Hypertensive disorders in pregnancy and venous thromboembolism in later life

Some studies have suggested that pre-eclampsia may be more common among women with inherited and acquired thrombophilias (Kupferminc et al., 2000), although the data are inconsistent (Morrison et al., 2002). Furthermore, pathological examination of placentae from women with pre-eclampsia often demonstrate thrombotic changes (Sikkema et al., 2002). These associations have led to studies of the possible association between pre-eclampsia and venous thromboembolism in later life. Hannaford etal. reported a relative risk for venous thromboembolism of 1.6 for women with a history of pre-eclampsia (Hannaford et al., 1997). When stratified by chronic hypertension, the relationship appeared stronger among women who were normotensive. A more recent analysis of almost 300,000 pregnancies from Canada demonstrated a twofold risk of venous thromboembolism among women with a pregnancy diagnosis of pre-eclampsia (van Walraven et al., 2003). Both studies included both first and subsequent pregnancies, employed register bases definitions of pre-eclampsia and could not adjust for important potential confounders, such as obesity. While these data suggest a possible association between pre-eclampsia and venous thromboembolism, further studies are clearly required.

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