Development and Validation of Risk Prediction Model for Venous Thromboembolism in Postpartum Women: Multinational Cohort Study

Abstract

(BMJ. 2016;355:i6253) Venous thromboembolism (VTE) is one of the leading causes of maternal mortality in developed countries as the risk is increased significantly during pregnancy with its occurrence at its peak during the postpartum period. Targeted thromboprophylaxis has been used to prevent postpartum VTE with evidence suggesting minimum harm associated with this treatment. However, there is not consensus about which parturients should receive thromboprophylaxis. While its use in high risk patients is not questioned, most women experiencing VTE do not fit into this category, but rather are considered to be low to moderate risk due to factors such as obesity or cesarean delivery. Currently, recommendations for thromboprophylaxis in pregnant women are inconsistent across countries. The aim of this cohort study was to develop and validate a risk prediction model for VTE within the first 6 weeks postpartum on the basis of each woman’s individualized clinical risk profile, and to compare this with the existing guidelines on thromboprophylaxis from the Royal College of Obstetricians and Gynaecologists in the United Kingdom and the Swedish guidelines.