Venous thromboembolism during pregnancy and the postpartum period, France, 2009–2014.
Introduction: Venous thromboembolism (VTE) is one of the leading complications of pregnancy and the second leading direct cause of maternal mortality. However, there are no recent data on perinatal incidence in France. The primary objective of this study was to estimate the annual incidence of pulmonary embolism (PE) and hospitalized VTE during pregnancy and within 18 weeks postpartum. Methods: The incidence of hospitalized VTE was estimated using data from the PMSI-MCO linked with individual data from Sniiram. This incidence was estimated annually, separately for PE and for VTE overall. A Poisson regression was used to examine risk factors for PE or VTE during pregnancy or the postpartum period and trends between 2009 and 2014. Results: In 2013, the incidence of PE and hospitalized VTE in France was 0.49 and 1.51 per 1,000 woman-years during pregnancy, and 1.06 and 2.65 per 1,000 woman-years during the postpartum period, respectively. The incidence of PE and VTE increased steadily throughout the three trimesters of pregnancy, peaking in the week following delivery. An increased risk of thromboembolism persisted for at least 10 weeks after delivery. The incidence of PE and, more broadly, VTE during pregnancy and the postpartum period increased significantly between 2009 and 2014. Age over 35 years, multiple pregnancies, a history of VTE, cesarean delivery, extreme prematurity, and intrauterine fetal death were the main risk factors for thromboembolism during pregnancy and the postpartum period. Conclusion: VTE is a potentially preventable condition. Implementing appropriate prevention requires careful, individualized identification of risk factors in pregnant women. Further studies are needed to assess the duration of the risk period during the postpartum period, which appears to persist beyond the six weeks traditionally considered to be at risk.
Author(s): Olie V, Moutengou E, Barry Y, Deneux Tharaux C, Pessione F, Plu Bureau G
Publishing year: 2016
Pages: 139-47
Weekly Epidemiological Bulletin, 2016, n° 7-8, p. 139-47
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