Risk of venous thrombo-embolic events in pregnant patients with cancer

Abstract

Objective: Venous thromboembolism (VTE) is one of the leading causes of pregnancy-associated death in the Western world. Cancer is a known risk factor for thrombosis outside of pregnancy. The objective of this study is to evaluate the effect of cancer on the risk of VTE, including deep vein thrombosis (DVT) and pulmonary embolism (PE) in pregnancy.Methods: We conducted a retrospective population-based cohort study using the Health Care Cost and Utilization Project database from 2003 to 2011. Risk of developing DVT, PE and VTE among pregnant patients with the 10 most prevalent malignancies was measured using unconditional logistic regression analysis.Results: A total of 2826 women were identified with underlying malignancies, among our study cohort of 7 917 453 women. Risk of VTE was increased among pregnant patients with cervical cancer (OR 8.64, 95% CI (2.15–34.79)), ovarian cancer (OR 10.35, 95% CI (1.44–74.19)), Hodgkin’s disease (OR 7.87, 95% CI (2.94–21.05)) and myeloid leukemia (OR 20.75, 95% CI (6.61–65.12)). There was no increased risk of VTE among women with brain cancer, thyroid cancer, melanoma and lymphoid leukemia.Conclusion: Many cancers may increase risk of VTE in pregnancy. Appropriate thromboprophylaxis should be considered in some of these women, particularly those with hematological malignancies and gynecologic cancers.