Risk factors for venous thromboembolism during pregnancy

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

N1 - Copyright © 2013 John Wiley & Sons, Ltd.

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 -