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Stillbirth or pre-term birth outcomes linked to elevated risk of blood clots after pregnancy
Date:4/2/2013

n women in the period between conception and birth (antepartum) and for up to 12 weeks after birth (postpartum) with the goal of optimizing the preventive use of heparin in this population, Dr. Grainge and colleagues designed a study examining data from more than 375,000 pregnancies in women ages 15-44 between January 1995 and July 2009. Data analysis was conducted through a retrospective review of The Health Improvement Network (THIN), a large primary-care database with input from more than 1,500 general practitioners across the U.K. Of the 375,000 pregnancies documented, the overall incidence of VTE was low, but higher during the postpartum period (338 per 100,000 person-years, which represents an individual's risk of an event during a one-year period) than during the pregnancy (84 per 100,000 person-years).

During the antepartum period, Dr. Grainge and colleagues found that the risk of VTE was highest in women who had reported inflammatory bowel disease (incidence rate ratio compared to women without the risk factor, or IRR, of 3.5) or pre-existing diabetes (IRR 3.1).

In the postpartum period, the team discovered a significant correlation between VTE risk and stillbirth (a six-fold increased risk of VTE compared with women who did not have a stillbirth, IRR 6.2), a risk factor that is not currently addressed in VTE risk assessment guidelines. Importantly, obese women with a high body mass index (BMI) of 30 or above also had a significantly increased VTE risk (IRR 3.75). The team also determined other factors that led to an increased risk of VTE, including a caesarian section delivery ( IRR 1.99), three or more previous births (IRR 2.07), pre-term birth (prior to 37 weeks gestation, IRR 2.69), and obstetric hemorrhage (IRR 2.89).

"The higher overall risks in the postpartum period may be attributable to a number of pregnancy-related factors, including delivery-related trauma, sudden increases in cardiac output and blood flow during de
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Contact: Andrea Slesinski
aslesinski@hematology.org
American Society of Hematology
Source:Eurekalert

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