Long-term Incidence of Venous Thromboembolic Recurrence After a First Venous Thrombotic Episode During Pregnancy

M. Ibrahim-Kosta^1,2, S. El Harake³, L. Goumidi², C. De Mari³, J.-F. Secondi³, D. Brunet¹, M.-C. Barthet¹, P. Suchon^1,2, P.-E. Morange^1,2, G. Sarlon-Bartoli^2,3

¹Laboratory of Haematology, La Timone Hospital, Marseille, France, ²Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France, ³Vascular Medicine Department, La Timone Hospital, Marseille, France

Abstract Number: PB2550

Meeting: ISTH 2020 Congress

Theme: Women Health » Pregnancy and Pregnancy Complications

Background: Pregnancy is considered as a major transient risk factor for venous thromboembolic (VTE) disease, but the long-term recurrence rate is poorly documented.

Aims: Determine the long-term incidence rate after a first VTE during pregnancy.

Methods: We performed a study on 595 consecutive patients who presented a first VTE during pregnancy or 6 weeks puerperium and who were referred in our institution between January 2000 to December 2015. VTE was defined as pulmonary embolism (PE) or deep venous thrombosis (DVT). We collected from our database demographics data, characteristics of first VTE and data on thrombophilia screening. Incidence rate was assessed after phone call or after a new visit in our department. The type of event (PE or DVT), presence and type of a provoked risk factor and biological thrombophilia were studied as predictors for VTE recurrence.

Results: 595 women were followed during 16 ± 14 years. Mean age at first VTE event was 29 ± 6 years. Anticoagulation therapy was conducted during 9 ± 13 months. VTE recurrence rate was 32% (188/595 patients). Mean age at VTE recurrence event was 42 ± 15 years. Type of recurrence was: 18% PE (n=33) and 82% DVT (n=153). 24% of recurrence occurred during new hormonal exposition (pregnancy or contraception, n=43), 26% after surgery or immobilization (n=48) and 50% were unprovoked (n=90). Prevalence of congenital thrombophilia was similar in patients with or without recurrence (28% vs 26% respectively; p=0.5). Results were similar when we restricted the analysis to severe thrombophilia (ie natural anticoagulant deficiencies, homozygosity or double heterozygosity for FV or FII G20210 variants: 9% vs 7%;p=0.64). ABO blood group distribution was also similar in patients with or without recurrence (73% vs 70% respectively; p=0.6).

Conclusions: Long-term recurrence of VTE after a first event during pregnancy is high, this recurrence is frequently unprovoked and challenges prevention strategy.

To cite this abstract in AMA style:

Ibrahim-Kosta M, El Harake S, Goumidi L, De Mari C, Secondi J-, Brunet D, Barthet M-, Suchon P, Morange P-, Sarlon-Bartoli G. Long-term Incidence of Venous Thromboembolic Recurrence After a First Venous Thrombotic Episode During Pregnancy [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/long-term-incidence-of-venous-thromboembolic-recurrence-after-a-first-venous-thrombotic-episode-during-pregnancy/. Accessed December 6, 2023.

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