Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands; Amsterdam Cardiovascular Sciences, Pulmonary Hypertension & Thrombosis, Amsterdam, Netherlands.
Department of Clinical Epidemiology, Aarhus University Hospital-Aarhus, Aarhus, Denmark.
Lancet Haematol. 2023 May;10(5):e359-e366. doi: 10.1016/S2352-3026(23)00013-3. Epub 2023 Mar 24.
The incidence of superficial vein thrombosis (SVT) of the legs and the subsequent risk of venous thromboembolism during pregnancy and the post-partum period is unknown. To better understand the clinical course of SVT during these times, we aimed to estimate the incidence rate of SVT during pregnancy and in the post-partum period, as well as the risk of subsequent venous thromboembolism.
In this nationwide cohort study, we collected data on all pregnant women who delivered between Jan 1, 1997, and Dec 31, 2017, in Denmark were extracted from the Danish Medical Birth Register, the Danish National Patient Registry, and the Danish National Prescription Registry. Data on ethnicity were not available. Incidence rates per 1000 person-years were calculated for each trimester and the antepartum and post-partum period. Among women with a pregnancy-related SVT, risk of subsequent venous thromboembolism within the same pregnancy or post-partum period were calculated and compared with a matched cohort of pregnant women without SVT using Cox proportional hazards analysis.
During 1 276 046 deliveries, 710 diagnoses of lower extremity SVT occurred from conception up to 12 weeks postpartum (0·6 per 1000 person-years [95% CI 0·5-0·6]). The incidence rates of SVT per 1000 person-years were 0·1 (95% CI 0·1-0·2) during the during the first trimester, 0·2 (0·2-0·3) during the second trimester, and 0·5 (0·5-0·6) during the third trimester. The incidence rate was 1·6 per 1000 person-years (95% CI 1·4-1·7) during the post-partum period. Of the 211 women with antepartum SVT included in the analysis, 22 (10·4%) were diagnosed with venous thromboembolism, compared with 25 (0·1%) in women without SVT (hazard ratio 83·3 [95% CI 46·3-149·7]).
The incidence rate of SVT during pregnancy and the post-partum period was low. However, if SVT during pregnancy was diagnosed, the risk of developing venous thromboembolism during the same pregnancy was high. These results might help physicians and patients to make decisions about anticoagulant management of pregnancy-related SVT.
None.
腿部浅表静脉血栓形成（SVT）的发生率以及妊娠和产后期间静脉血栓栓塞的风险尚不清楚。为了更好地了解这些时期 SVT 的临床病程，我们旨在估计妊娠和产后期间 SVT 的发生率，以及随后发生静脉血栓栓塞的风险。
在这项全国性队列研究中，我们从丹麦的丹麦医学出生登记处、丹麦国家患者登记处和丹麦国家处方登记处中收集了 1997 年 1 月 1 日至 2017 年 12 月 31 日期间分娩的所有孕妇的数据。数据中不包括种族信息。计算了每个孕早期、产前和产后期间每 1000 人年的发生率。对于妊娠相关 SVT 的女性，计算了同一妊娠或产后期间发生静脉血栓栓塞的风险，并与无 SVT 的妊娠女性匹配队列进行比较，使用 Cox 比例风险分析。
在 1276046 次分娩中，有 710 例下肢 SVT 的诊断是在受孕后至产后 12 周内发生的（每 1000 人年 0.6 例[95%CI 0.5-0.6]）。每 1000 人年的 SVT 发生率分别为 0.1（95%CI 0.1-0.2）、0.2（0.2-0.3）和 0.5（0.5-0.6）。产后期间的发生率为 1.6 例（95%CI 1.4-1.7）。在纳入分析的 211 例产前 SVT 女性中，有 22 例（10.4%）诊断为静脉血栓栓塞，而无 SVT 的女性中仅有 25 例（0.1%）（危险比 83.3[95%CI 46.3-149.7]）。
妊娠和产后期间 SVT 的发生率较低。然而，如果在妊娠期间诊断出 SVT，则同一妊娠期间发生静脉血栓栓塞的风险很高。这些结果可能有助于医生和患者决定对妊娠相关 SVT 进行抗凝管理。
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