Pharmacy Department, Rotunda Hospital, Dublin, Ireland.
Division of Population Health Sciences, Royal College of Surgeons, Dublin, Ireland.
Am J Perinatol. 2023 Jan;40(1):22-24. doi: 10.1055/s-0041-1739471. Epub 2021 Nov 22.
While the majority of venous thromboembolism (VTE) during pregnancy events resolve with anticoagulation, long-term complications may occur including (1) postthrombotic syndrome and (2) chronic pulmonary embolism. The objective of this study was to determine risk of these two complications.
A retrospective cohort study using the MarketScan databases was performed on deliveries from 2008 to 2014. We identified women aged 15 to 54 years diagnosed with acute VTE during pregnancy, the delivery hospitalization, or ≤60 days postpartum who received at least one prescription postpartum for anticoagulants. Risks of (1) chronic PE and (2) postthrombotic syndrome were evaluated for women at 6, 12, 24, and 60 months after delivery hospitalization through 2017 via the International Classification of Diseases, 9th/10th Revision, Clinical Modification codes.
Of 4,267 of 4,128,900 pregnancies complicated by VTE, the majority had DVT alone (61.8%, = 2,637), while 25.8% had PE alone ( = 1,103) and 12.4% ( = 527) had both DVT and PE. Of the entire cohort, 3,328 retained insurance coverage at 6 months, 2,823 at 12 months, 2,161 at 24 months, and 831 at 60 months. Restricted to DVT, risk of postthrombotic syndrome was 0.7% at 6 months ( = 17), 1.1% at 12 months ( = 22), 1.7% at 24 months ( = 26), and 2.7% at 60 months ( = 16). Among women with PE diagnoses, the risk of chronic PE was 2.4% at 6 months ( = 30), 3.3% at 12 months ( = 36), 4.2% at 24 months ( = 36), and 7.2% at 60 months ( = 24).
In comparison to the general population, the risk of postthrombotic syndrome was lower. In comparison, the risk of chronic PE was similar to the estimates in the general population at comparable time points after PE events. For women with obstetric PE, it may be appropriate to be vigilant for findings and symptoms associated with chronic PE.
· Risk of postthrombotic syndrome after obstetric deep vein thrombosis is low.. · Risk of chronic pulmonary embolism may approximate that in the general population.. · Overall risk of chronic complications after obstetric VTE was relatively low..
尽管大多数妊娠期间发生的静脉血栓栓塞症（VTE）通过抗凝治疗可得到解决，但仍可能出现长期并发症，包括（1）血栓后综合征和（2）慢性肺栓塞。本研究旨在确定这两种并发症的风险。
这是一项回顾性队列研究，使用 MarketScan 数据库，对 2008 年至 2014 年的分娩进行了研究。我们确定了在妊娠期间、分娩住院期间或产后≤60 天内被诊断为急性 VTE 且在产后至少接受一次抗凝药物处方的年龄在 15 至 54 岁之间的女性。通过国际疾病分类，第 9/10 修订版临床修正码，在 2017 年之前，评估了女性在产后住院后 6、12、24 和 60 个月时（1）慢性 PE 和（2）血栓后综合征的风险。
在 4128900 例妊娠合并 VTE 中，4267 例（大多数为单纯性深静脉血栓形成，61.8%，2637 例），25.8%为单纯性肺栓塞（1103 例），12.4%（527 例）为两者均有。在整个队列中，3328 人在 6 个月时保留了保险覆盖范围，2823 人在 12 个月时保留了保险覆盖范围，2161 人在 24 个月时保留了保险覆盖范围，831 人在 60 个月时保留了保险覆盖范围。在单纯性深静脉血栓形成患者中，血栓后综合征的风险在 6 个月时为 0.7%（17 例），12 个月时为 1.1%（22 例），24 个月时为 1.7%（26 例），60 个月时为 2.7%（16 例）。在诊断为肺栓塞的女性中，慢性 PE 的风险在 6 个月时为 2.4%（30 例），12 个月时为 3.3%（36 例），24 个月时为 4.2%（36 例），60 个月时为 7.2%（24 例）。
与一般人群相比，血栓后综合征的风险较低。相比之下，在 PE 事件发生后可比时间点，慢性 PE 的风险与一般人群中的估计值相似。对于患有产科性肺栓塞的女性，可能需要警惕与慢性 PE 相关的发现和症状。
·产后深静脉血栓形成后血栓后综合征的风险较低。·慢性肺栓塞的风险可能与一般人群相似。·妊娠合并 VTE 后慢性并发症的总体风险相对较低。
