Abstract
BackgroundIn Japan, the numbers of deliveries by women of older maternal age and women with overweight or obesity have recently increased. Since 2008, the guidelines and practices to prevent the maternal venous thromboembolism (VTE) have been recommended antepartum and postpartum thromboprophylaxis for each risk level of VTE. This study aimed to clarify the incidence and characteristics (type of VTE and thromboprophylaxis) of VTE in pregnant women in Japan to reduce the rate of mortality from VTEMethodsOf 2299 institutions sent the surveillance questionnaire, 666 (29.0%) responded, and data from 295,961 women who gave birth in those institutions in 2018 were analyzed. We calculated the incidence and characteristics of VTE before and after the deliveries.ResultsAt the responding institutions, 243 women (0.082%) had VTE in 2018. In 2018, deep vein thrombosis was significantly more common (0.0053%) than pulmonary thromboembolism (0.0019%; p < 0.0001). The incidence of antepartum VTE (0.0055%) was significantly higher than that of postpartum VTE (0.0026%; p < 0.0001). The incidence of VTE after cesarean Sect. (0.0074%) was significantly higher than that after vaginal delivery (0.0012%; p < 0.0001). Of the women with VTE, 4 (1.6%) died.ConclusionsAmong the women thought to have a low risk of VTE during the antepartum period, and especially women who had a vaginal delivery, the actual incidence of VTE might have increased in Japan.
Highlights
In Japan, the numbers of deliveries by women of older maternal age and women with overweight or obesity have recently increased
Pregnant women and women who have recently given birth are in states of hypercoagulability [1] and are at increased risk of venous thromboembolism (VTE) [2]
In Japan [3], the mortality induced by venous thrombo‐ embolism (VTE) was 7.1% (24) of all 338 maternal deaths from 2010 to 2016, according to the maternal death registration system established by the Japan Association of Obstetricians and Gynecologists (JAOG) and the Maternal Death Exploratory Committee [3]
Summary
In Japan, the numbers of deliveries by women of older maternal age and women with overweight or obesity have recently increased. Since 2008, the guidelines and practices to prevent the maternal venous thrombo‐ embolism (VTE) have been recommended antepartum and postpartum thromboprophylaxis for each risk level of VTE. In Japan, deliveries by women of older maternal age and by women with overweight or obesity have recently increased; the risk of VTE may have increased. Since 2008, the Japan Society of Obstetrics and Gynecology (JSOG) and JAOG have recommended guidelines and practices to prevent the maternal VTE [11, 12], and so the incidence of VTE onset in Japan might have decreased since
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