Paper

Research pointers

Risk of subsequent thromboembolism for patients with pre-eclampsia

BMJ 2003; 326 doi: 10.1136/bmj.326.7393.791 (Published 12 April 2003)
Cite this as: BMJ 2003;326:791
  1. Carl van Walraven, scientist (carlv@ohri.ca)a,
  2. Muhammad Mamdani, scientistb,
  3. Adam Cohn, residentc,
  4. Yasir Katib, residentc,
  5. Mark Walker, associate scientista,
  6. Marc A Rodger, associate scientista
  1. a Thrombosis of placental vessels causes pre-eclampsia. Women with pre-eclampsia had an increased risk of subsequent venous thromboembolism Ottawa Health Research Institute, Ottawa, Canada K1Y 4E9
  2. b Institute for Clinical Evaluative Sciences, Toronto, Canada M4N 3N5
  3. c University of Ottawa, Ottawa, Canada K1H 8M5
  1. Correspondence to: C van Walraven
  • Accepted 2 August 2002

Inherited thrombophilias affect over 16% of people and predispose them to venous thromboembolism.1 Pre-eclampsia is associated with occlusion of the placental spiral arteries.2 Thrombophilias may cause thrombosis of placental vessels,3 thereby explaining the link between thrombophilia and pre-eclampsia. 4 5 We tested the hypothesis that women with pre-eclampsia have a higher risk of subsequent venous thromboembolism.

Participants, methods, and results

The study was approved by our research ethics board and took place in Ontario, Canada, where all hospital services are publicly funded. We used an administrative database that is based on anonymised populations and which records all hospitalisations from 1 April 1988 onwards. All discharges between 1 April 1990 and 1 January 1994 with a primary ICD-9 (international classification of diseases, 9th revision) code of pre-eclampsia, severe pre-eclampsia, eclampsia, or toxaemia were identified (see appendix A on bmj.com). These codes had a sensitivity of 89% (95% confidence interval 78% to 94%) and a …

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