Risk Factors for Venous Thromboembolism in Pregnancy and Postpartum: A
Systematic Review and Meta-analysis
Abstract
Background: Venous thromboembolism (VTE) is a disease that could
endanger maternal health, especially its serious complications. Although
several previous studies have examined many risk factors of VTE in
pregnancy and postpartum, we still lack studies that use quantitative
methods to evaluate the strength, quality, and consistency of existing
evidence. Objectives: to summarize risk factors for VTE in pregnancy and
postpartum. Search Strategy: The search was conducted in PubMed、EMBASE,
web of science、MEDLINE. Selection Criteria: Study reporting risk
factors for VTE in pregnancy and postpartum. Data Collection and
Analysis: Review Manager (RevMan, version 5.3) was used for
meta-analysis, and the outcome of the analysis was presented as odds
ratio (OR). Main Results: We included 24 studies (7 case-control
studies, 2 nested case-control studies and 15 cohort studies) and 14 of
them were used for the meta-analysis. There were 59 risk factors with
positive evidence in all studies and we selected 13 risk factors for the
meta-analysis. The three most significant risk factors in the
meta-analysis were Factor V Leiden (FVL) (OR = 9.95, 95% CI:
5.93–16.70), Placenta previa (OR = 8.74, 95% CI: 3.40–22.50), and
cardiac disease (OR = 7.77, 95% CI: 5.31–11.38). Conclusions: The
number of risk factors for VTE during pregnancy and postpartum is very
huge. Our study showed that the main risk factors are advanced age,
overweight, cesarean section, multiple pregnancy, placenta previa, FVL,
F2 20210A and cardiac disease.