Predisposing factors for deep vein thrombosis during pregnancy: An integrative review
DOI:
https://doi.org/10.5281/zenodo.17903922Keywords:
Venous thrombosis, Pregnancy, Risk factors, Thromboembolism, PreventionAbstract
Introduction: Venous thromboembolism (VTE) is a key cause of maternal morbidity and mortality. Pregnancy induces hypercoagulability, raising VTE risk up to fivefold, peaking postpartum (risk 84 times higher than in nonpregnant women). Factors such as cesarean delivery, obesity, thrombophilias and COVID-19 complicate baseline risk. This review synthesizes current evidence on predisposing factors for DVT to guide clinical decision-making.
Methods: An integrative literature review used a six-stage systematic methodology. The PICO question was: which factors predispose to venous thrombosis during pregnancy? Searches in PubMed, SciELO and LILACS included 14 primary studies (2019–2023) with key descriptors; selection was documented with a PRISMA diagram.
Results: Critical factors clustered as: hereditary (prior VTE, thrombophilias such as Factor V Leiden OR 3.8); obstetric (cesarean up to 4-fold risk; multiple pregnancy; IVF); medical conditions (antiphospholipid syndrome OR 15.8, preeclampsia OR 5.1, lupus, diabetes); and modifiable (obesity BMI ≥30 kg/m², smoking, immobility). Synergistic interactions, such as obesity and cesarean, may multiply risk by 12.3.
Discussion: Multifactorial risk complexity underscores stratified, individualized prevention. Evidence supports selective genetic screening and prophylaxis protocols after cesarean and in patients with comorbidities. Actively addressing modifiable factors (e.g., obesity, smoking) is essential to optimize primary prevention and improve maternal outcomes.
Downloads
References
Abdalhabib, E. K., Alfeel, A., Ali, E. I., Ibrahim, I. K., Mobarki, A. A., Dobie, G., Hamali, H. A., & Saboor, M. (2021). Risk Factors of Venous Thromboembolism in Sudanese Pregnant Women. Balkan Journal of Medical Genetics: BJMG, 24(2), 49–54. https://doi.org/10.2478/bjmg-2021-0018
Agbo, C. F. (2023). Elevated Factor VIII Level: An Implication for Thrombosis During Pregnancy. Open Access Research Journal of Life Sciences, 6(1), 058–067. https://doi.org/10.53022/oarjls.2023.6.1.0053
Alsheef, M. A., Alabbad, A. M., Albassam, R. A., Alarfaj, R. M., Zaidi, A. R. Z., Al-Arfaj, O., & Abu-Shaheen, A. (2020). Pregnancy and Venous Thromboembolism: Risk Factors, Trends, Management, and Mortality. BioMed Research International, 2020(1), 4071892. https://doi.org/10.1155/2020/4071892
Bitsadze, V., Khizroeva, J., Alexander, M., & Elalamy, I. (2022). Venous thrombosis risk factors in pregnant women. Journal of Perinatal Medicine, 50(5), 505–518. https://doi.org/10.1515/jpm-2022-0008
Bukhari, S., Fatima, S., Barakat, A. F., Fogerty, A. E., Weinberg, I., & Elgendy, I. Y. (2022). Venous thromboembolism during pregnancy and postpartum period. European Journal of Internal Medicine, 97, 8–17. https://doi.org/10.1016/j.ejim.2021.12.013
de Moreuil, C., Tromeur, C., Daoudal, A., Trémouilhac, C., Merviel, P., Anouilh, F., Le Mao, R., Hoffman, C., Guegan, M., Poulhazan, E., Gourhant, L., Lemarié, C., Couturaud, F., & Le Moigne, E. (2022). Risk factors for recurrence during a pregnancy following a first venous thromboembolism: A French observational study. Journal of Thrombosis and Haemostasis, 20(4), 909–918. https://doi.org/10.1111/jth.15639
Gris, J.-C., Guillotin, F., Chéa, M., Bourguignon, C., & Bouvier, S. (2022). The Risk of Thrombosis Around Pregnancy: Where Do We Stand? Frontiers in Cardiovascular Medicine, 9. https://doi.org/10.3389/fcvm.2022.901869
Hart, C., Bauersachs, R., Scholz, U., Zotz, R. B., Bergmann, F., Rott, H., & Linnemann, B. (2020). Prevention of Venous Thromboembolism During Pregnancy and the Puerperium With a Special Focus on Women With Hereditary Thrombophilia or Prior VTE—Position Paper of the Working Group in Women’s Health of the Society of Thrombosis and Haemostasis (GTH). Hämostaseologie, 40(05), 572–590. https://doi.org/10.1055/a-1132-0750
Jaya-Bodestyne, S. L., Lee, L. H., Tan, L. K., Tan, K. H., Østbye, T., Malhotra, R., Allen, J., Tan, S. S. X., Tan, M. S. Y., Ng, L. C. K., Yong, Y., & Tan, T. C. (2021). Risk factors for pregnancy-associated venous thromboembolism in Singapore. Journal of Perinatal Medicine, 49(2), 153–158. https://doi.org/10.1515/jpm-2020-0298
Kalaitzopoulos, D. R., Panagopoulos, A., Samant, S., Ghalib, N., Kadillari, J., Daniilidis, A., Samartzis, N., Makadia, J., Palaiodimos, L., Kokkinidis, D. G., & Spyrou, N. (2022). Management of Venous Thromboembolism in Pregnancy. Thrombosis Research, 211, 106–113. https://doi.org/10.1016/j.thromres.2022.02.002
Karsanji, D. J., Bates, S. M., & Skeith, L. (2020). The risk and prevention of venous thromboembolism in the pregnant traveller. Journal of Travel Medicine, 27(2), taz091. https://doi.org/10.1093/jtm/taz091
Li, C., Zuo, Y., Zhang, S., Makris, U. E., Karp, D. R., & Li, Z. (2022). Additional risk factors associated with thrombosis and pregnancy morbidity in a unique cohort of antiphospholipid antibody-positive patients. Chinese Medical Journal, 135(6), 658–664. https://doi.org/10.1097/CM9.0000000000001964
Mahmoud, A. (2023). Prepregnancy Overweight and Obesity and Long-Term Risk of Venous Thromboembolism in Women. Scientific Reports, 13(1). https://doi.org/10.1038/s41598-023-41186-2
Malas, M. B., Naazie, I., Elsayed, N., Mathlouthi, A., Marmor, R. A., & Clary, B. M. (2020). Thromboembolism Risk of COVID-19 Is High and Associated With a Higher Risk of Mortality: A Systematic Review and Meta-Analysis. Eclinicalmedicine, 29–30, 100639. https://doi.org/10.1016/j.eclinm.2020.100639
Maughan, B. C., Marin, M., Han, J., Gibbins, K. J., Brixey, A. G., Caughey, A. B., Kline, J. A., & Jarman, A. F. (2022). Venous Thromboembolism During Pregnancy and the Postpartum Period: Risk Factors, Diagnostic Testing, and Treatment. Obstetrical & Gynecological Survey, 77(7), 433–444. https://doi.org/10.1097/OGX.0000000000001043
Naue, C., & Köhler, C. (2022). Thrombophilia, Thrombosis and Thromboprophylaxis in Pregnancy: For What and in Whom? Hämostaseologie, 42(01), 054–064. https://doi.org/10.1055/a-1717-7663
Raia-Barjat, T., Edebiri, O., & Chauleur, C. (2022). Venous Thromboembolism Risk Score and Pregnancy. Frontiers in Cardiovascular Medicine, 9, 863612. https://doi.org/10.3389/fcvm.2022.863612
Rybstein, M. D., & DeSancho, M. T. (2019). Risk factors for and clinical management of venous thromboembolism during pregnancy. Clinical Advances in Hematology & Oncology: H&O, 17(7), 396–404.
Silva-Reyna, P. (2020). Enfermedad tromboembólica venosa en el embarazo. Revista mexicana de anestesiología, 43(1), 41–47. https://doi.org/10.35366/cma201g
Spanos, M., Kokkinidis, D. G., Zoumpourlis, P., & Varrias, D. (2023). Venous Thromboembolism in Pregnancy: Challenges and Solutions. Vascular Health and Risk Management, Volume 19, 469–484. https://doi.org/10.2147/vhrm.s404537
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Héctor Adrián Franco, Alma Graciela González de Lamas, Noelia Teresa Pérez Sosa, Cristian Armando Gauto Martínez, Rubén Darío Ibarrola Valenzuela, Óscar Darío Aquino Martínez (Autor/a)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Los artículos publicados en la Revista UniNorte de Medicina y Ciencias de la Salud se distribuyen bajo una licencia Creative Commons Reconocimiento 4.0 Internacional (CC BY 4.0).
Esta licencia permite a cualquier usuario copiar, distribuir, adaptar, transformar y construir a partir del material para cualquier propósito, incluso comercial, siempre que se otorgue el crédito adecuado a los autores y a la fuente original de publicación.
Los autores conservan los derechos de autor y otorgan a la revista el derecho de primera publicación.
La reutilización del contenido deberá reconocer la autoría, citar la fuente original e indicar si se han realizado modificaciones.
