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Prepregnancy overweight and obesity and long-term risk of venous thromboembolism in women

Mahmoud, Ahmad LU ; Sandblad, Katarina Glise ; Lundberg, Christina E ; Hellsén, Gustaf ; Hansson, Per Olof ; Adiels, Martin and Rosengren, Annika (2023) In Scientific Reports 13(1).
Abstract

Overweight and obesity rates have increased in recent decades, particularly among the younger population. The long-term consequences of obesity with respect to early venous thromboembolism (VTE) in women have not been established. The aim was to investigate the association between body mass index (BMI) in early pregnancy as a proxy for non-pregnant weight and long-term post-pregnancy risk of VTE in women. This registry-based prospective cohort study analysed data from the Swedish Medical Birth Registry, linked to the National Patient and the National Cause of Death Registries for information on post-pregnancy long-term risk of VTE. Cox proportional hazards model were used to determine the association between BMI at baseline and VTE... (More)

Overweight and obesity rates have increased in recent decades, particularly among the younger population. The long-term consequences of obesity with respect to early venous thromboembolism (VTE) in women have not been established. The aim was to investigate the association between body mass index (BMI) in early pregnancy as a proxy for non-pregnant weight and long-term post-pregnancy risk of VTE in women. This registry-based prospective cohort study analysed data from the Swedish Medical Birth Registry, linked to the National Patient and the National Cause of Death Registries for information on post-pregnancy long-term risk of VTE. Cox proportional hazards model were used to determine the association between BMI at baseline and VTE events during follow-up starting 1 year after baseline. The mean age at registration was 27.5 (standard deviation, 4.9) years. During a median follow-up duration of 12 years (interquartile range, 6-21 years) starting 1 year after the first antenatal visit, 1765 and 2549 women had a deep vein thrombosis and/or pulmonary embolism. The risk of VTE linearly increased with increasing BMI. Compared to women with 20 ≤ BMI < 22.5 kg/m2, women with high normal weight, i.e. with a BMI of 22.5-25.0 kg/m2, had an adjusted hazard ratio (HR) of 1.30 (95% confidence interval [CI] 1.19-1.41), whereas those with a BMI of 30-35 kg/m2 and ≥ 35 kg/m2 (severe obesity) had an adjusted HR of 2.35 (95% CI 2.04-2.70) and 3.47 (95% CI 2.82-4.25, respectively. Using BMI in early pregnancy as a proxy for pre-pregnancy or non-pregnant BMI in young women, we found a significantly increased risk of post-pregnancy long-term risk of VTE even in those with high normal BMI, compared with lean women, whereas those with severe obesity had a markedly high risk.

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author
; ; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Pregnancy, Female, Humans, Overweight, Venous Thromboembolism, Obesity, Morbid, Prospective Studies, Obesity
in
Scientific Reports
volume
13
issue
1
article number
14597
publisher
Nature Publishing Group
external identifiers
  • scopus:85169759581
  • pmid:37670016
ISSN
2045-2322
DOI
10.1038/s41598-023-41186-2
language
English
LU publication?
no
additional info
© 2023. Springer Nature Limited.
id
9aa22ed8-90c6-4b04-ad2e-d3d525c2048b
date added to LUP
2025-03-05 14:50:57
date last changed
2025-07-10 15:01:11
@article{9aa22ed8-90c6-4b04-ad2e-d3d525c2048b,
  abstract     = {{<p>Overweight and obesity rates have increased in recent decades, particularly among the younger population. The long-term consequences of obesity with respect to early venous thromboembolism (VTE) in women have not been established. The aim was to investigate the association between body mass index (BMI) in early pregnancy as a proxy for non-pregnant weight and long-term post-pregnancy risk of VTE in women. This registry-based prospective cohort study analysed data from the Swedish Medical Birth Registry, linked to the National Patient and the National Cause of Death Registries for information on post-pregnancy long-term risk of VTE. Cox proportional hazards model were used to determine the association between BMI at baseline and VTE events during follow-up starting 1 year after baseline. The mean age at registration was 27.5 (standard deviation, 4.9) years. During a median follow-up duration of 12 years (interquartile range, 6-21 years) starting 1 year after the first antenatal visit, 1765 and 2549 women had a deep vein thrombosis and/or pulmonary embolism. The risk of VTE linearly increased with increasing BMI. Compared to women with 20 ≤ BMI &lt; 22.5 kg/m2, women with high normal weight, i.e. with a BMI of 22.5-25.0 kg/m2, had an adjusted hazard ratio (HR) of 1.30 (95% confidence interval [CI] 1.19-1.41), whereas those with a BMI of 30-35 kg/m2 and ≥ 35 kg/m2 (severe obesity) had an adjusted HR of 2.35 (95% CI 2.04-2.70) and 3.47 (95% CI 2.82-4.25, respectively. Using BMI in early pregnancy as a proxy for pre-pregnancy or non-pregnant BMI in young women, we found a significantly increased risk of post-pregnancy long-term risk of VTE even in those with high normal BMI, compared with lean women, whereas those with severe obesity had a markedly high risk.</p>}},
  author       = {{Mahmoud, Ahmad and Sandblad, Katarina Glise and Lundberg, Christina E and Hellsén, Gustaf and Hansson, Per Olof and Adiels, Martin and Rosengren, Annika}},
  issn         = {{2045-2322}},
  keywords     = {{Pregnancy; Female; Humans; Overweight; Venous Thromboembolism; Obesity, Morbid; Prospective Studies; Obesity}},
  language     = {{eng}},
  month        = {{09}},
  number       = {{1}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Scientific Reports}},
  title        = {{Prepregnancy overweight and obesity and long-term risk of venous thromboembolism in women}},
  url          = {{http://dx.doi.org/10.1038/s41598-023-41186-2}},
  doi          = {{10.1038/s41598-023-41186-2}},
  volume       = {{13}},
  year         = {{2023}},
}