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Infant, obstetrical and maternal characteristics associated with thromboembolism in infancy: a nationwide population-based case-control study
  1. Ruta Tuckuviene1,2,
  2. Anette Luther Christensen1,
  3. Jon Helgested2,
  4. Heidi Holmager Hundborg3,
  5. Søren Risom Kristensen1,
  6. Søren Paaske Johnsen3
  1. 1Department of Clinical Biochemistry, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark
  2. 2Department of Paediatrics, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark, Aalborg, Denmark
  3. 3Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark, Aarhus, Denmark
  1. Correspondence to Ruta Tuckuviene, Department of Clinical Biochemistry, Aarhus University Hospital, Aalborg Hospital, 9000, Aalborg, Denmark; rt{at}rn.dk

Abstract

Objectives To identify infant, obstetrical and maternal characteristics associated with arterial ischaemic stroke (AIS) and venous thromboembolism (VTE) in infancy (<1 year).

Design Nationwide, population-based nested case-control study. All infants with a verified first-time diagnosis of AIS, VTE or both in Denmark through the years 1994–2006 were included, and 10 population controls were selected for each case.

Results Case-infants presented with AIS (n=71) or VTE (n=38). AIS in infancy was associated with primiparity (adjusted OR 5.9 CI 95% 3.0 to 11.6)), delivery by an emergency caesarean section (adjusted OR 1.9 (CI 95% 1.0 to 3.3)), and post-term birth (adjusted OR 2.2 (CI 95% 1.1 to 4.8)). Male sex was associated with an increased risk of AIS among neonates (crude OR 1.8 (CI 95% 1.0 to 3.4)) but not among later born (crude OR 0.6 (CI 95% 0.2 to 1.4)). Risk factors for VTE in infancy included preterm birth (adjusted OR 5.5 (CI 95% 1.8 to 16.9)), low Apgar score (adjusted OR 9.2 (CI 95% 1.9 to 45.2)), and multiple births (adjusted OR 7.1 (CI 95% 1.1 to 48.1)). Previous maternal thromboembolism and pregnancy-related disorders were not associated with the risk of thromboembolism in the children.

Conclusion Several apparently independent infant, obstetrical and maternal characteristics were associated with thromboembolism in early life.

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Footnotes

  • Competing interests None.

  • Ethics approval The study was approved by The Danish Data Protection Agency (J.no.: 2007-41-0539 ) and by The National Board of Health (J.no.: 7-604-04-2 /37/ EHE).

  • Provenance and peer review Not commissioned; externally peer reviewed.