School of Medicine and Health Sciences Poster Presentations

Title

Predicting Venous Thromboembolism in Obese Pregnant Women in a National Study

Document Type

Poster

Abstract Category

Women/Child Health

Keywords

Pregnancy, Venous Thromboembolism, Obesity, Women

Publication Date

Spring 5-1-2019

Abstract

Venous thromboembolism (VTE) in pregnancy and postpartum is a leading cause of maternal morbidity and mortality in developed countries, where obesity is a known risk for this complication. Current guidelines vary in which patients qualify for VTE prophylaxis, precluding a uniform approach for management. The purpose of this study was to derive a risk prediction model for VTE in obese pregnant women. We performed a retrospective cohort analysis using the Consortium on Safe Labor (CSL) database. The CSL includes detailed information from the electronic medical record for >200,000 deliveries from 19 hospitals across the United States from 2002 through 2008. Women ages 16-45 who were pregnant with singletons and had an obese body mass index (BMI>30kg/m2) were included in our study population. Maternal characteristics and preexisting conditions as well as pregnancy-related conditions and complications were analyzed to identify differences between those had a VTE and those who did not. Multivariable logistic regression was used in order to identify predictors of VTE. Of the 83,500 women who met inclusion criteria, on average women were 27.8 ± 6.0 years old, 38.6 ± 2.21 weeks gestation, with BMI of 35.8 ± 5.45 kg/m2, and cesarean delivery (CD) incidence of 35.2%. The racial makeup of our cohort was 45.1% Caucasian, 27.2% African American and 20.2% Hispanic women. 109 women (0.13%) experienced a VTE event. Independent predictors of VTE in our final multivariable predictive model included: mode of delivery, BMI, pregestational diabetes, chronic heart disease, preeclampsia, blood transfusion (intrapartum or postpartum), prenatal history of thromboembolic disorder, and postpartum maternal length of stay. A receiver operating characteristic curve was developed to assess the model; area under the curve was 0.826. We developed a strong predictive model using a large, retrospective database to distinguish risk of VTE in obese pregnant women, which may provide the foundation for future protocol development of obstetrical thromboprophylaxis in obese women.

Open Access

1

Comments

Presented at Research Days 2019.

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Predicting Venous Thromboembolism in Obese Pregnant Women in a National Study

Venous thromboembolism (VTE) in pregnancy and postpartum is a leading cause of maternal morbidity and mortality in developed countries, where obesity is a known risk for this complication. Current guidelines vary in which patients qualify for VTE prophylaxis, precluding a uniform approach for management. The purpose of this study was to derive a risk prediction model for VTE in obese pregnant women. We performed a retrospective cohort analysis using the Consortium on Safe Labor (CSL) database. The CSL includes detailed information from the electronic medical record for >200,000 deliveries from 19 hospitals across the United States from 2002 through 2008. Women ages 16-45 who were pregnant with singletons and had an obese body mass index (BMI>30kg/m2) were included in our study population. Maternal characteristics and preexisting conditions as well as pregnancy-related conditions and complications were analyzed to identify differences between those had a VTE and those who did not. Multivariable logistic regression was used in order to identify predictors of VTE. Of the 83,500 women who met inclusion criteria, on average women were 27.8 ± 6.0 years old, 38.6 ± 2.21 weeks gestation, with BMI of 35.8 ± 5.45 kg/m2, and cesarean delivery (CD) incidence of 35.2%. The racial makeup of our cohort was 45.1% Caucasian, 27.2% African American and 20.2% Hispanic women. 109 women (0.13%) experienced a VTE event. Independent predictors of VTE in our final multivariable predictive model included: mode of delivery, BMI, pregestational diabetes, chronic heart disease, preeclampsia, blood transfusion (intrapartum or postpartum), prenatal history of thromboembolic disorder, and postpartum maternal length of stay. A receiver operating characteristic curve was developed to assess the model; area under the curve was 0.826. We developed a strong predictive model using a large, retrospective database to distinguish risk of VTE in obese pregnant women, which may provide the foundation for future protocol development of obstetrical thromboprophylaxis in obese women.