Risk of Venous Thromboembolic Events in Pregnant Women With Cancer [311

Abstract

INTRODUCTION: Venous thromboembolism 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 venous thromboembolism in pregnancy. METHODS: We conducted a retrospective population-based cohort study using the Health Care Cost and Utilization Project, Nationwide Inpatient Sample database from 2003 to 2011. We classified cancers according to location and estimated the risk of developing venous thromboembolism among pregnant women with the 10 most prevalent malignancies using unconditional logistic regression analysis. RESULTS: There were 7,917,453 births in our cohort of which 2,826 were to women with underlying malignancies. Risk of venous thromboembolism among women with no malignancy was 7.22 per 10,000 births. This risk was considerably increased among women with cervical cancer (odds ratio [OR] 8.64, 95% confidence interval [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). CONCLUSION: Many cancers increase risk of venous thromboembolism in pregnancy. In light of this risk, thromboprophylaxis should be considered for all women with an underlying malignancy.