Risk factors for venous thromboembolism in 1.3 million pregnancies: a nationwide prospective cohort.

<h4>Objective</h4>To quantify risk factors for venous thromboembolism during pregnancy and the puerperal period.<h4>Design</h4>In a nationwide prospective cohort study we followed pregnant and puerperal women in Denmark from 1995 to 2009 for venous thromboembolism. Informatio...

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Autores principales:	Rie Adser Virkus, Ellen Løkkegaard, Øjvind Lidegaard, Jens Langhoff-Roos, Anne Kristine Nielsen, Kenneth J Rothman, Thomas Bergholt
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/3bf695e6db3a49d693bb93da9ab9707c
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spelling	oai:doaj.org-article:3bf695e6db3a49d693bb93da9ab9707c2021-11-18T08:21:02ZRisk factors for venous thromboembolism in 1.3 million pregnancies: a nationwide prospective cohort.1932-620310.1371/journal.pone.0096495https://doaj.org/article/3bf695e6db3a49d693bb93da9ab9707c2014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24788753/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>To quantify risk factors for venous thromboembolism during pregnancy and the puerperal period.<h4>Design</h4>In a nationwide prospective cohort study we followed pregnant and puerperal women in Denmark from 1995 to 2009 for venous thromboembolism. Information on risk factors and confounders was retrieved from national registries. The diagnosis of venous thromboembolism was confirmed through medical charts. We calculated adjusted incidence rates per 10,000 women years and used Poisson regression to estimate effects during pregnancy and the puerperal period.<h4>Results</h4>We studied 1,297,037 pregnancies and related puerperal periods, during which there were 748 venous thromboembolisms. The incidence rate for venous thromboembolism during a pregnancy with and without hospitalization for hyperemesis was 15.2/10,000 yr and 6.3/10,000 yr, respectively, (adjusted rate ratio: 2.5 (95%-confidence interval; 1.4-4.5)). The incidence rate among women with multiple pregnancies was 18.2/10,000 yr and 6.3/10,000 yr in singletons (adjusted rate ratio: 2.8 (1.9-4.2)). Increased risk was found with hospitalization during pregnancy or the puerperal period with incidence rates of 42.1/10.000 and 54.7/10.000, respectively, (rate ratios: 12.2 (8.7-17) and 5.9 (4.0-8.8)). Women hospitalized with infections during pregnancy had incidence rates of 25.9/10,000 yr and 29.3/10,000 yr during pregnancy and the puerperal period, respectively, and of 62.7/10,000 yr if hospitalized with infection in the puerperal period. Puerperal venous thromboembolism was associated with hospitalization for preeclampsia and intrauterine growth restriction/fetal death with incidence rates of 45.8/10,000 yr and 18.3/10,000 yr, respectively (rate ratio: 5.0 (3.1-7.8) and 1.9 (0.9-4.4)). Additionally puerperal venous thromboembolism was associated with obesity, elective and acute caesarean sections and major postpartum bleeding with incidence rates of 25.5/10,000 yr, 23.2/10,000 yr, 34.0/10,000 yr and 20.3/10,000 yr, respectively (rate ratios 1.7 (1.1-2.7), 2.1 (1.4-3.1), 3.0 (2.3-4.0) and 1.4 (1.0-2.1)).<h4>Conclusions</h4>Important risk factors for venous thromboembolism during pregnancy or the puerperal period were hospitalization, infection, hyperemesis, multiple pregnancies, preeclampsia, obesity, caesarean section, major postpartum bleeding, and intrauterine growth restriction or fetal death.Rie Adser VirkusEllen LøkkegaardØjvind LidegaardJens Langhoff-RoosAnne Kristine NielsenKenneth J RothmanThomas BergholtPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 5, p e96495 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Rie Adser Virkus Ellen Løkkegaard Øjvind Lidegaard Jens Langhoff-Roos Anne Kristine Nielsen Kenneth J Rothman Thomas Bergholt Risk factors for venous thromboembolism in 1.3 million pregnancies: a nationwide prospective cohort.
description	<h4>Objective</h4>To quantify risk factors for venous thromboembolism during pregnancy and the puerperal period.<h4>Design</h4>In a nationwide prospective cohort study we followed pregnant and puerperal women in Denmark from 1995 to 2009 for venous thromboembolism. Information on risk factors and confounders was retrieved from national registries. The diagnosis of venous thromboembolism was confirmed through medical charts. We calculated adjusted incidence rates per 10,000 women years and used Poisson regression to estimate effects during pregnancy and the puerperal period.<h4>Results</h4>We studied 1,297,037 pregnancies and related puerperal periods, during which there were 748 venous thromboembolisms. The incidence rate for venous thromboembolism during a pregnancy with and without hospitalization for hyperemesis was 15.2/10,000 yr and 6.3/10,000 yr, respectively, (adjusted rate ratio: 2.5 (95%-confidence interval; 1.4-4.5)). The incidence rate among women with multiple pregnancies was 18.2/10,000 yr and 6.3/10,000 yr in singletons (adjusted rate ratio: 2.8 (1.9-4.2)). Increased risk was found with hospitalization during pregnancy or the puerperal period with incidence rates of 42.1/10.000 and 54.7/10.000, respectively, (rate ratios: 12.2 (8.7-17) and 5.9 (4.0-8.8)). Women hospitalized with infections during pregnancy had incidence rates of 25.9/10,000 yr and 29.3/10,000 yr during pregnancy and the puerperal period, respectively, and of 62.7/10,000 yr if hospitalized with infection in the puerperal period. Puerperal venous thromboembolism was associated with hospitalization for preeclampsia and intrauterine growth restriction/fetal death with incidence rates of 45.8/10,000 yr and 18.3/10,000 yr, respectively (rate ratio: 5.0 (3.1-7.8) and 1.9 (0.9-4.4)). Additionally puerperal venous thromboembolism was associated with obesity, elective and acute caesarean sections and major postpartum bleeding with incidence rates of 25.5/10,000 yr, 23.2/10,000 yr, 34.0/10,000 yr and 20.3/10,000 yr, respectively (rate ratios 1.7 (1.1-2.7), 2.1 (1.4-3.1), 3.0 (2.3-4.0) and 1.4 (1.0-2.1)).<h4>Conclusions</h4>Important risk factors for venous thromboembolism during pregnancy or the puerperal period were hospitalization, infection, hyperemesis, multiple pregnancies, preeclampsia, obesity, caesarean section, major postpartum bleeding, and intrauterine growth restriction or fetal death.
format	article
author	Rie Adser Virkus Ellen Løkkegaard Øjvind Lidegaard Jens Langhoff-Roos Anne Kristine Nielsen Kenneth J Rothman Thomas Bergholt
author_facet	Rie Adser Virkus Ellen Løkkegaard Øjvind Lidegaard Jens Langhoff-Roos Anne Kristine Nielsen Kenneth J Rothman Thomas Bergholt
author_sort	Rie Adser Virkus
title	Risk factors for venous thromboembolism in 1.3 million pregnancies: a nationwide prospective cohort.
title_short	Risk factors for venous thromboembolism in 1.3 million pregnancies: a nationwide prospective cohort.
title_full	Risk factors for venous thromboembolism in 1.3 million pregnancies: a nationwide prospective cohort.
title_fullStr	Risk factors for venous thromboembolism in 1.3 million pregnancies: a nationwide prospective cohort.
title_full_unstemmed	Risk factors for venous thromboembolism in 1.3 million pregnancies: a nationwide prospective cohort.
title_sort	risk factors for venous thromboembolism in 1.3 million pregnancies: a nationwide prospective cohort.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/3bf695e6db3a49d693bb93da9ab9707c
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Risk factors for venous thromboembolism in 1.3 million pregnancies: a nationwide prospective cohort.

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