Characteristics and Risk Factors of Cancer Associated Venous Thromboembolism

The objective of this study was to examine the differences in commonly associated characteristics and risk factors of venous thromboembolism (VTE) between patients with and without cancer in a VTE population

Differences in Thrombotic Risk Factors in Black and White Women with Adverse Pregnancy Outcome

Black women have an increased risk of adverse pregnancy outcomes and the characteristics of thrombotic risk factors in this population are unknown. The objective of this study was to examine the racial differences in thrombotic risk factors among women with adverse pregnancy outcomes

Ambient air pollution and the risk of stillbirth in New Jersey

Introduction The purpose of this study was to examine the secular trends in the rates of stillbirth by race and ethnicity and to examine the risk of stillbirth with increase in ambient air pollution in each of the three trimesters of pregnancy and with short term increase in ambient air pollution. Materials and Methods We used New Jersey births and fetal deaths records linked to hospital discharge data for 1997-2005. Gestational age specific stillbirth rates were calculated by fetus at risk approach and Cox proportional hazard model was used to estimate the risk of stillbirth. We used logistic regression models to estimate the risk of stillbirth associated with incremental increase in ambient air pollution in each of the three trimesters. The association of transient increase in ambient air pollution with the risk of stillbirth was analyzed with a time stratified case crossover design using conditional logistic regression. Results The rate of stillbirth was 4.4 per 1000 total births (3.4 for white non-Hispanics, 7.9 for black non-Hispanics and 4.4 for Hispanics /1000 total births) in NJ for the period 1997 to 2005. The rates of stillbirth decreased only for white non-Hispanics but remained unchanged for other race/ethnicity groups. In the first trimester, increased risk of stillbirth was associated with interquartile range increase in PM2.5 (OR 1.14, 95% CI, 1.00, 1.31) and NO2 (OR 1.10, 95% CI, 1.00, 1.21) and SO2 (OR 1.12, 95% CI, 1.00, 1.25) and with PM2.5 ( OR 1.20, 95% CI, 1.04, 1.37) in the second trimester and with SO2 in both 2nd trimester (OR 1.21, 95% CI, 1.03, 1.29) and the 3rd trimester (OR 1.18, 95% CI, 1.00, 1.28). There was an increased risk of stillbirth for each interquartile range increase in 2nd day concentration of SO2 (RR 1.12, 95% CI, 1.02-1.23) and CO (RR 1.20, 95% CI, 1.04-1.38). Conclusion We found an increased risk of stillbirth associated with increase in ambient air pollution in all three trimesters of pregnancy and with short term increase in ambient air pollution. Understanding the biological mechanism for the association of criteria pollutants with the risk of stillbirth merits attention.Ph.D.Includes bibliographical referencesIncludes vitaby Ambarina S. Fai

Differences in Thrombotic Risk Factors in Black and White Women with Adverse Pregnancy Outcome

INTRODUCTION: Black women have an increased risk of adverse pregnancy outcomes and the characteristics of thrombotic risk factors in this population are unknown. The objective of this study was to examine the racial differences in thrombotic risk factors among women with adverse pregnancy outcomes. METHODS: Uniform data were collected in women with adverse pregnancy outcomes (pregnancy losses, intrauterine growth restriction (IUGR), prematurity, placental abruption and preeclampsia) referred to Thrombosis Network Centers funded by the Centers for Disease Control and Prevention (CDC). RESULTS: Among 343 white and 66 black women seen for adverse pregnancy outcomes, protein S and antithrombin deficiencies were more common in black women. The prevalence of diagnosed thrombophilia was higher among whites compared to blacks largely due to Factor V Leiden mutation. The prevalence of a personal history of venous thromboembolism (VTE) did not differ significantly by race. A family history of VTE, thrombophilia, and stroke or myocardial infarction (MI) was higher among whites. Black women had a higher body mass index, and a higher prevalence of hypertension, while the prevalence of sickle cell disease was approximately 27 fold higher compared to the general US black population. CONCLUSIONS: Thrombotic risk factors differ significantly in white and black women with adverse pregnancy outcomes. Such differences highlight the importance of considering race separately when assessing thrombotic risk factors for adverse pregnancy outcomes

Characteristics and Risk Factors of Cancer Associated Venous Thromboembolism

INTRODUCTION: The objective of this study was to examine the differences in commonly associated characteristics and risk factors of venous thromboembolism (VTE) between patients with and without cancer in a VTE population. MATERIALS AND METHODS: Uniform data were collected for patients with a diagnosis of VTE obtaining care at CDC funded Thrombosis Network Centers. Patient characteristics and risk factors were compared in VTE patients with and without cancer. Logistic regression was used to calculate the unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) to assess patient characteristics and thrombotic risk factors more frequently identified among VTE patients with cancer compared to those without cancer. RESULTS: Between August 2003 and April 2011, 3,115 adult patients with a diagnosis of VTE including 189 (6.1%) patients with active cancer participated in the multi-site thrombosis registry. VTE patients with cancer had a higher prevalence of PE and DVT in unusual sites compared to those without cancer. Thrombophilia was more common among VTE patients without cancer than those with cancer (25.1% vs 10.6%, p < 0.001). In adjusted analysis, age group ≥ 45 years (OR =5.20, 95% CI, 3.30, 8.18), surgery (OR =1.86, 95% CI, 1.19, 2.91), and hypertension (OR =1.66, 95% CI, 1.15, 2.40) were the VTE risk factors more commonly found among VTE patients with cancer. CONCLUSION: The study identified several thrombotic risk factors more likely to be found with cancer associated VTE, which may help to characterize at risk cancer patients and to develop prevention and management strategies in this population