Department of Obstetrics and Gynecology, Lis Maternity Hospital, Sourasky Medical Center, Tel Aviv, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Int J Gynaecol Obstet. 2023 Mar;160(3):962-968. doi: 10.1002/ijgo.14414. Epub 2022 Sep 4.
To determine the incidence and risk factors for pregnancy-associated venous thromboembolism (VTE).
An observational retrospective study was conducted using data from 452 176 live births between the years 2010 and 2019. The study group consisted of women who were diagnosed with VTE during pregnancy or the postpartum period. The exclusion criteria included women who purchased anticoagulant drugs during pregnancy or postpartum. The hazard ratios (HRs) of VTE per week of each trimester and the postpartum period were calculated.
A total of 421 125 live births were included in the study. Among the study population, 302 cases (0.71 cases/1000 pregnancies) were diagnosed with VTE during pregnancy and postpartum. The overall rates of diagnosis did not change significantly during the study period but followed a declining trend in the postpartum period. The highest risk of VTE was found to be during the third trimester (HR 0.002% per week, 95% confidence interval [CI] 0.0016-0.0023), while the lowest rate was during the postpartum period (HR 0.0007% per week, 95% CI 0.0004-0.0011).
Pregnancy and the puerperium are well-established risk factors for VTE. The present study demonstrates a declining trend in the risk and incidence of VTE during the postpartum period, which can be explained by a liberal and effective VTE prevention policy.
确定妊娠相关静脉血栓栓塞症（VTE）的发生率和危险因素。
采用 2010 年至 2019 年间 452176 例活产的观察性回顾性研究数据。研究组包括在妊娠或产后期间被诊断为 VTE 的女性。排除标准包括在妊娠或产后期间购买抗凝药物的女性。计算了每个孕早期、孕中期和产后期间每周 VTE 的风险比（HR）。
共纳入 421125 例活产。在研究人群中，302 例（0.71 例/1000 例妊娠）在妊娠和产后期间被诊断为 VTE。在研究期间，总体诊断率没有显著变化，但在产后期间呈下降趋势。VTE 的风险最高发生在孕晚期（HR 每周 0.002%，95%置信区间[CI] 0.0016-0.0023），而最低发生在产后期间（HR 每周 0.0007%，95%CI 0.0004-0.0011）。
妊娠和产褥期是 VTE 的明确危险因素。本研究表明，产后期间 VTE 的风险和发生率呈下降趋势，这可以用宽松有效的 VTE 预防政策来解释。
