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Pre‐Existing and Gestational Diabetes and Risk of Maternal Venous Thromboembolism: A Systematic Review and Meta‐Analysis of Observational Studies
Author(s) -
Orrin Molly,
Barber Emilia,
Grainge Matthew J.
Publication year - 2025
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.18043
Subject(s) - medicine , gestational diabetes , obstetrics , observational study , pregnancy , diabetes mellitus , meta analysis , relative risk , gestation , confidence interval , endocrinology , genetics , biology
ABSTRACT Background Women who are pregnant are at increased risk of venous thromboembolism (VTE), which persists for up to 3 months following childbirth. Diabetes is known to increase the risk of serious cardiovascular outcomes. Objective To comprehensively review literature on the extent to which pre‐existing or gestational diabetes influences the risk of VTE in both pregnancy and postpartum. Search Strategy We used Medline, Embase and Google Scholar to identify observational studies published up to 2 November 2023. Selection Criteria Studies which quantified the relationship between diabetes on antepartum and/or postpartum VTE, and which provide separate data for pre‐existing and gestational diabetes. Data Collection and Analysis Results were pooled, where appropriate, using random‐effects meta‐analysis. Main Results Twenty one studies from Europe, the United States and Asia were included. There was an increased risk of antepartum VTE in women with gestational diabetes (RR = 2.48, 95% CI 1.47 – 4.16, I 2 = 45%, 4 studies) but not pre‐existing diabetes (RR = 1.71, 0.43 – 6.77, I 2 = 68%, 2 studies). For postpartum VTE, there was no clear association with either pre‐existing (RR = 1.28, 0.73 – 2.24, I 2 = 73%, 6 studies) or gestational (RR = 1.39, 0.77 – 2.51, I 2 = 70%, 10 studies) diabetes. Conclusions Our results will provide some reassurance for pregnant women with pre‐existing or gestational diabetes, owing to no clear evidence of an increased risk of maternal VTE. While some studies report a raised risk of VTE during antepartum specifically, results must be interpreted in light of high levels of heterogeneity.