A systematic review and meta-analysis of the epidemiology and burden of venous thromboembolism among pregnant women.
BACKGROUND
Pregnancy-related venous thromboembolism (VTE) is one of the leading causes of maternal morbidity and mortality.


OBJECTIVE
To review the epidemiology, and humanistic and economic burden of pregnancy-related VTE.


METHODS
Medline, the Cochrane Central Register of Controlled Trials, Econlit, Science Direct, JSTOR, Oxford Journals, and Cambridge Journals were searched for reports published between January 2000 and December 2012. Keywords related to VTE, pregnancy, and epidemiology and the humanistic and economic burdens were combined.


METHODS
Eligible studies evaluated the incidence, mortality, recurrence, complications, quality-of-life, and economic burden of VTE among pregnant women, and had been published in English.


METHODS
Background information of the study, participants' characteristics, and study outcomes were collected. Meta-analyses of data were performed.


RESULTS
Twenty studies were included, none of which investigated the economic burden. The pooled overall incidence of pregnancy-related VTE was 1.2 per 1000 deliveries. The pooled VTE case fatality rate was 0.68% and the recurrence rate was 4.27%. The pooled risk of major bleeding was 1.05%. Post-thrombotic syndrome seemed to have a negative effect on quality of life.


CONCLUSIONS
Although the incidence of VTE was found to be relatively low during pregnancy and the postpartum period, the clinical burden is high. Further research is required to assess the economic burden of pregnancy-relate VTE.
The Stavros Niarchos Foundation-Collaborative Center for Clinical Epidemiology and Outcomes Research, National and Kapodistrian University of Athens School of Medicine, Athens, Greece.
Georgia
G
Kourlaba
Department of Health Services Organization and Management, National School of Public Health, Athens, Greece. Electronic address: jrelakis@gmail.com.
John
J
Relakis
Corporate Affairs & Market Access, LEO Pharmaceutical Products Hellas S.A., Athens, Greece.
Stathis
S
Kontodimas
Patient Access, Global Patient Solutions Thrombosis, LEO Pharma A/S, Ballerup, Denmark.
Majbrit V
MV
Holm
Department of Health Services Organization and Management, National School of Public Health, Athens, Greece.
Nikos
N
Maniadakis
D000328:Adult; D017281:Cost of Illness; D005260:Female; D006801:Humans; D015994:Incidence; D049590:Postpartum Period; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000191:economics / Q000453:epidemiology* / Q000523:psychology; D011788:Quality of Life; D012008:Recurrence; D054556:Venous Thromboembolism / Q000191:economics / Q000453:epidemiology* / Q000523:psychology
Bleeding; Case fatality; Humanistic burden; Maternal morbidity; Pregnancy; Quality of life; Recurrence; Thrombosis