A systematic review and meta-analysis of the epidemiology and burden of venous thromboembolism among pregnant women

Abstract

Background: Pregnancy-related venous thromboembolism (VTE) is one of the leading causes of maternal morbidity and mortality.

Objectives: To review the epidemiology, and humanistic and economic burden of pregnancy-related VTE.

Search strategy: Medline, the Cochrane Central Register of Controlled Trials, Econlit, Science Direct, JSTOR, Oxford Journals, and Cambridge Journals were searched for reports published between January 2000 and December 2012. Keywords related to VTE, pregnancy, and epidemiology and the humanistic and economic burdens were combined.

Selection criteria: Eligible studies evaluated the incidence, mortality, recurrence, complications, quality-of-life, and economic burden of VTE among pregnant women, and had been published in English.

Data collection and analysis: Background information of the study, participants' characteristics, and study outcomes were collected. Meta-analyses of data were performed.

Main results: Twenty studies were included, none of which investigated the economic burden. The pooled overall incidence of pregnancy-related VTE was 1.2 per 1000 deliveries. The pooled VTE case fatality rate was 0.68% and the recurrence rate was 4.27%. The pooled risk of major bleeding was 1.05%. Post-thrombotic syndrome seemed to have a negative effect on quality of life.

Conclusions: Although the incidence of VTE was found to be relatively low during pregnancy and the postpartum period, the clinical burden is high. Further research is required to assess the economic burden of pregnancy-relate VTE.

Keywords: Bleeding; Case fatality; Humanistic burden; Maternal morbidity; Pregnancy; Quality of life; Recurrence; Thrombosis.