593: Maternal history of recurrent pregnancy loss and long-term risk of thromboembolic events

Abstract

Recurrent pregnancy loss (RPL) is a multifactorial disorder with potential underlying maternal hypercoagulability. We aimed to investigate whether a history of RPL poses an independent risk for future maternal long-term thromboembolic morbidity. A population-based study compared the incidence of long-term thromboembolic morbidity in a cohort of women with and without a history of RPL. Data were collected from two tertiary medical center databases that were cross- linked and merged: the computerized hospitalization database and the computerized perinatal database of the obstetrics and gynecology department. Deliveries occurred between the years 1991-2017. The rrisk for long-term thromboembolic morbidity was based on the hospital’s database and a pre-defined set of ICD code list related to thromboembolic hospitalizations. A Kaplan-Meier survival curve was constructed to compare cumulative incidence of significant thromboembolic morbidity in the exposed and unexposed groups, and a Cox proportional hazards model, to control for confounders. During the study period 123,791 parturients met the inclusion criteria; 6.7% (n=8,247) of which experienced previous RPL. The rate of thromboembolic related hospitalizations was significantly higher in exposed women as compared to non-exposed ones (1.1% vs. 0.6%, OR=1.8; 95% 1.4-2.2; p<0.001). Cumulative thromboembolic event incidence, as depicted in the survival curves, was also significantly higher among patients with RPL history (Figure, Log rank p <0.001). The Cox model confirmed RPL history to be an independent risk factor for later maternal thromboembolic morbidity, while controlling for maternal age, ethnicity, and known thrombophilia (aHR 1.26, 95%CI 1.01-1.58, p=0.040; Table). A history of RPL is an independent risk factor for long-term thromboembolic morbidity, even in the absence of known maternal thrombophilia.View Large Image Figure ViewerDownload Hi-res image Download (PPT)