GRADE table 2, (Question 2): Among women of reproductive age, do postpartum women have increased risk of venous thromboembolism (VTE) compared with non-postpartum, non-pregnant women? (Indirect evidence) - Medical Eligibility Criteria for Contraceptive Use

Outcome	Type and number of studies (number of participants)	Limitations	Inconsistency	Imprecision	Indirectness	Other factors	Quality	Estimate of effect
First 6 weeks postpartum vs non-pregnant, non-postpartum
Venous thromboembolism (VTE)	4 cohort studies (n=3 365 650); 1 case-control study (285 cases)	Serious limitations (1 good, 4 fair)	No serious inconsistency (direction consistent; variability in magnitude)	No serious imprecision	Serious indirectness (not women using CHC vs not using CHC)	Duration-response effect in first 6 weeks, first 1–3 weeks associated with highest risk;^a weeks 0–6 associated with higher risk than after week 7^b	Low	Any VTE (2 studies): rate ratio 21.5 (CI not available) and 22 (95% CI 18–27) and OR 84 (95% CI 32–223) and 12 (95% CI 7.9–18.6) DVT (1 study): incidence ratio 15 (95% CI 13–18) Pulmonary embolism (1 study): incidence ratio 9.2 (95% CI 6.5–13)

Outcome

Type and number of studies (number of participants)

Limitations

Inconsistency

Imprecision

Indirectness

Other factors

Quality

Estimate of effect

First 6 weeks postpartum vs non-pregnant, non-postpartum

Venous thromboembolism (VTE)

4 cohort studies (n=3 365 650); 1 case-control study (285 cases)

Serious limitations
(1 good, 4 fair)

No serious inconsistency
(direction consistent; variability in magnitude)

No serious imprecision

Serious indirectness
(not women using CHC vs not using CHC)

Duration-response effect in first 6 weeks, first 1–3 weeks associated with highest risk;^a weeks 0–6 associated with higher risk than after week 7^b

Low

Any VTE (2 studies): rate ratio 21.5 (CI not available) and 22 (95% CI 18–27) and OR 84 (95% CI 32–223) and 12 (95% CI 7.9–18.6)

DVT (1 study): incidence ratio 15 (95% CI 13–18)

Pulmonary embolism (1 study): incidence ratio 9.2 (95% CI 6.5–13)

From: I, Development of the Medical eligibility criteria for contraceptive use, fifth edition

Cover of Medical Eligibility Criteria for Contraceptive Use

Medical Eligibility Criteria for Contraceptive Use. 5th edition.

Geneva: World Health Organization; 2015.

All rights reserved. Publications of the World Health Organization are available on the WHO website (www.who.int) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: tni.ohw@sredrokoob).

Requests for permission to reproduce or translate WHO publications –whether for sale or for non-commercial distribution– should be addressed to WHO Press through the WHO website (www.who.int/about/licensing/copyright_form/en/index.html).

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

GRADE table 2(Question 2): Among women of reproductive age, do postpartum women have increased risk of venous thromboembolism (VTE) compared with non-postpartum, non-pregnant women? (Indirect evidence)