE risk factors during pregnancy (antepartum). Methods: The population comprised all pregnant women in Denmark aged 15-50 giving birth 2003-2010. Pregnancies were linked on an individual level with national registers for hospital admissions and drug dispenses from pharmacies. Risk of first occurring VTE antepartum was examined with Cox regression models. Results: Out of 299810 pregnancies, 337 experienced a VTE, incidence rate 1.1 (95% confidence interval [CI] 1.0-1.3) per 1000 pregnancies. Being underweight (body mass index [BMI]<18.5 kg/m2) was associated with a decreased risk of VTE (hazard ratio [HR] 0.53 [CI 0.29-0.98]) compared to normal weight (18.5≤BMI<25 kg/m2). Overweight (25≤BMI<30 kg/m2) increased VTE risk (HR 1.30 [CI 1.01-1.67]) but obesity (BMI≥30 kg/m2) was insignificant (HR 1.14 [CI 0.82-1.58]). A history of VTE was highly significant (HR 72.65 [CI 51.17-103.15]). The youngest (<20 years) and oldest (≥35 years) had insignificantly increased risks (HR 1.45 [CI 0.80-2.62] and HR 1.31 [CI 0.98-1.75], respectively) compared to those aged 20-30 years. Sixteen groups of medications, including anti-infectious medications, hormones, aminosalicylic acid, insulin, and benzodiazepine derivatives, were associated with VTE. Conclusion: The risk of antepartum VTE was increased in women with prior VTE. Compared to normal weight women, being underweight decreased the risk of VTE whereas being overweight increased the risk. Also, the use of several medications was associated with increased risk of VTE.

AB - Background: Pregnant women are at an increased risk of venous thromboembolism (VTE). Risk factors for VTE among pregnant women are not sufficiently investigated. Purpose: To examine pharmacological and non-pharmacological VTE risk factors during pregnancy (antepartum). Methods: The population comprised all pregnant women in Denmark aged 15-50 giving birth 2003-2010. Pregnancies were linked on an individual level with national registers for hospital admissions and drug dispenses from pharmacies. Risk of first occurring VTE antepartum was examined with Cox regression models. Results: Out of 299810 pregnancies, 337 experienced a VTE, incidence rate 1.1 (95% confidence interval [CI] 1.0-1.3) per 1000 pregnancies. Being underweight (body mass index [BMI]<18.5 kg/m2) was associated with a decreased risk of VTE (hazard ratio [HR] 0.53 [CI 0.29-0.98]) compared to normal weight (18.5≤BMI<25 kg/m2). Overweight (25≤BMI<30 kg/m2) increased VTE risk (HR 1.30 [CI 1.01-1.67]) but obesity (BMI≥30 kg/m2) was insignificant (HR 1.14 [CI 0.82-1.58]). A history of VTE was highly significant (HR 72.65 [CI 51.17-103.15]). The youngest (<20 years) and oldest (≥35 years) had insignificantly increased risks (HR 1.45 [CI 0.80-2.62] and HR 1.31 [CI 0.98-1.75], respectively) compared to those aged 20-30 years. Sixteen groups of medications, including anti-infectious medications, hormones, aminosalicylic acid, insulin, and benzodiazepine derivatives, were associated with VTE. Conclusion: The risk of antepartum VTE was increased in women with prior VTE. Compared to normal weight women, being underweight decreased the risk of VTE whereas being overweight increased the risk. Also, the use of several medications was associated with increased risk of VTE.

U2 - 10.1002/pds.3536

DO - 10.1002/pds.3536

M3 - Journal article

C2 - 24130063

SN - 1053-8569

VL - 22

SP - 1283

EP - 1291

JO - Pharmacoepidemiology and Drug Safety

JF - Pharmacoepidemiology and Drug Safety

IS - 12

ER -

Risk factors for venous thromboembolism during pregnancy

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