| Recurrent venous thromboembolism after pregnancy-associated versus unprovoked thromboembolism. | |
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MedLine Citation:
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PMID: 18690344 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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It is not known whether women who develop venous thromboembolism (VTE) during pregnancy have a higher or lower incidence of recurrent VTE than women with unprovoked VTE. The aim of the study was to compare the risk of recurrent VTE among women with pregnancy-associated VTE to women with unprovoked VTE. Hospital discharge data identified women age 18-46 years old with pregnancy-associated or unprovoked index VTE between 1994 and 2005. Risk of recurrent VTE was compared between six and 60 months after the index event using both age-matched comparison of disease-free survival and proportional hazard modelling, adjusting for age and other risk factors. The Kaplan-Meier incidence of recurrent VTE in 1085 women with pregnancy-associated VTE was 5.8% versus 10.4% in 7625 women with unprovoked VTE (p = 0.02). Twelve of 34 (35%) recurrent events in the pregnancy-associated group occurred during a subsequent pregnancy compared with 29 of 331 (8.7%) events in the unprovoked group (p < 0.001). In the risk-adjusted multivariate model, women with pregnancy-associated VTE had a significantly lower risk of recurrent VTE (HR = 0.6, 95%CI = 0.4-0.9). Overall, the incidence of recurrent VTE during subsequent pregnancies was higher in the pregnancy group, 21 of 465 (4.5%), than in the unprovoked group, 37 of 1353 (2.7%, RR = 1.7, CI: 1.0-2.8). Compared to women with unprovoked VTE, women with pregnancy-associated VTE had a significantly lower long-term risk of recurrent VTE but a higher risk of recurrent VTE during a subsequent pregnancy. These findings should be considered when decisions are made about VTE prophylaxis in women with a history of pregnancy-associated VTE. |
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Authors:
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Richard H White; Wee-Shian Chan; Hong Zhou; Jeffrey S Ginsberg |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Thrombosis and haemostasis Volume: 100 ISSN: 0340-6245 ISO Abbreviation: Thromb. Haemost. Publication Date: 2008 Aug |
Date Detail:
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Created Date: 2008-08-11 Completed Date: 2008-10-08 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7608063 Medline TA: Thromb Haemost Country: Germany |
Other Details:
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Languages: eng Pagination: 246-52 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine, UC Davis, Sacramento, CA 95817, USA. rhwhite@ucdavis.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Cohort Studies Comorbidity Databases, Factual Female Humans Incidence Kaplan-Meiers Estimate Middle Aged Multivariate Analysis Pregnancy Pregnancy Complications, Hematologic / epidemiology* Proportional Hazards Models Recurrence Retrospective Studies Risk Factors Venous Thromboembolism / epidemiology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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