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Risk of first venous thromboembolism in pregnant women in hospital: population based cohort study from England

Objective To examine the potential for preventing venous thromboembolism during and after antepartum hospital admissions in pregnant women. Design Cohort study using linked primary (Clinical Practice Research Datalink) and secondary (Hospital Episode Statistics) care records. Setting Primary and sec...

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Autores principales: Abdul Sultan, Alyshah, West, Joe, Tata, Laila J, Fleming, Kate M, Nelson-Piercy, Catherine, Grainge, Matthew J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group Ltd. 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3898207/
https://www.ncbi.nlm.nih.gov/pubmed/24201164
http://dx.doi.org/10.1136/bmj.f6099
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author Abdul Sultan, Alyshah
West, Joe
Tata, Laila J
Fleming, Kate M
Nelson-Piercy, Catherine
Grainge, Matthew J
author_facet Abdul Sultan, Alyshah
West, Joe
Tata, Laila J
Fleming, Kate M
Nelson-Piercy, Catherine
Grainge, Matthew J
author_sort Abdul Sultan, Alyshah
collection PubMed
description Objective To examine the potential for preventing venous thromboembolism during and after antepartum hospital admissions in pregnant women. Design Cohort study using linked primary (Clinical Practice Research Datalink) and secondary (Hospital Episode Statistics) care records. Setting Primary and secondary care centres, England. Participants 206 785 women aged 15-44 who had one or more pregnancies from1997 up to 2010. Main outcome measure Risk of first venous thromboembolism in pregnant women admitted to hospital for one or more days for reasons other than delivery or venous thromboembolism. Risk was assessed by calculating the absolute rate of venous thromboembolism and comparing these rates with those observed during follow-up time not associated with hospital admission using a Poisson regression model to estimate incidence rate ratios. Results Admission to hospital in pregnancy was associated with an increased risk of venous thromboembolism (absolute rate 1752/100 000 person years; incidence rate ratio 17.5, 95% confidence interval 7.69 to 40.0) compared with time outside hospital. The rate of venous thromboembolism was also high during the 28 days after discharge (absolute rate 676; 6.27, 3.74 to 10.5). The rate during and after admission combined was highest in the third trimester (961; 5.57, 3.32 to 9.34) and in those aged ≥35 years (1756; 21.7, 9.62 to 49.0). While the absolute rate in the combined period was highest for those with three or more days in hospital (1511; 12.2, 6.65 to 22.7), there was also a fourfold increase (558; 4.05, 2.23 to 7.38) in the risk of venous thromboembolism for those admitted to hospital for less than three days. Conclusion The overall risk of first venous thromboembolism in pregnant women increased during admissions to hospital not related to delivery, and remained significantly higher in the 28 days after discharge. During these periods need for thromboprophylaxis should receive careful consideration.
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spelling pubmed-38982072014-02-19 Risk of first venous thromboembolism in pregnant women in hospital: population based cohort study from England Abdul Sultan, Alyshah West, Joe Tata, Laila J Fleming, Kate M Nelson-Piercy, Catherine Grainge, Matthew J BMJ Research Objective To examine the potential for preventing venous thromboembolism during and after antepartum hospital admissions in pregnant women. Design Cohort study using linked primary (Clinical Practice Research Datalink) and secondary (Hospital Episode Statistics) care records. Setting Primary and secondary care centres, England. Participants 206 785 women aged 15-44 who had one or more pregnancies from1997 up to 2010. Main outcome measure Risk of first venous thromboembolism in pregnant women admitted to hospital for one or more days for reasons other than delivery or venous thromboembolism. Risk was assessed by calculating the absolute rate of venous thromboembolism and comparing these rates with those observed during follow-up time not associated with hospital admission using a Poisson regression model to estimate incidence rate ratios. Results Admission to hospital in pregnancy was associated with an increased risk of venous thromboembolism (absolute rate 1752/100 000 person years; incidence rate ratio 17.5, 95% confidence interval 7.69 to 40.0) compared with time outside hospital. The rate of venous thromboembolism was also high during the 28 days after discharge (absolute rate 676; 6.27, 3.74 to 10.5). The rate during and after admission combined was highest in the third trimester (961; 5.57, 3.32 to 9.34) and in those aged ≥35 years (1756; 21.7, 9.62 to 49.0). While the absolute rate in the combined period was highest for those with three or more days in hospital (1511; 12.2, 6.65 to 22.7), there was also a fourfold increase (558; 4.05, 2.23 to 7.38) in the risk of venous thromboembolism for those admitted to hospital for less than three days. Conclusion The overall risk of first venous thromboembolism in pregnant women increased during admissions to hospital not related to delivery, and remained significantly higher in the 28 days after discharge. During these periods need for thromboprophylaxis should receive careful consideration. BMJ Publishing Group Ltd. 2013-11-07 /pmc/articles/PMC3898207/ /pubmed/24201164 http://dx.doi.org/10.1136/bmj.f6099 Text en © Abdul Sultan et al 2013 http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/.
spellingShingle Research
Abdul Sultan, Alyshah
West, Joe
Tata, Laila J
Fleming, Kate M
Nelson-Piercy, Catherine
Grainge, Matthew J
Risk of first venous thromboembolism in pregnant women in hospital: population based cohort study from England
title Risk of first venous thromboembolism in pregnant women in hospital: population based cohort study from England
title_full Risk of first venous thromboembolism in pregnant women in hospital: population based cohort study from England
title_fullStr Risk of first venous thromboembolism in pregnant women in hospital: population based cohort study from England
title_full_unstemmed Risk of first venous thromboembolism in pregnant women in hospital: population based cohort study from England
title_short Risk of first venous thromboembolism in pregnant women in hospital: population based cohort study from England
title_sort risk of first venous thromboembolism in pregnant women in hospital: population based cohort study from england
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3898207/
https://www.ncbi.nlm.nih.gov/pubmed/24201164
http://dx.doi.org/10.1136/bmj.f6099
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