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Maternal Body Mass Index and the Risk of Antepartum and Postpartum Venous Thromboembolism
Abstract Number: T2A-1
Abstract Type: Original Research
Introduction: Maternal obesity is considered to be an important risk factor for venous thromboembolism (VTE).(1,2) However, the relations between maternal body mass index (BMI) and pregnancy-related VTE have been poorly examined. We sought to characterize the associations between maternal BMI and the risk of VTE among pregnancy-related hospitalizations.
Methods: We performed a retrospective cohort study of women with singleton pregnancies who underwent delivery in California between 2008 and 2012. VTE events during antepartum and postpartum hospitalizations were identified using ICD-9 codes. For our main exposure of interest, pre-pregnancy BMI was categorized using WHO criteria for adult underweight, overweight, and obesity class 1,2, and 3. Multivariate logistic regression was performed for determining adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the associations between BMI class with antepartum VTE and postpartum VTE, respectively.
Results: Our study cohort comprised 2,459,346 deliveries. The event rate for antepartum VTE and postpartum VTE was 4 per 10,000 deliveries and 4 per 10,000 deliveries, respectively. Compared to normal BMI, the adjusted odds of antepartum VTE were increased for overweight and obese class 1,2,and 3 groups, with the highest odds observed for obesity class 3 women (aOR=2.87; 95% CI=2.22-3.70) (Table). The odds of postpartum VTE were relatively higher in these BMI groups, with obese class 3 women being at highest risk (aOR=3.20; 95% CI=2.51-4.06) compared to normal BMI women (Table).
Conclusion: The risk of VTE during antepartum or postpartum hospitalization is positively associated with prepregnancy BMI. Findings from this analysis may inform strategies to limit VTE risk among women requiring antepartum or postpartum hospitalization.
References: (1) BMJ 2013;347:f6099; (2) Am J Obstet Gynecol 2013;209:433 e1-8.