Venous thromboembolism risk factors appeared highly prevalent among postpartum women at a Dublin hospital, according to results of a cross-sectional study published in Journal of Thrombosis and Haemostasis.
Researchers cited a need for further studies to determine the absolute risk for VTE associated with individual risk factors, the most appropriate mechanism to quantify overall VTE risk, and the risk threshold at which thromboprophylaxis should be initiated.
“Effective prevention of VTE is limited by a paucity of high-quality evidence,” Fergal O’Shaughnessy, pharmacist and PhD candidate at Rotunda Hospital in Dublin, and colleagues wrote. “Standardized interventions to reduce the risk for VTE at a population [level] have not been agreed [upon], and the proportion of women recommended postpartum thromboprophylaxis varies considerably among international guidelines.”
O’Shaughnessy and colleagues conducted a cross-sectional study of prospectively collected data from 21,019 women who gave birth between 2015 and 2017 at Rotunda Hospital. The number of women sampled consecutively represented 90% of all women gave birth at the hospital over a 3-year period.
Results showed the most common risk factors for postpartum VTE included overweight and obesity (36%), age 35 years or older (35%), and cesarean delivery (32%).
Most of the women sampled (78%) had at least one VTE risk factor, and more than 40% had two or more risk factors.
One-fifth of women had no risk factors before delivery but developed at least one VTE risk factor during the postpartum period.
The proportion of women from Rotunda Hospital who would have received a recommendation for postpartum thromboprophylaxis ranged between 7% and 37% under various international clinical guidelines.
Potential underreporting of VTE risk factors because of the omission of less common factors not included in the risk assessment tool served as the study’s primary limitation.
“[Postpartum] VTE risk is often multidimensional, highly individualized and complex,” O’Shaughnessy and colleagues wrote. “Strategies to prevent obstetric VTE should reflect the changing demographic of women of childbearing potential and changes in the delivery of maternity services.” – by John DeRosier
Disclosures: The authors report no relevant financial disclosures.