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Postpartum Venous Thromboembolism: Altitudinal Gradients, Decadal Trends, and PE-Specific Risk Profiling in Highland
Jianbo Yu1,2, Lobsang Chodron1, Tenzin Chodron1
1Emergency Department, People's Hospital of Xizang Autonomous Region, Lhasa, China.
Canadian Respiratory Journal
|June 29, 2026
Summary
Postpartum venous thromboembolism (VTE) risk increases with altitude, with higher rates of pulmonary embolism (PE) in very high-altitude areas. Key risk factors include altitude, multiparity, and comorbidities like hypertension and heart disease.
Area of Science:
- Obstetrics and Gynecology
- Cardiovascular Medicine
- Public Health
Background:
- Venous thromboembolism (VTE) is a significant concern during the postpartum period.
- Altitude is a potential environmental factor influencing VTE risk.
- Understanding temporal trends and risk factors for postpartum VTE is crucial for maternal health.
Purpose of the Study:
- To analyze differences in VTE characteristics across various altitudes during the puerperium.
- To examine temporal trends of VTE and deep vein thrombosis (DVT) from 2015-2024.
- To identify independent risk factors for postpartum pulmonary embolism (PE).
Main Methods:
- Retrospective cohort study of 172 postpartum women from 2015-2024.
- Comparison of VTE characteristics between high-altitude (HA) and very high-altitude (VHA) groups.
- Joinpoint regression analysis for temporal trends and multivariate analysis for risk factors.
Main Results:
- Pulmonary embolism (PE) proportion was significantly higher in the VHA group (p=0.033).
- VHA was associated with elevated preterm delivery (p=0.033) and multiparity (p<0.001).
- VTE and DVT showed significant early-phase escalations (2015-2022), while PE increased overall; altitude gradient, multiparity, hypertension/eclampsia, and heart disease were independent PE predictors.
Conclusions:
- Significant altitudinal gradients in postpartum VTE were observed.
- The escalating burden of postpartum VTE in high-altitude populations necessitates urgent intervention.
- Integrated management of multiparity and comorbidities is vital for addressing perinatal thrombotic risks.
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