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This is fascinating, Alison, and backs up my hunch that perceptions of 'risk' are rather vague and conflicting. Thank you so much. I hope you will be publishing your work? It sounds as though it will make a really important contribution to the debate. Very best wishes Mary Mary Stewart Consultant midwife Room J334 Chelsea and Westminster Hospital NHS Foundation Trust 369 Fulham Road London SW10 9NH Tel: 07872 423085 -----Original Message----- From: A forum for discussion on midwifery and reproductive health research. [mailto:[log in to unmask]] On Behalf Of Alison Cooke Sent: Friday, February 04, 2011 1:43 PM To: [log in to unmask] Subject: Re: VTE risk factors Dear Mary, I have just completed my MRes looking at advanced maternal age. I am not aware that any existing studies have included venous thrombo-embolism as an age related risk factor. The studies that are available are conflicting, all but one are retrospective, most include small samples and have no control for confounders such as obesity, smoking, underlying medical conditions etc. Further studies are required. The prospective study by Cleary-Goldman actually suggested that outcomes were quite favourable in this population. The only clear increased risks appear to be stillbirth after 38 weeks, chromosomal anomolies and infertility. Alison Quoting "Stewart, Mary" <[log in to unmask]>: > Hi everyone > > Does anyone have any thoughts on potential risk factors for venous > thrombo-embolism? We are in the process of updating the guidelines > for our unit, and have been having lengthy discussions about what > might constitute a risk factor. Maternal age is a particular > sticking point. It has been suggested that maternal age >35, along > with one or more risk factors (woman who smokes etc) constitutes > 'risk' and women should be recommended TED stockings and low > molecular weight heparin. This seems excessive, to be honest, but > I'm interested to know what happens in other units. > > Many thanks for your help and thoughts > > Mary > > Mary Stewart > Consultant midwife > Room J334 > Chelsea and Westminster Hospital NHS Foundation Trust > 369 Fulham Road > London SW10 9NH > > Tel: 07872 423085 > > > ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ > > [log in to unmask]: > > This e-mail is confidential and may well also be legally privileged. > If you have received it in error, you are on notice of its status. > Please notify us immediately by reply e-mail and then delete this > message from your system. > Please do not copy it or use it for any purposes, > or disclose its contents to any other person: to do so could be a > breach of confidence. > Any views expressed in this message are those of the individual sender, > except where the sender specifically states them to be the views of > the Trust. > Thank you for your co-operation. > > This footnote confirms that the message has been swept for computer > viruses by > McAfee VirusScan Enterprise Edition: whilst every care is taken to > avoid the transmission > of virus code; please ensure that you have up to date virus > detection software before opening > any E-mail messages or attachments. > > Chelsea and Westminster Hospital NHS Foundation Trust > > ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ > > If you have received this email in error please notify the > originator of the message. > > Any views expressed in this message are those of the individual sender. > > Scanning of this message and addition of this footer is performed > by Websense Email Security software in conjunction with > Mcafee virus detection software. > > -- Alison Cooke Research Midwife Central Manchester University Hospitals NHS Foundation Trust and The University of Manchester 5th Floor, Research St Mary's Hospital Oxford Road Manchester M13 9WL Tel +44 (0)161 276 5469 Email: [log in to unmask] [log in to unmask] ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ [log in to unmask]: This e-mail is confidential and may well also be legally privileged. If you have received it in error, you are on notice of its status. Please notify us immediately by reply e-mail and then delete this message from your system. Please do not copy it or use it for any purposes, or disclose its contents to any other person: to do so could be a breach of confidence. Any views expressed in this message are those of the individual sender, except where the sender specifically states them to be the views of the Trust. Thank you for your co-operation. This footnote confirms that the message has been swept for computer viruses by McAfee VirusScan Enterprise Edition: whilst every care is taken to avoid the transmission of virus code; please ensure that you have up to date virus detection software before opening any E-mail messages or attachments. Chelsea and Westminster Hospital NHS Foundation Trust ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ If you have received this email in error please notify the originator of the message. Any views expressed in this message are those of the individual sender. Scanning of this message and addition of this footer is performed by Websense Email Security software in conjunction with Mcafee virus detection software.