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Prepregnancy maternal body mass index and venous thromboembolism: a population‐based cohort study
Author(s) -
Butwick AJ,
Bentley J,
Leonard SA,
Carmichael SL,
ElSayed YY,
Stephansson O,
Guo N
Publication year - 2019
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 - 10.1111/1471-0528.15567
Subject(s) - medicine , underweight , body mass index , obstetrics , odds ratio , overweight , pregnancy , population , obesity , cohort study , gynecology , environmental health , biology , genetics
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.