Hennessey Catherine A, Patel Vrunda K, Tefera Eshetu A, Gomez-Lobo Veronica
Georgetown University School of Medicine, Washington, DC.
MedStar Washington Hospital Center/Children's National Medical Center, Department of Obstetrics and Gynecology, Pediatric and Adolescent Gynecology, Washington, DC.
J Pediatr Adolesc Gynecol. 2018 Oct;31(5):503-508. doi: 10.1016/j.jpag.2018.06.007. Epub 2018 Jun 19.
Our goal was to describe the period prevalence of venous thromboembolism (VTE) and characterize adolescent female patients diagnosed with VTE by describing their age, race, and number of comorbidities. Female adolescents with estrogen exposure were of particular interest because estrogen-containing contraceptives increase the risk of VTE.
DESIGN, SETTING, PARTICIPANTS, AND INTERVENTIONS: We queried the Pediatric Health Information System database for International Classification of Diseases, Ninth/Tenth Revision, Clinical Modification codes to identify female patients aged 12-18 years diagnosed with a VTE or pulmonary embolism from April 2006 to March 2016 in the United States. Patient demographic characteristics and comorbidities were also analyzed. We divided our study population into two five-year groups and calculated the change in period prevalence of VTE between those groups.
Primary diagnosis of VTE in the extremities, or pulmonary embolism.
The period prevalence of VTE increased from 2.3 female adolescents per 10,000 hospitalized children (group 1) to 3.3 per 10,000 (group 2), representing a statistically significant increase of 0.010% (P < .001). Caucasian and black individuals were most commonly affected. The number of girls affected increased steadily from ages 12 to 16 years and a large percentage (59.6%) had four or more comorbidities. In patients (n = 32) with estrogen exposure, more than 96% had one or more comorbidity in addition to estrogen exposure.
Pediatric health care providers should be aware that the period prevalence of VTEs in female adolescents is increasing. Those with a history of estrogen exposure rarely develop VTEs from estrogen alone and they typically have multiple comorbidities.
