Dataset Information

Prepregnancy maternal body mass index and venous thromboembolism: a population-based cohort study.

ABSTRACT:

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.

SUBMITTER: Butwick AJ

PROVIDER: S-EPMC6448573 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Prepregnancy maternal body mass index and venous thromboembolism: a population-based cohort study.

Butwick A J AJ Bentley J J Leonard S A SA Carmichael S L SL El-Sayed Y Y YY Stephansson O O Guo N N

BJOG : an international journal of obstetrics and gynaecology 20181219 5

<h4>Objective</h4>To assess the relation between maternal body mass index (BMI) and pregnancy-related venous thromboembolism (VTE).<h4>Design</h4>Cohort study.<h4>Setting and population</h4>A total of 2 449 133 women with singleton pregnancies who underwent delivery hospitalisation in California between 2008 and 2012.<h4>Methods</h4>Association of pre-pregnancy BMI and the risk of an antepartum and postpartum VTE was examined using logistic regression, with normal BMI as reference.<h4>Main outco ...[more]

PMID: 30500109

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Project description:ImportanceAlthough high body mass index (BMI) is associated with adverse birth outcomes, the association with severe maternal morbidity is unclear.ObjectiveTo examine the association between prepregnancy BMI and severe maternal morbidity.Design, setting, and participantsRetrospective population-based cohort study including all singleton hospital births in Washington State, 2004-2013. Demographic data and morbidity diagnoses were obtained from linked birth certificates and hospitalization files.ExposuresPrepregnancy BMI (weight in kilograms divided by height in meters squared) categories included underweight (<18.5), normal BMI (18.5-24.9), overweight (25.0-29.9), obesity class 1 (30.0-34.9), obesity class 2 (35.0-39.9), and obesity class 3 (≥40).Main outcomes and measuresComposite severe maternal morbidity or mortality included life-threatening conditions and conditions leading to serious sequelae (eg, amniotic fluid embolism, hysterectomy), complications requiring intensive care unit admission, and maternal death. Logistic regression was used to obtain adjusted odds ratios (ORs) and adjusted rate differences with 95% confidence intervals, adjusted for confounders (eg, maternal age and parity).ResultsOverall, 743 630 women were included in the study (mean age, 28.1 [SD, 6.0] years; 41.4% nulliparous). Prepregnancy BMI was distributed as follows: underweight, 3.2%; normal weight, 47.5%; overweight, 25.8%; obesity class 1, 13.1%; obesity class 2, 6.2%; and obesity class 3, 4.2%. Rates of severe maternal morbidity or mortality were 171.5, 143.2, 160.4, 167.9, 178.3 and 202.9 per 10 000 women, respectively. Adjusted ORs were 1.2 (95% CI, 1.0-1.3) for underweight women; 1.1 (95% CI, 1.1-1.2) for overweight women; 1.1 (95% CI, 1.1-1.2) for women with class 1 obesity; 1.2 (95% CI, 1.1-1.3) for women with class 2 obesity; and 1.4 (95% CI, 1.3-1.5) for women with class 3 obesity compared with women with normal BMI. Absolute risk increases (adjusted rate differences per 10 000 women, compared with women with normal BMI) were 28.8 (95% CI, 12.2-47.2) for underweight women, 17.6 (95% CI, 10.5-25.1) for overweight women, 24.9 (95% CI, 15.7-34.6) for women with class 1 obesity, 35.8 (95% CI, 23.1-49.5) for women with class 2 obesity, and 61.1 (95% CI, 44.8-78.9) for women with class 3 obesity.Conclusions and relevanceAmong pregnant women in Washington State, low and high prepregnancy BMI, compared with normal BMI, were associated with a statistically significant but small absolute increase in severe maternal morbidity or mortality.

Dataset Information

Prepregnancy maternal body mass index and venous thromboembolism: a population-based cohort study.

Objective

Design

Setting and population

Methods

Main outcome measures

Results

Conclusions

Tweetable abstract

Publications

Prepregnancy maternal body mass index and venous thromboembolism: a population-based cohort study.

Similar Datasets

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