Background Women of childbearing age are exposed to venous thromboembolic risk mainly for pregnancy and use of oral contraceptives. The impact of risk factors (RF) on venous thromboembolism ( VTE) in these circumstances is still unclear. Aim In the context of START registry, we aimed to investigate the weight of a series of RF on the occurrence of pregnancy- or combined oral contraceptive (COC)-associated VTE. Methods and Materials We selected all women included in the START for VTE occurred between 18-42 years and compared those with a first or recurrent pregnancy/ postpartum- (group A) or COC-VTE (group B) with those who had VTE outside these circumstances (group C). Final analysis included a cohort of 532 women. Follow-up data showed that there were no significant differences between the groups in terms of thrombotic and haemorrhagic complications. As for pregnancy-associated VTE, the overall outcome was good in terms of both maternal and fetal prognosis. Results In a binarymodel of logistic regression, correcting for potential confounders, VTE family history conferred a significant and independent higher risk of COC-VTE compared with group C. Similarly, comparison between group A and C documented that family history significantly affected the risk of pregnancy-associated VTE. VTE in the group C was significantly associated with older age. Lastly, smoke was a significant risk factor for pregnancy/ postpartum VTE when group A and group B were compared. Conclusion Present data suggest that in the setting of fertile women, family history of VTE has a greater role in predicting COC- and pregnancy/ postpartum- VTE than outside these circumstances.

Venous thromboembolism in women of childbearing age: insights from the START registry

Grandone, Elvira
;
Colaizzo, Donatella;Margaglione, Maurizio;
2023-01-01

Abstract

Background Women of childbearing age are exposed to venous thromboembolic risk mainly for pregnancy and use of oral contraceptives. The impact of risk factors (RF) on venous thromboembolism ( VTE) in these circumstances is still unclear. Aim In the context of START registry, we aimed to investigate the weight of a series of RF on the occurrence of pregnancy- or combined oral contraceptive (COC)-associated VTE. Methods and Materials We selected all women included in the START for VTE occurred between 18-42 years and compared those with a first or recurrent pregnancy/ postpartum- (group A) or COC-VTE (group B) with those who had VTE outside these circumstances (group C). Final analysis included a cohort of 532 women. Follow-up data showed that there were no significant differences between the groups in terms of thrombotic and haemorrhagic complications. As for pregnancy-associated VTE, the overall outcome was good in terms of both maternal and fetal prognosis. Results In a binarymodel of logistic regression, correcting for potential confounders, VTE family history conferred a significant and independent higher risk of COC-VTE compared with group C. Similarly, comparison between group A and C documented that family history significantly affected the risk of pregnancy-associated VTE. VTE in the group C was significantly associated with older age. Lastly, smoke was a significant risk factor for pregnancy/ postpartum VTE when group A and group B were compared. Conclusion Present data suggest that in the setting of fertile women, family history of VTE has a greater role in predicting COC- and pregnancy/ postpartum- VTE than outside these circumstances.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11369/439792
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