Cancer in pregnancy increases the risk of venous thromboembolism: a nationwide cohort study

Greiber, Iben Katinka; Mikkelsen, A. B.; Karlsen, Mona Aarenstrup; Storgaard, Lone; Viuff, Jakob Hansen; Mellemkjær, Lene; Hjortshøj, CS; Lidegaard, Ø

doi:10.1111/1471-0528.16627

Cited by 15 publications

(22 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several patient‐ and delivery‐related risk factors for readmission with VTE were identified, with the most significant being increased maternal age, prolonged hospitalisation and caesarean delivery. The association between these factors and VTE has been consistently demonstrated in previous studies 24,26–29 . Additionally, this study found that low household income and public insurance independently increased the risk of readmission with VTE.…”

Section: Discussionsupporting

confidence: 82%

“…The association between these factors and VTE has been consistently demonstrated in previous studies. 24,[26][27][28][29] Additionally, this study found that low household income and public insurance independently increased the risk of readmission with VTE. This is consistent with the findings of Clapp et al, who reported lower all-cause postpartum readmission rates in women with private insurance and higher income.…”

Section: Main Findingsmentioning

confidence: 53%

See 1 more Smart Citation

Uncaptured rates of postpartum venous thromboembolism: a US national analysis

Cioci

Kedar²,

Urréchaga

et al. 2021

BJOG

View full text Add to dashboard Cite

Objective To quantify the proportion of postpartum venous thromboembolism (VTE) readmissions, including those that occur at different hospitals from index admission, and describe risk factors for this outcome. Design Retrospective observational study. Setting US hospitals included in the Nationwide Readmissions Database. Sample A total of 3 719 238 patients >14 years of age with a delivery‐associated hospitalisation in 2014. Methods Univariate analysis was performed to identify patient and hospital factors associated with readmissions. Significant factors were included in multivariate logistic regression to identify independent risk factors. Results were weighted for national estimates. Main outcome measures Readmission with VTE to both index and different hospitals at 30, 60 and 90 days. Results The VTE cumulative readmission rate was 0.053% (n = 1477), 0.063% (n = 1765) and 0.069% (n = 1938) at 30, 60 and 90 days, respectively. Patients were readmitted to different hospitals 31% of the time within 90 days. Risk factors for different hospital VTE readmission were unique and included younger age and initial admission to a small/medium‐sized hospital. Initial admission to a for‐profit hospital increased the likelihood of readmission to a different hospital. Conclusions Nearly one in three postpartum VTEs are missed by the current quality metrics, with significant implications for outcomes and quality. For‐profit hospitals have a significant portion of their VTE readmissions hidden, falsely lowering their readmission rates relative to public hospitals. Tweetable abstract US analysis shows 1 in 3 readmissions for postpartum venous thromboembolism currently missed.

show abstract

Section: Discussionsupporting

confidence: 82%

Section: Main Findingsmentioning

confidence: 53%

Uncaptured rates of postpartum venous thromboembolism: a US national analysis

Cioci

Kedar²,

Urréchaga

et al. 2021

BJOG

View full text Add to dashboard Cite

show abstract

“…Treatment strategies have shifted, offering individualised oncological and surgical treatment depending on the cancer type and gestational age whenever possible instead of delaying cancer treatment until after the delivery or induced termination of pregnancy 4–7 . Melanoma, cervical and breast cancer are the most common cancer types presenting during pregnancy 1,8–10 …”

Section: Introductionmentioning

confidence: 99%

“…[4][5][6][7] Melanoma, cervical and breast cancer are the most common cancer types presenting during pregnancy. 1,[8][9][10] Previous studies have shown an increased risk of induced abortion, stillbirth, preterm birth, admission to neonatal intensive care unit (NICU), small-for-gestational age (SGA) and neonatal death in pregnancies complicated by cancer. 5,8,[11][12][13][14][15] In contrast, smaller studies and case reports concerning neonatal and paediatric outcomes after intrauterine exposure to cancer treatment have been reassuring.…”

Section: Introductionmentioning

confidence: 99%

Cancer in pregnancy and the risk of adverse pregnancy and neonatal outcomes: A nationwide cohort study

Greiber

Viuff

Mellemkjær

et al. 2022

BJOG

Self Cite

View full text Add to dashboard Cite

Methods: Exposure was defined as pregnancies exposed to maternal cancer (n = 1068). The control group comprised pregnancies without cancer. The groups were compared using logistic regression analysis and adjusted for potential confounders. Main outcome measures:The outcomes were induced abortion, preterm birth and adverse neonatal outcomes.Results: More women with cancer in pregnancy, as compared with the control group, experienced induced abortion (24.8% vs. 20.0%); first-trimester induced abortion adjusted odds ratio (aOR) 3.5 (95% confidence interval [CI] 2.7-4.5), second-trimester induced abortion; aOR 8.8 (95% CI 6.3-12.3), planned preterm birth (11.8% vs. 1.3%); aOR 10.8 (95% CI 8.0-14.6) and planned preterm birth at <32 gestational weeks; aOR . Neonates born to mothers with cancer in pregnancy had a higher risk of respiratory distress syndrome; aOR 3.5 (95% CI 2.8-4.4), low birthweight; aOR 3.8 (95% CI 3.1-4.8), admission to neonatal intensive care unit for >7 days; aOR 5.1 (95% CI 3.9-6.6), neonatal infection; aOR 1.8 (95% CI1.1-3.1) and neonatal mortality; aOR 4.7 (95% CI 2.7-8.2), but not of SGA; aOR 1.0 (95% CI 0.6-1.5) and malformations; 1.2 (95% CI 0.9-1.7). Conclusion:Cancer in pregnancy increases the risk of induced abortion and planned premature birth. Neonates born to mothers with cancer in pregnancy had an increased risk of neonatal morbidity and mortality, presumably due to prematurity. K E Y W O R D Scancer in pregnancy, chemotherapy treatment, iatrogenic prematurity, neonatal outcomes, obstetrical management, pregnancy outcome, pregnancy-associated cancer, prematurity, termination of pregnancy planned preterm birth

show abstract

“…They demonstrated a VTE rate of 75.2 per 10,000 pregnancies with active malignancy compared to 10.7 per 10,000 without malignancy. 27 The present case demonstrated that LMWH VTE prophylaxis can safely be used throughout a pregnancy complicated by active thoracic malignancy and recurrent surgeries without sustaining additional complications related to anticoagulation. but one woman was diagnosed with the disease in pregnancy.…”

Section: Introductionmentioning

confidence: 59%

Maternal Metastatic Synovial Sarcoma in Pregnancy

Okonkwo

Wallace

Colwell

et al. 2022

Can Journ Gen Int Med

View full text Add to dashboard Cite

Pregnancy with known metastatic cancer is rare. A case of a woman with known metastatic synovial sarcoma in pregnancy is presented in the study. Her disease progressed with an enlarging and new pulmonary metastasis requiring bilateral pulmonary metastasectomies, both during pregnancy and after delivery. Her pregnancy was uncomplicated otherwise, and she had a successful at term vaginal delivery of a healthy female baby. During her second pregnancy, her disease aggressively recurred at eight weeks gestation without therapeutic options. Thus, palliative care was initiated and she died shortly thereafter. The implications of sarcoma growth and the potential thromboembolic risk with active malignancy in pregnancy is discussed in the study. RésuméLa grossesse accompagnée d’un cancer métastatique connu est rare. Cette étude présente le cas d’une femme enceinte atteinte d’un sarcome synovial métastatique connu. Sa maladie a progressé sous forme d’une nouvelle métastase pulmonaire en croissance nécessitant une métastasectomie pulmonaire bilatérale pratiquée pendant la grossesse et après l’accouchement. Sa grossesse s’est déroulée sans autre complication et elle a accouché à terme par voie vaginale d’une fille en bonne santé. Au cours de sa deuxième grossesse, son cancer a récidivé de manière agressive à huit semaines de grossesse sans qu’aucune option thérapeutique ne soit possible. Par conséquent, des soins palliatifs ont été mis en place et elle est décédée peu de temps après. Cette étude exam-ine les conséquences de la croissance du sarcome et le risque thromboembolique potentiel lié aux tumeurs malignes actives durant la grossesse.

show abstract

Cancer in pregnancy increases the risk of venous thromboembolism: a nationwide cohort study

Cited by 15 publications

References 33 publications

Uncaptured rates of postpartum venous thromboembolism: a US national analysis

Uncaptured rates of postpartum venous thromboembolism: a US national analysis

Cancer in pregnancy and the risk of adverse pregnancy and neonatal outcomes: A nationwide cohort study

Maternal Metastatic Synovial Sarcoma in Pregnancy

Contact Info

Product

Resources

About