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Thromb Haemost 2023; 123(09): 904-910
DOI: 10.1055/a-2019-0607
Stroke, Systemic or Venous Thromboembolism

Incidence of Pregnancy-Associated Venous Thromboembolism: Second Nationwide Study

Hun-Gyu Hwang
1   Division of Respiratory, Department of Internal Medicine, Soonchunhyang University Gumi Hospital, Soonchunhyang University School of Medicine, Republic of Korea
,
Ju Hyun Lee
2   Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
,
Soo-Mee Bang
2   Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
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Funding This work was supported by a grant (KSTH 2017-001) from the Korean Society for Thrombosis and Hemostasis. This study was supported by the Soonchunhyang University Research Fund (SURF-20160740). The funder had no role in the study design, data collection and analysis, decision to publish, or manuscript preparation.
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Abstract

Background Pregnancy is a transient risk factor for venous thromboembolism (VTE). This second nationwide study aimed to inspect trend changes in the incidence rate of pregnancy-associated VTE (PA-VTE) during the study period (2014–2018) compared with that reported in a previous study (2006–2010).

Methods Using the Korean Health Insurance Review and Assessment Service database, we retrospectively identified all PA-VTE events using both diagnostic and medication codes.

Results Of the 124,228 VTE events, 510 (0.4%) cases of PA-VTE were identified in 499 women (median age: 34 years; range: 20–49 years). The incidence rate of PA-VTE/10,000 deliveries (PA-VTE/104D) in this second study (2.62) was 3.2 times higher than that in the first study (0.82). In the second study, the PA-VTE/104D ratio of women in their 40s (5.46) was three times higher than that of women in their 20s (1.80) (relative risk: 3.03; 95% confidence interval: 2.04–4.51; p < 0.01). The incidence rate for women in their 40s in the second study was 2.3 times higher than that in the first study. PA-VTE/104D cases occurred more frequently in multiparous than in primiparous women, in cesarean section cases compared with vaginal delivery, and in multiple rather than single pregnancies. Most PA-VTE cases occurred during the postpartum period (321/510, 62.9%), of which pulmonary embolism was the most frequently occurring type (231/321, 72%).

Conclusion Advanced maternal age, cesarean section, multiparity, and multifetal pregnancies increased the risk of PA-VTE. Obstetricians need to be cautious of VTE, particularly during the postpartum period, in high-risk pregnant patients.

Keywords

pregnancy - venous thromboembolism - age - cesarean section - multiparity - multifetal pregnancies

Authors' Contribution

S.-M. Bang and H.-G. Hwang designed the study. J.H. Lee performed data curation and statistical analyses. S.-M. Bang and H.-G. Hwang wrote the initial draft of the manuscript. All authors performed the adjudication. All authors have read, revised, and approved the manuscript.


Supplementary Material



Publication History

Received: 25 July 2022

Accepted: 17 January 2023

Accepted Manuscript online:
24 January 2023

Article published online:
24 February 2023

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