Document Detail


Recurrent venous thromboembolism after pregnancy-associated versus unprovoked thromboembolism.
MedLine Citation:
PMID:  18690344     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Richard H White; Wee-Shian Chan; Hong Zhou; Jeffrey S Ginsberg
Related Documents :
10511964 - Low molecular weight heparin use during pregnancy: issues of safety and practicality.
3581714 - Prophylactic use of antithrombin iii concentrate following surgery in congenital antith...
17762534 - Coagulation factor deficiency as a cause of recurrent fetal loss: a red herring!
17963764 - Inheritance and perinatal consequences of inherited thrombophilia in greece.
2847774 - Massive feto-maternal haemorrhage: effect of passively administered anti-d in the preve...
18225684 - Evaluation of vegf in placental bed biopsies from preeclamptic women by immunohistochem...
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Thrombosis and haemostasis     Volume:  100     ISSN:  0340-6245     ISO Abbreviation:  Thromb. Haemost.     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-08-11     Completed Date:  2008-10-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7608063     Medline TA:  Thromb Haemost     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  246-52     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, UC Davis, Sacramento, CA 95817, USA. rhwhite@ucdavis.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
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


Previous Document:  Thrombin generation in patients after acute deep-vein thrombosis.
Next Document:  Inhibitors and activation markers of the haemostatic system during hormone therapy: a comparative st...