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Observational Study
. 2019 Apr;126(5):581-588.
doi: 10.1111/1471-0528.15567. Epub 2018 Dec 19.

Prepregnancy maternal body mass index and venous thromboembolism: a population-based cohort study

A J Butwick  1 , J Bentley  2 , S A Leonard  3 , S L Carmichael  3 , Y Y El-Sayed  4 , O Stephansson  5   6 , N Guo  1
Affiliations
Observational Study

Prepregnancy maternal body mass index and venous thromboembolism: a population-based cohort study

A J Butwick et al. BJOG. 2019 Apr.

Abstract

Objective: To assess the relation between maternal body mass index (BMI) and pregnancy-related venous thromboembolism (VTE).

Design: Cohort study.

Setting and population: A total of 2 449 133 women with singleton pregnancies who underwent delivery hospitalisation in California between 2008 and 2012.

Methods: Association of pre-pregnancy BMI and the risk of an antepartum and postpartum VTE was examined using logistic regression, with normal BMI as reference.

Main outcome measures: Antepartum and postpartum VTE-related hospitalisation.

Results: The prevalence of antepartum and postpartum VTE increased with increasing BMI (antepartum: 2.3, 3.0, 3.8, 4.2, 4.7, and 10.6 per 10 000 women for underweight, normal BMI, overweight, obesity class I, II, and III, respectively, P < 0.001; postpartum: 2.0, 3.1, 3.9, 5.6, 9.0, and 13.2 per 10 000 women, P < 0.01). The adjusted odds of antepartum and postpartum VTE increased progressively with increasing BMI, with obesity class III women having the highest risk of pregnancy-related VTE compared with normal BMI women: adjusted odds ratio for antepartum VTE: 2.9; 95% CI 2.2-3.8 and adjusted odds ratio for postpartum VTE: 3.6; 95% CI 2.9-4.6.

Conclusions: Our findings clearly demonstrate an increasing risk of pregnancy-related VTE with increasing BMI.

Tweetable abstract: Obesity was associated with increased odds of antepartum and postpartum venous thromboembolism.

Keywords: Antepartum; body mass index; delivery; postpartum; pregnancy; venous thromboembolism.

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Conflict of interest statement

Disclosure of Interests: The authors declare no competing interests. Completed disclosure of interest forms are available to view online as supporting information.

Figures

Figure 1.
Figure 1.
Flow Diagram for the Study Cohort Examining the Relations between Maternal Body Mass Index and Antepartum Venous Thromboembolism
Figure 2.
Figure 2.
Prevalences of VTE among antepartum, delivery and postpartum cohorts
See this image and copyright information in PMC

Comment in

References

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