Risk of first venous thromboembolism in pregnant women in hospital: Population based cohort study from England
Open accessAbstract
OBJECTIVE: To examine the potential for preventing venous thromboembolism during and after antepartum hospital admissions in pregnant women. DESIGN: Cohort study using linked primary (Clinical Practice Research Datalink) and secondary (Hospital Episode Statistics) care records. SETTING: Primary and secondary care centres, England. PARTICIPANTS: 206,785 women aged 15-44 who had one or more pregnancies from 1997 up to 2010. MAIN OUTCOME MEASURE: Risk of first venous thromboembolism in pregnant women admitted to hospital for one or more days for reasons other than delivery or venous thromboembolism. Risk was assessed by calculating the absolute rate of venous thromboembolism and comparing these rates with those observed during follow-up time not associated with hospital admission using a Poisson regression model to estimate incidence rate ratios. RESULTS: Admission to hospital in pregnancy was associated with an increased risk of venous thromboembolism (absolute rate 1752/100,000 person years; incidence rate ratio 17.5, 95% confidence interval 7.69 to 40.0) compared with time outside hospital. The rate of venous thromboembolism was also high during the 28 days after discharge (absolute rate 676; 6.27, 3.74 to 10.5). The rate during and after admission combined was highest in the third trimester (961; 5.57, 3.32 to 9.34) and in those aged ≥ 35 years (1756; 21.7, 9.62 to 49.0). While the absolute rate in the combined period was highest for those with three or more days in hospital (1511; 12.2, 6.65 to 22.7), there was also a fourfold increase (558; 4.05, 2.23 to 7.38) in the risk of venous thromboembolism for those admitted to hospital for less than three days. CONCLUSION: The overall risk of first venous thromboembolism in pregnant women increased during admissions to hospital not related to delivery, and remained significantly higher in the 28 days after discharge. During these periods need for thromboprophylaxis should receive careful consideration.
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Hospital admission increases the risk for first venous thromboembolism, which remains significantly higher in the 28 days after discharge.
“This also increases the risk for first venous thromboembolism, which is increased during admission to hospital and is not related to delivery, but remains significantly higher in the 28 days after discharge [28].”
From Activity Restriction and Hospitalization in Pregnancy: Can Bed-Rest Exercise Prevent Deconditioning? A Narrative Review (2023) · cites this paper as [28]
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“This also increases the risk for first venous thromboembolism, which is increased during admission to hospital and is not related to delivery, but remains significantly higher in the 28 days after discharge [28].”
Background
- Authors
- Abdul Sultan, A., West, J., Tata, L. J., Fleming, K. M., Nelson-Piercy, C., & Grainge, M. J.
- Affiliations
- University of Nottingham (GB)
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2013-11-07
- Volume
- 347
- Issue
- nov07 15
- Pages
- f6099-f6099
- ISSN
- 1756-1833 (ISSN-L)
- PMC
- PMC3898207
- OpenAlex
- W2102714729
- Cited by
- 111
- References
- 19
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 12 · 2023: 7 · 2022: 8 · 2021: 14 · 2020: 8 · 2019: 14 · 2018: 9 · 2017: 11 · 2016: 8 · 2015: 6 · 2014: 5 · 2013: 2
- FWCI
- 6.11
- 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)
- Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by)
- Research Portal (King's College London) (submittedVersion)
- Funders
- Aga Khan Foundation
- Topics
- Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Health Sciences › Medicine › Neurology › Cerebral Venous Sinus Thrombosis
- Keywords
- venous thromboembolism, pregnancy, thromboprophylaxis, postpartum period, thrombosis risk, third trimester, maternal age, length of hospital stay, England, Hospital Episode Statistics, Clinical Practice Research Datalink, incidence rate ratio
- MeSH terms
- Adolescent, Adult, England, Female, Hospitalization, Humans, Pregnancy, Pregnancy Complications, Cardiovascular, Risk Factors, Time Factors, Cohort Studies, Venous Thromboembolism, Young Adult
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