Original ArticlesThrombotic risk during pregnancy: a population study☆
Section snippets
Methods
Over 99% of deliveries in Sweden are registered in the national birth registry,9 and all patients who have been hospitalized (even if only overnight) are registered in the national patient registry. The national birth and patient registries were used to identify all women with pregnancy-related thromboses during the 4-year period 1990–1993. Pregnancy-related thrombosis was defined as deep-vein thrombosis or pulmonary embolism. The diagnosis numbers classified as thrombosis (according to
Results
The incidence of pregnancy-related thrombosis was 13 per 10,000 pregnancies. The results of bivariate analysis of explanatory variables are shown in Table 1. The results of logistic regression analysis of antepartum thrombosis are shown in Table 2. Only parity differed significantly in regard to risk of thrombosis, and neither preeclampsia nor advanced age (at least 35 years of age) was associated with increased risk of antepartum thrombosis.
The results of multiple logistic regression analysis
Discussion
A notable finding was that preeclampsia was associated with increased risk of thrombosis postpartum but not antepartum. The increased thrombin generation in preeclampsia has been assumed to be evidence for a prothrombotic state,10 but it has also been suggested that fibrinolysis is more pronounced than fibrin formation in women with severe preeclampsia.11 The routine recommendation of bed rest before and after delivery for women with preeclampsia might add to the risk of postpartum thrombosis.
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This study was supported by University Hospital in Malmö research funds.