Anticipation grows stronger, anticipation grows stronger, the east wind arrives, and the Spring Festival is drawing near...
For expectant mothers, the most inconvenient thing when they are pregnant is going out, especially "super long trips", such as going home for the Spring Festival, which requires taking a plane.
Studies have shown that pregnancy and air travel are risk factors for venous thromboembolism (VTE), blood clots in the legs or lungs. So, wouldn't the risk of VTE for pregnant women who travel by air during the Spring Festival increase dramatically?
But don't worry! A recent study published in the Journal of Travel Medicine has prepared a few tips for expectant mothers to make it easy to bring their babies on the plane.
Is long-distance travel more likely to cause blood clots and embolisms?
The study noted that, on average, 2.8 out of every 1,000 long-haul travelers experience venous thromboembolism. With over 2 billion air passengers annually, approximately 150,000 cases of thrombosis are travel-related.
Dr. Leslie Skeith of the University of Calgary is a member of the CanVECTOR Thrombosis Research Network in Canada.
She and her colleagues reviewed many factors that influence an individual's risk of thrombosis, including: height, weight, recent surgery, pregnancy, use of oral contraceptives, hormone replacement therapy, and family history or diseases that promote thrombosis.
They found that the risk of developing VTE is higher during pregnancy.
This is due to a series of physiological changes (such as vasodilation caused by progesterone, compression of pelvic veins by fetal development, and compression of the left iliac vein by the right iliac artery), as well as vascular damage caused by endothelial injury (due to childbirth and venous dilation). The hypercoagulable state of blood during pregnancy is also a significant factor contributing to the risk of thrombosis in expectant mothers.
The risk of developing VTE also depends on individual factors. For example, women with a history of thrombosis have a 4% higher risk during pregnancy, while pregnant women with thrombosis caused by hormones have a 6% higher risk.
Although studies have shown that the absolute risk of pregnant women developing blood clots during flight is low, less than 1%.
However, in pregnant women with a history of venous thromboembolism, a high tendency to thrombosis, or high-risk prenatal factors (such as obesity and lack of exercise), the travel-related risk of venous thromboembolism is >1%.
Postpartum women with thrombotic hemophilia (especially those with a family history of the disease) and other transient risk factors may have a >1% risk of developing venous thromboembolism while traveling.
According to a recent meta-analysis, approximately 1.2 out of every 1,000 women during or after childbirth are affected.
Although the risks may be roughly the same before and after delivery, the risk of VTE is higher within 6 weeks postpartum, then gradually decreases, continuing until after 12 weeks.
After all that talk—
So how exactly can we prevent it?
Those who want a clear and concise version of the preventative measures can skip to the end. You're welcome.
Based on the findings of Skeith et al., it is recommended that all pregnant travelers (pregnant women without additional VTE risk, if the VTE risk after flight is less than 1%) take simple measures such as walking more, drinking water, exercising their calves, and wearing comfortable, loose clothing and slippers.
For individuals at moderate risk, such as those with a minor risk of venous thromboembolism, it is recommended to consider using 20-30 mmHg graded compression stockings (hereinafter referred to as "compression stockings").
Medical compression stockings
For pregnant women with a history of thrombosis or high-risk factors such as thrombotic hemophilia (VTE risk may be >1%), such measures should be considered if the traveler has not yet received relevant low molecular weight heparin (LMWH) thrombosis prevention treatment.
If anticoagulation therapy has been initiated during pregnancy and breastfeeding, a prophylactic dose of LMWH should be chosen. Considering the drug's peak effect over 3-4 hours, it is recommended to start LMWH use from the day of travel.
However, the optimal dosage during travel remains unknown, and no data provides guidance.
Think it's too complicated?
No worries, Skeeth and her colleagues have thoughtfully summarized the advice from various guides for us, and we've also translated it for you.
If you're still not entirely comfortable with this, consult a local thrombosis specialist. A doctor needs to understand your specific situation to provide better advice.
In addition, most airlines stipulate:
Pregnant women less than 32 weeks pregnant can travel as regular passengers, unless a doctor has diagnosed them as unfit to fly. Pregnant women between 32 and 35 weeks pregnant must provide a medical certificate for air travel (valid for 72 hours) stamped by a medical institution and signed by a doctor (some airlines require a certificate from a Grade II or higher medical institution). Women 35 weeks pregnant or older, those nearing their due date but with an unknown date, those with a known history of multiple pregnancies or anticipated delivery complications, those showing signs of premature labor, and those less than 7 days postpartum are not advised to fly.
Mothers worried about whether airport security radiation might harm their babies can rest assured. More important than the tiny amount of radiation from airport security is figuring out if your baby is even allowed to board the plane.
Unless you're planning to lie on a conveyor belt and experience what it's like to be luggage...
