Abstract
Introduction: Chronic venous disorder (CVeD) has a high prevalence, being commonly diagnosed by the presence of varicose veins. In fact, the development of varicose veins in lower extremities and/or pelvic venous insufficiency (LEPVI) is frequent. However, its potential impact on fetal health has not been investigated. This study aimed to examine whether the presence of varicose veins in women's LEPVI is related to an intrapartum fetal compromise event.Materials: A cross-sectional, national study was conducted using medical administrative records (CMBD) of all vaginal births (n = 256,531) recorded in 2015 in Spain. The independent variable was defined as the presence of varicose veins in the legs, vulva, and perineum or hemorrhoids. A logistic regression model was used to assess the association of interest.Results: Among women with vaginal deliveries, those with varicose veins in their LEPVI have a significantly greater odds of intrapartum fetal compromise (OR = 1.30, 99.55%CI = 1.08–1.54) than their counterparts without varicose veins. After adjustment, this association remained significant (OR = 1.25, 99.5%CI = 1.05–1.50).Conclusions: Our findings of an association between varicose veins in women's lower extremities and/or pelvis and intrapartum fetal compromise suggest that varicose veins may be a novel and important clinical risk factor for fetal well-being and health.
Highlights
Chronic venous disorder (CVeD) has a high prevalence, being commonly diagnosed by the presence of varicose veins
Women with lower extremities and/or pelvic venous insufficiency (LEPVI) have a greater odds of placental dysfunction (OR = 1.74, 99.5% CI = 1.00–3.05) than their counterparts without LEPVI
After adjusting for age, smoking, obesity, asthma, hypothyroidism, coagulopathy disorders, and anemia, these associations remained significant but slightly attenuated for intrapartum fetal compromise (IFC) [adjusted Odds ratios (ORs) = 1.25, 99.5% CI = 1.05–1.50] and placental dysfunction
Summary
Chronic venous disorder (CVeD) has a high prevalence, being commonly diagnosed by the presence of varicose veins. It was observed that LEPVI was associated with the development of structural lesions of hypoxemic pathogenesis of the placental villi [4, 5] This association between varicose veins in the infra-diaphragmatic area and placental damage could be explained by the impact of gestational venous hypertension and blood stasis in the placental area and/or abnormal placental development. Either one of these conditions could produce a high-resistance, low-flow circulation predisposing to hypoperfusion, hypoxia, reperfusion injury, and oxidative stress within the placenta. If the hypoxic insult is severe enough and long lasting under intensifying conditions such as a vaginal delivery, trophoblastic function could be altered enough to affect fetal well-being
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