Pregnancy-Related Factors and the Development of Varicose Veins

Pregnancy is a known risk factor for developing varicose veins (VVs). However, prior studies lacked sufficient size and follow-up to determine the specific characteristics of pregnancy that might influence VV formation. We sought identify which pregnancy-specific factors are associated with development VVs. All women who gave birth from 1998 2020 within multicenter healthcare system were retrospectively identified followed up through all hospital encounters (inpatient outpatient). The primary outcome was VVs, defined as any encounter diagnosis code VVs or procedure study period each woman interval first last encounter. Extended Cox regression modeling used evaluate association between pregnancy-related time-varying covariates control patient comorbidities. A total 156,622 median 8.3 years (interquartile range, 2.7-16.6 years) included. During period, 225,758 live births occurred. 10- 20-year freedom 97.0% (95% confidence [CI], 96.8%-97.1%) 92.7% CI, 92.4%-93.0%), respectively, estimated start pregnancy. Overall, 4028 (2.57%) had developed during 1594 (1.02%) undergone After adjustment, increasing parity significantly subsequent (parity 1: hazard ratio [HR] 1.78; 95% 1.55-1.99; P < .001; ≥6: HR, 4.83; 2.15-10.9; Table). Other significant included excessive weight gain (HR, 1.44; 2.09-1.91; = .011), post-term 1.12; 1.02-1.21; .021), preeclampsia 0.79; 0.70-0.90; .001), antepartum transfusion platelets, plasma, cryoprecipitate 2.05; 1.19-3.53; .001). Increasing parity, in pregnancy, affect after Although likely underreported true incidence unknown, pregnant should be counseled regarding effect these on pregnancy.TableResults multivariable modelVariableOR95% CIP valueTime-varying (pregnancy factors) Age (reference, <35 years)35-40 years1.611.48-1.77<.00140-50 years1.661.51-1.84<.001>50 years1.911.63-2.23<.001 Parity 0)11.781.59-1.99<.00122.342.07-2.65<.00133.42.93-3.95<.00143.923.06-5.03<.00153.762.2-6.44<.001≥64.832.15-10.9<.001 Excessive gain1.441.09-1.91.011 Large gestational age2.810.7-11.2.145 Post-term pregnancy1.111.02-1.21.021 Preeclampsia0.790.70-0.90<.001 Antepartum FFP, cryoprecipitate2.051.19-3.53.01Non–time-varying Sickle cell anemia0.670.49-0.92.012 Anemia1.191.11-1.27<.001 Smoker0.780.7-0.88<.001 Hyperlipidemia1.171.08-1.26<.001 COPD1.311.04-1.65.021 DVT2.962.66-3.3<.001 Connective tissue disorder/vasculopathy1.441.2-1.72<.001 Hypothyroidism1.191.1-1.3<.001 Migraine1.31.2-1.4<.001 Primary language English)Spanish2.632.38-2.91<.001Other1.421.22-1.65<.001 Median income quintile first)Second0.970.88-1.08.64Third1.10.98-1.22.099Fourth1.191.07-1.33.002Fifth1.31.16-1.45<.001CI, Confidence interval; COPD, chronic obstructive pulmonary disease; DVT, deep vein thrombosis; fresh-frozen plasma; OR, odds ratio. Open table new tab