AI Article Synopsis
- The study analyzed trends in pregnancy-related venous thromboembolism (VTE) in Scotland from 1980 to 2005, noting an increase in overall VTE incidence, particularly for antenatal deep venous thromboembolism (DVT) and pulmonary embolism (PTE).
- The research utilized data from over 1.4 million maternity discharges and identified several risk factors, including age, number of previous pregnancies, and certain obstetric complications, which contributed to the rising incidences, especially in deprived areas.
- Although antenatal DVTs increased, postnatal DVTs declined during the same period, possibly due to improved thromboprophylaxis practices following emergency caesarean deliveries, highlighting the
Article Abstract
Objectives: Data on time trends in the incidence of pregnancy-related venous thromboembolism (VTE) are sparse. This report charts the incidence of pregnancy-related VTE over the period 1980-2005 in Scotland, and discusses the results in relation to potential risk factors.
Study Design: 1475301 maternity discharges from Scottish hospitals recorded on the Scottish Morbidity Record 2 (SMR2) were included. Incidences of pregnancy-related VTE, antenatal deep venous thromboembolism (DVT), postnatal DVT and pulmonary embolism (PTE) were derived relative to the number of deliveries, and risk factors were analysed using Poisson regression.
Results: Over the period, VTE incidence rose from 13.7 to 18.3 per 10000 deliveries, antenatal DVTs from 8.8 to 12.2 per 10000 deliveries and PTE from 1.5 to 3.0 per 10000 deliveries. Postnatal DVTs, on the other hand, declined from 4.2 to 2.7 per 10000 deliveries. Risk factors were: age over 35 years; three or more previous pregnancies; previous VTE; obstetric haemorrhage; and preeclampsia. Antenatal DVT risk was highest in the most deprived areas, where events started increasing before those in less deprived areas. Postnatal DVT risk was increased following caesarean delivery, especially when unplanned, although after 1996, events following emergency caesarean decreased.
Conclusion: During the 26-year period, pregnancy-related VTEs increased, with the greatest rise for antenatal DVTs. Postnatal DVTs, on the other hand, declined over the period, particularly following emergency section. Thromboprophylaxis use following emergency delivery may have led to the postpartum reduction. To continue to prevent events, risk assessment and intervention are required, particularly antenatally.
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| http://dx.doi.org/10.1016/j.ejogrb.2013.03.024 | DOI Listing |
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