Jacob Thomas, Charles Brewerton, Calla Holmgren, Rachel Harrison
{"title":"Type 1 Diabetes Mellitus and Thromboembolism in Pregnancy.","authors":"Jacob Thomas, Charles Brewerton, Calla Holmgren, Rachel Harrison","doi":"10.1055/a-2515-2602","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong> The impact of type 1 DM (T1DM) on thromboembolism in pregnancy is uncertain. We hypothesized that T1DM is associated with higher rates of thrombotic events during pregnancy and the postpartum period.</p><p><strong>Study design: </strong> This is a retrospective cohort study utilizing the National Inpatient Sample database from HCUP/AHRQ for 2017-2019. Pregnant and postpartum patients with a history of T1DM were compared to those without. The primary outcome was a composite diagnosis of any thrombotic disease (pulmonary embolism [PE], deep vein thrombosis [DVT], cerebral vascular thrombosis [CVT], or other thromboses). Secondary outcomes were the diagnosis of each individual type of thromboembolic event. Groups were compared via student's test, chi-squared, and logistic regression analyses, controlling for confounders including age, race, obesity, tobacco use, cHTN, asthma, anemia, and cesarean section.</p><p><strong>Results: </strong> A total of 2,361,711 subjects met the criteria. Patients with T1DM encompassed 0.4% of subjects (<i>n</i> = 9,983). T1DM subjects were more likely to be younger, non-Hispanic white, obese, tobacco users, chronic hypertensive, asthmatic, and have a history of cesarean (all <i>p</i> < 0.001). They were less likely to be in the top income quartile. Thromboembolic events occurred more frequently in those with T1DM (0.45% vs. 0.20%, <i>p</i> < 0.001). DVT was the most common event (0.25%). After controlling for confounders, T1DM remained independently associated with any thromboembolic event in pregnancy (adjusted odds ratio [aOR] = 2.19, 95% confidence interval [CI]: 1.49-3.23), PE (aOR = 3.59, 95% CI: 1.65-7.82), and DVT (aOR = 2.43, 95% CI: 1.43-4.14).</p><p><strong>Conclusion: </strong> T1DM is associated with an increased risk of thromboembolic events in pregnancy.</p><p><strong>Key points: </strong>· T1DM is independently associated with VTE.. · PE and DVT are the most common events.. · T1DM has an impact on VTE similar to obesity..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5000,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of perinatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/a-2515-2602","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: The impact of type 1 DM (T1DM) on thromboembolism in pregnancy is uncertain. We hypothesized that T1DM is associated with higher rates of thrombotic events during pregnancy and the postpartum period.
Study design: This is a retrospective cohort study utilizing the National Inpatient Sample database from HCUP/AHRQ for 2017-2019. Pregnant and postpartum patients with a history of T1DM were compared to those without. The primary outcome was a composite diagnosis of any thrombotic disease (pulmonary embolism [PE], deep vein thrombosis [DVT], cerebral vascular thrombosis [CVT], or other thromboses). Secondary outcomes were the diagnosis of each individual type of thromboembolic event. Groups were compared via student's test, chi-squared, and logistic regression analyses, controlling for confounders including age, race, obesity, tobacco use, cHTN, asthma, anemia, and cesarean section.
Results: A total of 2,361,711 subjects met the criteria. Patients with T1DM encompassed 0.4% of subjects (n = 9,983). T1DM subjects were more likely to be younger, non-Hispanic white, obese, tobacco users, chronic hypertensive, asthmatic, and have a history of cesarean (all p < 0.001). They were less likely to be in the top income quartile. Thromboembolic events occurred more frequently in those with T1DM (0.45% vs. 0.20%, p < 0.001). DVT was the most common event (0.25%). After controlling for confounders, T1DM remained independently associated with any thromboembolic event in pregnancy (adjusted odds ratio [aOR] = 2.19, 95% confidence interval [CI]: 1.49-3.23), PE (aOR = 3.59, 95% CI: 1.65-7.82), and DVT (aOR = 2.43, 95% CI: 1.43-4.14).
Conclusion: T1DM is associated with an increased risk of thromboembolic events in pregnancy.
Key points: · T1DM is independently associated with VTE.. · PE and DVT are the most common events.. · T1DM has an impact on VTE similar to obesity..
期刊介绍：
The American Journal of Perinatology is an international, peer-reviewed, and indexed journal publishing 14 issues a year dealing with original research and topical reviews. It is the definitive forum for specialists in obstetrics, neonatology, perinatology, and maternal/fetal medicine, with emphasis on bridging the different fields.
The focus is primarily on clinical and translational research, clinical and technical advances in diagnosis, monitoring, and treatment as well as evidence-based reviews. Topics of interest include epidemiology, diagnosis, prevention, and management of maternal, fetal, and neonatal diseases. Manuscripts on new technology, NICU set-ups, and nursing topics are published to provide a broad survey of important issues in this field.
All articles undergo rigorous peer review, with web-based submission, expedited turn-around, and availability of electronic publication.
The American Journal of Perinatology is accompanied by AJP Reports - an Open Access journal for case reports in neonatology and maternal/fetal medicine.
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