Incidence of pulmonary and venous thromboembolism in pregnancies after in vitro fertilisation: cross sectional study
Open accessAbstract
OBJECTIVE: To estimate the risk of pulmonary embolism and venous thromboembolism in pregnant women after in vitro fertilisation. DESIGN: Cross sectional study. SETTING: Sweden. PARTICIPANTS: 23,498 women who had given birth after in vitro fertilisation between 1990 and 2008 and 116,960 individually matched women with natural pregnancies. MAIN OUTCOME MEASURES: Risk of pulmonary embolism and venous thromboembolism (identified by linkage to the Swedish national patient register) during the whole pregnancy and by trimester. RESULTS: Venous thromboembolism occurred in 4.2/1000 women (n=99) after in vitro fertilisation compared with 2.5/1000 (n=291) in women with natural pregnancies (hazard ratio 1.77, 95% confidence interval 1.41 to 2.23). The risk of venous thromboembolism was increased during the whole pregnancy (P<0.001) and differed between the trimesters (P=0.002). The risk was particularly increased during the first trimester, at 1.5/1000 after in vitro fertilisation versus 0.3/1000 (hazard ratio 4.22, 2.46 to 7.26). The proportion of women experiencing pulmonary embolism during the first trimester was 3.0/10,000 after in vitro fertilisation versus 0.4/10,000 (hazard ratio 6.97, 2.21 to 21.96). CONCLUSIONS: In vitro fertilisation is associated with an increased risk of pulmonary embolism and venous thromboembolism during the first trimester. The risk of pulmonary embolism is low in absolute terms but because the condition is a leading cause of maternal mortality and clinical suspicion is critical for diagnosis, an awareness of this risk is important. TRIAL REGISTRATION: ClinicalTrials.gov NCT01524393.
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Adverse outcomes may be even more pronounced among women with a lower reserve, including those with pre-existing excess CV risk or frank CVD.
“Adverse outcomes may be even more pronounced among women with a lower reserve, including those with pre-existing excess CV risk (20) or frank CVD (21).”
From Cardiovascular Risk Following Fertility Therapy (2017) · cites this paper as [20]
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- Authors
- Henriksson, P., Westerlund, E., Wallen, H., Brandt, L., Hovatta, O., & Ekbom, A.
- Affiliations
- Danderyds sjukhus (SE)
- Karolinska Institutet (SE)
- Corresponding author
- Henriksson, P.
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2013-01-15
- Volume
- 346
- Issue
- jan15 3
- Pages
- e8632-e8632
- ISSN
- 1756-1833 (ISSN-L)
- PMC
- PMC3546085
- OpenAlex
- W1968036356
- Cited by
- 180
- References
- 39
- Citations by year
- 2026: 8 · 2025: 9 · 2024: 9 · 2023: 15 · 2022: 13 · 2021: 13 · 2020: 13 · 2019: 13 · 2018: 20 · 2017: 11 · 2016: 10 · 2015: 16 · 2014: 20 · 2013: 10
- FWCI
- 16.35
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Assisted Reproductive Technology and Twin Pregnancy
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Keywords
- pulmonary embolism, venous thromboembolism, in vitro fertilization, pregnancy, first trimester, thromboembolic risk, maternal mortality, assisted reproduction
- MeSH terms
- Adult, Cross-Sectional Studies, Female, Fertilization in Vitro, Humans, Middle Aged, Pregnancy, Pregnancy Trimester, First, Pulmonary Embolism, Registries, Risk Factors, Sweden, Multivariate Analysis, Proportional Hazards Models, Venous Thromboembolism
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