OC 31.3 - Incidence and time trends over 33-years in pregnancy-related venous thromboembolism – a nationwide register-based study of Swedish women.

Monday, June 24, 2024

10:00 - 10:15 ICT

Room: Ballroom B1

Co-Author(s)

JP

Jacob Philipson, MD

Attending physician/MD
Region Västra Götaland, Sahlgrenska University Hospital/Östra, Department of Medicine, Geriatrics and Emergency Medicine, Gothenburg, Sweden.
Gothenburg, Vastra Gotaland, Sweden

Co-Author(s)

ET

Erik Thunström

Associate professor
Region Västra Götaland, Sahlgrenska University Hospital/Östra, Department of Medicine, Geriatrics and Emergency Medicine, Gothenburg, Sweden.
Gothenburg, Vastra Gotaland, Sweden
EW

Eli Westerlund

Associate professor
Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden
Stockholm, Stockholms Lan, Sweden
TS

Teresia Svanvik

MD/PhD
Region Västra Götaland, Sahlgrenska University Hospital/Ostra, Department of Obstetrics, Gothenburg, Sweden
Gothenburg, Vastra Gotaland, Sweden
HN

Henrik Norrsell

Consultant
Region Västra Götaland, Sahlgrenska University Hospital/Östra, Department of Medicine, Geriatrics and Emergency Medicine, Gothenburg, Sweden
Gothenburg, Vastra Gotaland, Sweden
MH

Margareta Hellgren

Professor
Region Västra Götaland, Sahlgrenska University Hospital/Ostra, Department of Obstetrics, Gothenburg, Sweden
Gothenburg, Vastra Gotaland, Sweden
PH

Per-Olof Hansson

Associate professor
Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Gothenburg, Vastra Gotaland, Sweden

Presenting Author(s)

Katarina Glise Sandblad, MD, PhD

Attending physician
Region Västra Götaland, Sahlgrenska University Hospital/Östra, Department of Medicine, Geriatrics and Emergency Medicine, Gothenburg, Sweden.
Göteborg, Vastra Gotaland, Sweden

Background: It is unknown if the increasing use of thromboprophylaxis is associated with a decrease in the incidence of pregnancy-related venous thromboembolism (VTE) over time.

Aims: We aimed to investigate time trends in the incidence rate of first-time pregnancy-related VTE and fatal pulmonary embolism (PE) over three decades.

Methods: A nationwide register-based cohort study including all women (12-55 years old) who gave birth to a living child in Sweden 1987-2019. Data from the Swedish National Registers were used to identify outcome events. Joinpoint analysis, featuring Annual Percent Change (APC) and Confidence Interval (CI), was employed for time trends.

Results: The study comprised 3,434,505 women, including 4,198 women with a first pregnancy-associated VTE. Among cases, 27.3% had a PE, and 72.7% had a deep venous thrombosis (DVT). The overall incidence of pregnancy-associated VTE was 1.2/1000 deliveries, including a PE-incidence of 0.3/1000 deliveries, and DVT-incidence of 0.9/1000.
Time trend analysis for pregnancy-associated DVT identified a significantly increasing incidence during 1987-1995 (APC of 5.2% (CI 1.2% – 9.3%)). However, from 1995-2019, a significant decreasing trend emerged (APC of -1.3% (CI -2.1% – -0.6%)). The incidence of first pregnancy-associated PE demonstrated a significant increase from 1987 to 2019 (APC of 4.0% (CI 3.1% – 4.8%)). Pregnancy-associated VTE incidence displayed an increasing trend from 1987 to 1996 (APC of 4.3% (CI 1.4% - 7.3%)), after which no significant changes were observed. The prescription of low molecular weight heparin during pregnancy and postpartum exhibited a notable increase from 2005-2019.

Conclusion(s): The incidence of first pregnancy-related PE exhibited a significant upward trend during the study period, whereas DVT incidence decreased from 1995. Although there was an increase in the prescription of low molecular weight heparin during pregnancy and postpartum, no significant change in pregnancy-related VTE was observed during the last two decades.