Blood Res  
Risk of venous thromboembolism in Chinese pregnant women: Hong Kong venous thromboembolism study
#Duo Huang1, #Emmanuel Wong1, #Ming-Liang Zuo2, Pak-Hei Chan1, Wen-Sheng Yue3, Hou-Xiang Hu4, Ling Chen4, Li-Xue Yin2, Xin-Wu Cui5, Ming-Xiang Wu6, Xi Su6, *Chung-Wah Siu1,3, *Jo-Jo Hai1
1Cardiology Division, Department of Medicine, the University of Hong Kong, Hong Kong, 2Department of Echocardiography, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, 3Affiliated Hospital of North Sichuan Medical College & Medical Imaging Key Laboratory, Nanchong, 4Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 5Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 6Wuhan Asian Heart Hospital, Wuhan, China
Correspondence to: Chung-Wah Siu, M.D. and Jo-Jo Hai, MBBS
Cardiology Division, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Pok Fu Lam Rd, High West, Hong Kong, China
E-mail C.W.S.: cwdsiu@hku.hk
E-mail J.J.H.: haishjj@hku.hk

#These authors contributed equally to this work.
*These authors are co-corresponding authors.
Published online: July 22, 2019.
© The Korean Journal of Hematology. All rights reserved.

Abstract
Background: Previous Caucasian studies have described venous thromboembolism in pregnancy; however, little is known about its incidence during pregnancy and early postpartum period in the Chinese population. We investigated the risk of venous thromboembolism in a “real-world” cohort of pregnant Chinese women with no prior history of venous thromboembolism.
Methods: In this observational study, 15,325 pregnancies were identified in 14,162 Chinese women at Queen Mary Hospital, Hong Kong between January 2004 and September 2016. Demographic data, obstetric information, and laboratory and imaging data were retrieved and reviewed.
Results: The mean age at pregnancy was 32.4±5.3 years, and the median age was 33 years (interquartile range, 29–36 yr). Pre-existing or newly diagnosed diabetes mellitus was present in 627 women (4.1%); 359 (0.7%) women had pre-existing or newly detected hypertension. There was a small number of women with pre-existing heart disease and/or rheumatic conditions. Most deliveries (86.0%) were normal vaginal; the remaining were Cesarean section 2,146 (14.0%). The incidence of venous thromboembolism was 0.4 per 1,000 pregnancies, of which 83.3% were deep vein thrombosis and 16.7% were pulmonary embolism. In contrast to previous studies, 66.7% of venous thrombosis occurred in the first trimester.
Conclusion: Chinese women had a substantially lower risk of venous thromboembolism during pregnancy and the postpartum period compared to that of Caucasians. The occurrence of pregnancy-related venous thromboembolism was largely confined to the early pregnancy period, probably related to the adoption of thromboprophylaxis, a lower rate of Cesarean section, and early mobilization.
Keywords: Pregnancy, Venous thromboembolism, Chinese


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