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. 2024 Jan-Dec:30:10760296241247203.
doi: 10.1177/10760296241247203.

Venous Thromboembolism Risk Factors in Women With Obesity Who Undergo Cesarean Delivery

Tolulope B Fatokun  1 , Sarah E Swartz  2 , Ahmed Ebeid  2 , Sophia A Cordes  2 , Alexis C Gimovsky  3 , Andrew D Sparks  4 , Richard L Amdur  5 , Homa K Ahmadzia  2
Affiliations

Venous Thromboembolism Risk Factors in Women With Obesity Who Undergo Cesarean Delivery

Tolulope B Fatokun et al. Clin Appl Thromb Hemost. 2024 Jan-Dec.

Abstract

Venous thromboembolism (VTE) is a leading cause of maternal mortality. Obesity and cesarean delivery are established risk factors for pregnancy-related VTE. We identified additional risk factors among patients with obesity who underwent a cesarean delivery to identify those who need VTE prophylaxis. We conducted a secondary analysis of data from the Maternal-Fetal Medicine Units Network (MFMU) Cesarean Registry Database using a case-control design. Cases were identified as women with obesity having a pre-pregnancy body mass index of >30 kg/m2, who underwent cesarean delivery and subsequently developed deep venous thrombosis (DVT) or pulmonary embolism (PE). These women were compared to a control group of women with obesity who underwent cesarean delivery but did not develop DVT or PE. Analysis of risk factors associated with VTE was performed using Chi-Square test and Fisher's exact test. We identified 43 VTE cases and 172 controls in the MFMU database. Increased risk of VTE was noted in women with endometritis (OR of 4.58 [95% CI: 1.86-11.2, P = .0004]), receiving a blood transfusion (OR 17.07 [95% CI: 4.46-65.3, P = .0001]), having a coagulopathy (OR 27.73 [95% CI: 3.24-237.25, P = .0003]), and urinary tract infection (OR 2.39 [95% CI: 1.08-5.28, P = .03]). Important risk factors for VTE in women with obesity who undergo cesarean delivery include endometritis, intra- or post-operative transfusion, coagulopathy, and urinary tract infection. The presence of one or more of these factors may help guide provider decision-making regarding whether to administer thromboprophylaxis.

Keywords: anticoagulation prophylaxis; cesarean delivery; obesity; venous thromboembolism.

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Conflict of interest statement

Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

    1. Creanga AA, Syverson C, Seed K, Callaghan WM. Pregnancy-related mortality in the United States, 2011–2013. Obstet Gynecol. 2017;130(2):366-373. - PMC - PubMed
    1. American College of Obstetricians and Gynecologists. Thromboembolism in pregnancy. ACOG Pract bull. 2011;19.
    1. Sultan AA, Tata LJ, West Jet al. et al. Risk factors for first venous thromboembolism around pregnancy: a population-based cohort study from the United Kingdom. Blood, J Am Soc Hematol. 2013;121(19):3953-3961. - PubMed
    1. Blondon M, Harrington LB, Boehlen F, Robert-Ebadi H, Righini M, Smith NL. Pre-pregnancy BMI, delivery BMI, gestational weight gain and the risk of postpartum venous thrombosis. Thromb Res. 2016;145:151-156. - PubMed
    1. Callaghan WM. Overview of maternal mortality in the United States. Semin Perinatol. 2012;36(1):2-6. - PubMed

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