CC BY-NC-ND 4.0 · Thromb Haemost 2019; 119(04): 606-617
DOI: 10.1055/s-0039-1677733
Coagulation and Fibrinolysis
Georg Thieme Verlag KG Stuttgart · New York

Endometriosis and Recurrent Pregnancy Loss as New Risk Factors for Venous Thromboembolism during Pregnancy and Post-Partum: The JECS Birth Cohort

Mayumi Sugiura-Ogasawara
1  Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
,
Takeshi Ebara
2  Department of Occupational and Environmental Health, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
,
Taro Matsuki
2  Department of Occupational and Environmental Health, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
,
Yasuyuki Yamada
2  Department of Occupational and Environmental Health, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
3  Graduate School of Health and Sports Science, Juntendo University, Chiba, Japan
,
Toyonori Omori
4  Department of Health Care Policy and Management, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
5  National Center for Child Health and Development, Tokyo, Japan
,
Yosuke Matsumoto
1  Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
,
Sayaka Kato
2  Department of Occupational and Environmental Health, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
6  Department of Pediatrics and Neonatology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
,
Hirohisa Kano
2  Department of Occupational and Environmental Health, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
,
Takahiro Kurihara
2  Department of Occupational and Environmental Health, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
,
Shinji Saitoh
6  Department of Pediatrics and Neonatology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
,
Michihiro Kamijima
2  Department of Occupational and Environmental Health, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
,
and the Japan Environment & Children's Study (JECS) Group› Author Affiliations
Funding This study was funded by the Ministry of the Environment, Government of Japan.
Further Information

Publication History

11 October 2018

17 December 2018

Publication Date:
05 February 2019 (eFirst)

  

Abstract

Background Since venous thromboembolism (VTE) is one of the causes of maternal mortality, several guidelines recommend prophylaxis using low molecular weight heparin for women in high-risk groups. The number of large population-based studies examining predictors for VTE has been limited, and there has been no study based on a Japanese population.

Objective Our objective was to examine VTE risk factor during the pregnancy and post-partum period.

Materials and Methods A nationwide birth cohort study known as the ‘Japan Environment and Children's Study (JECS)’ was conducted by the Ministry of the Environment. The subjects consisted of 103,070 pregnancies recruited by the JECS between January 2011 and March 2014. Pregnant women completed the questionnaires during the first and second/third trimester. Their medical records were transcribed by physicians or research coordinators at registration, just after delivery and at 1 month after delivery.

Results The frequency of VTE was 7.5 per 10,000 pregnancies (77 of 103,070) during the pregnancy and post-partum period. After the adjustment of multiple covariates for each factor, endometriosis and recurrent pregnancy loss (RPL) were identified as novel independent risk factors for VTE. Adjusted odds ratios were as follows: 2.70 (95% confidence interval, 1.21–6.00) for endometriosis and 6.13 (2.48–15.16) for RPL. Threatened abortion, threatened pre-term birth, pre-term birth and caesarean section were ascertained to be risk factors for VTE.

Conclusion Careful attention should be given to novel predictors, such as endometriosis and a history of RPL, to prevent VTE during the pregnancy and post-partum period.

Authors' Contributions

The JECS group conducted the nationwide study project. M.S.O. designed the present study, analysed the data and wrote the first draft of the manuscript. T.E. organized the study team and was responsible for obtaining and analysing the data. M.K., a member of the JECS Steering Committee, was responsible for data acquisition and supervision of the study. M.K. and T.O. took the initiative in the launch of the Aichi regional sub-cohort of JECS. T.M. analysed the data. Y.Y., T.O., Y.M., S.K. and S.S. were responsible for data acquisition. All authors interpreted the data, contributed to the writing of the manuscript and revised it critically for important intellectual content.


Note

Data sharing is not permitted by the JECS due to a government policy restricting the deposition of data containing personal information. See the reference for more details.[12]


Supplementary Material