Hypertensive Complications of Pregnancy and Risk of Venous Thromboembolism

Abstract

Hypertension during pregnancy and preeclampsia are associated with increased arterial thrombotic risk in later life. Whether these complications are associated with risk of venous thromboembolism (VTE) on the short term after pregnancy and on the long term, that is, outside pregnancy, is largely unknown. We conducted a nationwide cohort study in women with at least 1 pregnancy and their first VTE risk by linking the Dutch perinatal registry (Perined) to anticoagulation clinics. We used Cox proportional hazard models to estimate hazard ratios (HRs) and corresponding 95% CI for VTE risk in women with hypertension during pregnancy, women with preeclampsia, compared with women with uncomplicated pregnancies (reference). A total of 1 919 918 women were followed for a median of 13.7 (interquartile range, 7.6–19.2) years for a total of 24 531 118 person-years in which 5759 first VTEs occurred; incidence rate: 2.3 (95% CI, 2.3–2.4) per 10 000 person-years. In the first pregnancy and 3-month postpartum period, VTE risk was higher in women with hypertension, HR, 2.0 (95% CI, 1.7–2.4), and highest among women with preeclampsia, HR, 7.8 (95% CI, 5.4–11.3), versus the reference group. On the long term, women with hypertension during pregnancy and preeclampsia had a higher VTE risk: HR, 1.5 (95% CI, 1.4–1.6) and HR, 2.1 (95% CI, 1.8–2.4), respectively, versus the reference group. When excluding events during pregnancy and postpartum, these HRs were 1.4 (95% CI, 1.3–1.5) and 1.6 (95% CI, 1.4–2.0), respectively. In conclusion, hypertension during pregnancy and preeclampsia are associated with an increased VTE risk during pregnancy and postpartum period and in the 13 years after.

Planned Pregnancy in Kidney Transplantation. A Calculated Risk

“…Hormonal methods may be safe in women with stable graft function but are not recommended in women with hypertension or risk of thrombosis. Indeed, arterial hypertension during pregnancy is associated with increased arterial thrombotic risk [9]. All combined oral contraceptives investigated in an analysis were associated with an increased risk of venous thrombosis; the effect size depended both on the progestogen used and the dose of ethinylestradiol [10].…”

Factores de riesgo y clasificación de riesgo para enfermedad tromboembólica en mujeres posparto

“…El tromboembolismo venoso es una de las principales causas de morbilidad y mortalidad en gestantes ( 13), siendo más común en el embarazo y periodo posparto (14), debido al estado de hipercoagulabilidad que acompaña de forma fisiológica a la gestación como prevención de la hemorragia posparto (15). Múltiples factores de riesgo han sido identificados en el puerperio como causas de eventos trombóticos (16), entre estos se puede observar: un índice de masa corporal mayor a 25, inmovilidad, parto pretérmino, preeclampsia, hipertensión arterial, cesárea, infección posparto y hemorragia posparto (13,17).…”

CNN-Based LCD Transcription of Blood Pressure From a Mobile Phone Camera

“…In LMICs, results showed that overall 10-15% of direct maternal deaths are associated with preeclampsia (Khan et al, 2006;Duley, 2009). Hypertensive disorders of pregnancy includes chronic hypertension, gestational hypertension, and preeclampsia, and there is substantial evidence that these lead to adverse outcomes both during pregnancy and after birth (Berends et al, 2008;Rich-Edwards et al, 2010;Melchiorre et al, 2011;Mosca et al, 2011;Powers et al, 2012;Catov et al, 2013;Parikh et al, 2017;Whelton et al, 2018;Haas et al, 2019;Bergman et al, 2020;Boardman et al, 2020;Gooding et al, 2020;Scheres et al, 2020;Wu et al, 2020).…”