Department of Haematology, Clinical Research, Oslo University Hospital, and Institute of Clinical Medicine, Oslo, Norway.
J Thromb Haemost. 2012 May;10(5):840-7. doi: 10.1111/j.1538-7836.2012.04690.x.
The long-term outcome of pregnancy-related venous thrombosis (VT) is not known.
To assess predictors and long-term frequency of post-thrombotic syndrome (PTS) after pregnancy-related VT.
PATIENTS/METHODS: In 2006, 313 women with pregnancy-related VT during 1990-2003 and 353 controls answered a comprehensive questionnaire that included self-reported Villalta score as a measure of PTS. Cases were identified from 18 Norwegian hospitals using the Norwegian Patient Registry and the Medical Birth Registry of Norway. The latter was used to select as possible controls women who gave birth at the same time as a case. Thirty-nine patients and four controls were excluded because of VT outside the lower limbs/lungs or missing Villalta scores. Two hundred and four patients had DVT in the lower limb and 70 had pulmonary embolism (PE). The control group comprised 349 women naive for VT at the time of the index pregnancy.
Forty-two per cent of cases with DVT in the lower limb, compared with 24% of cases with PE and 10% of controls, reported a Villalta score of ≥ 5. Severe PTS (Villalta score of ≥ 15) was reported among 7%, 4% and 1%. Proximal postnatal, but not antenatal, thrombosis was a strong predictor of PTS with an adjusted odds ratio of 6.3 (95% confidence interval, 2.0-19.8; P = 0.002). Daily smoking before the index pregnancy and age above 33 years at event were independent predictors for post-thrombotic syndrome.
PTS is a common long-term complication after pregnancy-related DVT. Proximal postnatal thrombosis, smoking and higher age were independent predictors of the development of PTS.
妊娠相关静脉血栓形成（VT）的长期预后尚不清楚。
评估妊娠相关 VT 后血栓后综合征（PTS）的预测因素和长期发生频率。
患者/方法：2006 年，313 名 1990-2003 年期间妊娠相关 VT 患者和 353 名对照者回答了一份综合问卷，其中包括自我报告的 Villalta 评分，作为 PTS 的衡量标准。病例通过挪威 18 家医院的挪威患者登记处和挪威医学出生登记处确定。后者用于选择与病例同时分娩的可能对照者。由于下肢/肺部以外的 VT 或缺失 Villalta 评分，39 名患者和 4 名对照者被排除在外。204 名患者下肢深静脉血栓形成（DVT），70 名患者肺栓塞（PE）。对照组由 349 名在指数妊娠时无 VT 病史的女性组成。
与 PE 组的 24%和对照组的 10%相比，下肢 DVT 患者中有 42%报告 Villalta 评分≥5，严重 PTS（Villalta 评分≥15）的报告率分别为 7%、4%和 1%。产后即刻血栓形成，而不是产前血栓形成，是 PTS 的一个强烈预测因素，调整后的优势比为 6.3（95%置信区间，2.0-19.8；P=0.002）。妊娠前每天吸烟和发病时年龄大于 33 岁是 PTS 的独立预测因素。
PTS 是妊娠相关 DVT 的常见长期并发症。产后即刻血栓形成、吸烟和年龄较大是 PTS 发展的独立预测因素。
