title: A population-based study of venous thrombosis in pregnancy in Scotland 1980-2005.
abstract: OBJECTIVE
  Data on time trends in the incidence of pregnancy-related venous thromboembolism (VTE) are sparse. This report charts the incidence of pregnancy-related VTE over the period 1980-2005 in Scotland, and discusses the results in relation to potential risk factors.
  
  
  METHODS
  1475301 maternity discharges from Scottish hospitals recorded on the Scottish Morbidity Record 2 (SMR2) were included. Incidences of pregnancy-related VTE, antenatal deep venous thromboembolism (DVT), postnatal DVT and pulmonary embolism (PTE) were derived relative to the number of deliveries, and risk factors were analysed using Poisson regression.
  
  
  RESULTS
  Over the period, VTE incidence rose from 13.7 to 18.3 per 10000 deliveries, antenatal DVTs from 8.8 to 12.2 per 10000 deliveries and PTE from 1.5 to 3.0 per 10000 deliveries. Postnatal DVTs, on the other hand, declined from 4.2 to 2.7 per 10000 deliveries. Risk factors were: age over 35 years; three or more previous pregnancies; previous VTE; obstetric haemorrhage; and preeclampsia. Antenatal DVT risk was highest in the most deprived areas, where events started increasing before those in less deprived areas. Postnatal DVT risk was increased following caesarean delivery, especially when unplanned, although after 1996, events following emergency caesarean decreased.
  
  
  CONCLUSIONS
  During the 26-year period, pregnancy-related VTEs increased, with the greatest rise for antenatal DVTs. Postnatal DVTs, on the other hand, declined over the period, particularly following emergency section. Thromboprophylaxis use following emergency delivery may have led to the postpartum reduction. To continue to prevent events, risk assessment and intervention are required, particularly antenatally.
authors.affiliation: Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, United Kingdom.
authors.forename: Eleanor V
authors.initials: EV
authors.lastname: Kane
authors.forename: Catherine
authors.initials: C
authors.lastname: Calderwood
authors.forename: Richard
authors.initials: R
authors.lastname: Dobbie
authors.forename: Carole
authors.initials: C
authors.lastname: Morris
authors.forename: Eve
authors.initials: E
authors.lastname: Roman
authors.forename: Ian A
authors.initials: IA
authors.lastname: Greer
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology* / Q000517:prevention & control; D011644:Puerperal Disorders / Q000453:epidemiology / Q000517:prevention & control; D012042:Registries; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D054556:Venous Thromboembolism / Q000453:epidemiology* / Q000517:prevention & control; D055815:Young Adult
keywords: Deep vein thrombosis; Pregnancy; Pulmonary embolism; Venous thromboembolism