Age and Body Mass Index Can Screen for VTE Risk at Labor and Delivery Admission [02D

Abstract

INTRODUCTION: Pregnancy is a risk factor for venous thromboembolism (VTE). VTE risk assessment models (RAM) have been created but not validated in obstetrics. The impact of maternal age and obesity on VTE risk score calculation is unclear. Our goal was to determine how maternal age and body mass index (BMI) affect VTE RAM scores. METHODS: IRB approved cross-sectional study evaluating 507 deliveries during November 2018 at an urban academic center. A total of 5 VTE cases were identified from 2013–2018. 6 RAM scores (ACOG, CMQCC, ACCP, RCOG, Caprini, Padua) were calculated for all subjects before and after exclusion of maternal age and BMI. Descriptive statistics and T-tests were utilized to ascertain the relationship between maternal age, BMI and high-risk RAM score (Caprini score of 2 or higher, RCOG score of 2 or higher, Padua score 4 or higher). RESULTS: The Caprini score classified 60% of cases as high risk when age and BMI were excluded versus 80% when these factors were included. Similarly, RCOG identified 80% of cases as high risk when BMI and age were excluded but captured 100% of cases when age and BMI were included. Age of 30 years or more and BMI greater than 30 kg/m2 correlated with higher Caprini and RCOG scores. CONCLUSION: Caprini and RCOG models were most impacted by age and BMI. If the RCOG and Caprini score are used to stratify patients for VTE risk, we propose using an abbreviated assessment utilizing only age and BMI since these had the most significant impact on final score.