Abstract Details

Title Postpartum Risk of Cerebral Venous Thrombosis

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P10 - Poster Session 10 (8:00 AM-9:00 AM)

Poster/Presentation
Number 13-006

Background

The postpartum state is associated with a heightened risk of thrombosis. The duration of heightened risk for postpartum CVT is uncertain.

Objective We investigated the duration of heightened risk for postpartum cerebral venous thrombosis (CVT).

Design/Methods

Using claims data from the Healthcare Cost and Utilization Project (HCUP) from all emergency departments and acute care hospitalizations in Florida (2005-2015) and New York (2006-2015), we identified women aged ≥18 years old who were hospitalized for labor and delivery. For women with multiple labor-related hospitalizations during a single 40-week period, we excluded cases of false labor by identifying delivery as the latest hospitalization during that time. Patients with claims for CVT before their first recorded delivery, and women with a second delivery during the follow-up period were also excluded. We compared the likelihood of a first-ever recorded CVT during postpartum days 0-41 compared with the same period 1 year later. We repeated this crossover-cohort analysis for consecutive 6-weeks periods after delivery, as compared with the corresponding 6-week period 1 year later. We used McNemar's to calculate odds ratios for each 6-week interval.

Results

Among the 1,406,447 women with a first recorded delivery, the risk of CVT was markedly higher within the 6 weeks postpartum than in the same period 1 year later (22 versus 3 CVTs per million deliveries). This corresponded to an absolute risk difference of 19 events per million (95% CI, 11-27) and an odds ratio of 10.0 (95% CI, 3.1-51.2). There was no significant increase in the risk of CVT during the period of 7-12 weeks after delivery as compared with the same period 1 year later with an absolute risk difference of 6.0 events (95% CI, 0-11) per million deliveries and an odds ratio of 3.0 (95% CI, 0.9-12.8).

Conclusions There appears to be a heightened postpartum risk of CVT for 6 weeks.

Authors/Disclosures
Tehniyat Baig, MD (NewYork Presbyterian / Weill Cornell Medical Center) PRESENTER	Ms. Baig has nothing to disclose.
Hamza Chaudhry	Dr. Chaudhry has nothing to disclose.
Santosh B. Murthy, MD (Weill Cornell Medicine)	Dr. Murthy has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Stroke and Neurological disorders. The institution of Dr. Murthy has received research support from National Institutes of Health/NINDS.
Neal S. Parikh, MD (Alnylam Pharmaceuticals)	Dr. Parikh has received personal compensation for serving as an employee of Alnylam Pharmaceuticals. Dr. Parikh has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for cases of neurological illness. Dr. Parikh has stock in Alnylam Pharmaceuticals. The institution of Dr. Parikh has received research support from Leon Levy Foundation. The institution of Dr. Parikh has received research support from Florence Gould Foundation. The institution of Dr. Parikh has received research support from NY State Empire Clinical Research Investigator Program. The institution of Dr. Parikh has received research support from NIA. The institution of Dr. Parikh has received research support from Medtronic.
Ava L. Liberman, MD (Weill Cornell Medicine)	The institution of Dr. Liberman has received research support from NIH.
Hooman Kamel, MD (Weill Cornell Medical College)	Dr. Kamel has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. Dr. Kamel has received personal compensation in the range of $50,000-$99,999 for serving as a Endpoint adjudication committee with Boehringer-Ingelheim.
	No disclosure on file
Alexander Merkler, MD	Dr. Merkler has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for The Neurohospitalist. Dr. Merkler has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for n/a.