Journal of Shanghai Jiao Tong University (Medical Science) ›› 2022, Vol. 42 ›› Issue (4): 415-421.doi: 10.3969/j.issn.1674-8115.2022.04.003

• High-risk pregnancy column • Previous Articles     Next Articles

Analysis of risk factors for postpartum thrombotic disease

ZHU Yueyue1(), ZHANG Jinwen1, MA Ruixiang2, CHEN Cailian2, LIN Yi1, LIU Xiaorui1()   

  1. 1.Central Laboratory of The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Embryo Original Diseases; Institute of Birth Defects and Rare Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
    2.Department of Automation, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University; Key Laboratory of System Control and Information Processing, Ministry of Education, Shanghai 200240, China
  • Received:2021-11-29 Accepted:2022-04-11 Online:2022-04-28 Published:2022-04-28
  • Contact: LIU Xiaorui E-mail:zhuyueyue216@126.com;xiaorui1211@126.com
  • Supported by:
    National Key R&D Program of China(2018YFC1002800);National Natural Science Foundation of China(82171669);Shanghai Jiao Tong University Trans-Med Awards Research (Major Project)(20210201)

Abstract: Objective

·To explore the high-risk factors and provide guidance for the prevention of postnatal thromboembolism.

Methods

·Based on a retrospective case-control design, a total of 45 262 electronic cases of women giving birth in the International Peace Maternal & Child Health Hospital, Shanghai Jiao Tong University School of Medicine from 2018 to 2020 were excavated. The case group was 60 parturients diagnosed with postpartum venous thrombosis or pulmonary embolism, while the control group was 45 202 parturients who were normal. Multivariate logistic regression analysis was used to find the risk factors of postpartum thrombosis.

Results

·The incidence of postpartum venous thrombosis was 130/100 000 and pulmonary embolism was 46/100 000. The incidence of postpartum thrombotic disease showed a trend of increasing year by year (P<0.05). The left lower extremity was the main site of postpartum thrombosis. In this study, the average age of the mothers at delivery was 33.52±4.79 years old in the case group and 31.35±4.01 years old in the control group. The proportion of preterm birth in the case group was 2.05 times that of the control group, and the proportion of pre-pregnancy overweight and obese was 1.94 times that of the control group. Multivariate Logistic regression analysis showed that the elder age (aOR=1.10, 95%CI 1.04?1.17), the smaller the gestational age (aOR=0.88, 95%CI 0.78?0.99), less than a bachelor's degree (aOR=2.24, 95%CI 1.20?4.18), elective caesarean (aOR=6.68, 95% CI 2.56?17.41), emergency caesarean (aOR=14.40, 95%CI 5.37?38.63) and pre-pregnancy overweight and obesity (aOR=1.91, 95%CI 1.04?3.49) all increased the risk of postpartum thrombosis.

Conclusion

·Maternal age, education level, gestational age, overweight and cesarean section were independent risk factors for postpartum thrombosis. The most prominent risk factor was emergency cesarean section. The occurrence of postpartum venous thrombosis was associated with a variety of risk factors and can lead to maternal death. Clinicians need to assess the risk of thrombosis in time, and take preventive measures as soon as possible for women with high risk factors to reduce the risk of postpartum thrombosis.

Key words: postpartum thrombotic disease, risk factors, emergency cesarean section

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