Incidence and risk patterns of venous thromboembolism in pregnancy and puerperium - a register-based case-control study
Incidence and risk patterns of venous thromboembolism in pregnancy and puerperium - a register-based case-control study
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DOI：
10.1016/j.ajog.2007.08.041
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发表时间：
2008-02-01
影响因子：
9.8
通讯作者：
Sandset, Per Morten
中科院分区：
文献类型：
--
作者：
Jacobsen, Anne Flem;Skjeldestad, Finn Egil;Sandset, Per Morten
目的：本研究旨在评估妊娠期和产褥期静脉血栓栓塞症的发病率，并确定妊娠相关静脉血栓栓塞症的危险因素。研究设计：一项基于登记的病例对照研究，1990-2003年挪威11个县的613,232例妊娠。对合格病例的病历进行了重新访问，并将相关医疗数据转移到特定病例报告表中。静脉血栓栓塞症的诊断是基于严格的标准。结果：共检出615例，其中男性615例，女性615例。静脉血栓栓塞的发生率为1/1000例妊娠。产前和产后的发病率非常相似。妊娠危险因素包括辅助生殖、妊娠期糖尿病、年龄大于35岁、多胎妊娠和产次过短。产后危险因素为剖宫产、先兆子痫、辅助生殖、胎盘前置、前置胎盘。结论：我们发现了不同的产前和产后危险模式。辅助生殖和妊娠期糖尿病是重要的产前危险因素，而剖宫产和先兆子痫是强大的产后危险因素。
OBJECTIVE: This study was undertaken to estimate the incidence of venous thromboembolism in pregnancy and puerperium and to identify risk factors for pregnancy-related venous thromboembolism.STUDY DESIGN: A register-based case-control study with 613,232 pregnancies from 1990-2003 in 11 Norwegian counties. Medical records for eligible cases were revisited and relevant medical data were transferred to a specific case-report form. The diagnosis of venous thromboembolism was based on strict criteria. Data were analyzed by chi(2) test and forward stepwise logistic regression.RESULTS: In total, 615 cases were detected. The incidence of venous thromboembolism was 1 per 1000 pregnancies. The ante-and postnatal incidences were quite similar. Antenatal risk factors were assisted reproduction, gestational diabetes, age older than 35 years, multiple pregnancies, and primi-parity. Postnatal risk factors were cesarean section, preeclampsia, assisted reproduction, abruptio placenta, and placenta previa.CONCLUSION: We found different ante- and postnatal risk patterns. Assisted reproduction and gestational diabetes were significant antenatal risk factors; whereas cesarean section and preeclampsia were strong postnatal risk factors.