Department of Molecular Medicine and Hematology, Faculty of Health Sciences, University of Witwatersrand Medical School, Johannesburg, South Africa.
HS Research Office and School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand Medical School, Johannesburg, South Africa.
Int J Gynaecol Obstet. 2021 Oct;155(1):110-118. doi: 10.1002/ijgo.13596. Epub 2021 Feb 12.
To assess risk factors for venous thromboembolism (VTE) in African women in order to guide thromboprophylaxis.
A case-control study was performed at a specialist obstetric unit in South Africa from July 1, 2017 to June 30, 2020. We identified 128 cases with VTE and 640 controls, matched for gestation.
Prepartum risk factors associated with VTE included; medical comorbidities (odds ratios [OR] 5.32, 95% confidence intervals [CI] 1.82-15.56), human immunodeficiency virus (HIV) (OR 2.84, 95% CI 1.50-5.41), and hospital admission or immobility (OR 5.33, 95% CI 1.17-24.22). Postpartum, the following were identified as significant risk factors; medical comorbidities (OR 23.72, 95% CI 8.75-64.27), hospital admission or immobility (OR 13.18, 95% CI 5.04-34.49), systemic infection (OR 4.48, 95% CI 1.28-15.68), HIV (OR 3.20, 95% CI 1.49-6.87), pre-eclampsia and fetal growth restriction (OR 2.74, 95% CI 1.18-6.36), and postpartum hemorrhage (OR 4.38, 95% CI 1.75-10.97). Antiretroviral therapy, opportunistic infections, and viral load >50 copies/ml, however, were not associated with VTE risk among HIV-infected participants.
HIV was a significant risk factor for pregnancy-related thrombosis. This was independent of traditional HIV risk factors. As such, future studies are recommended to explore the mechanisms of thrombosis associated with HIV infection.
评估非洲女性静脉血栓栓塞症（VTE）的风险因素，以指导血栓预防。
本病例对照研究于 2017 年 7 月 1 日至 2020 年 6 月 30 日在南非一家专科产科病房进行。我们共确定了 128 例 VTE 患者和 640 例孕周匹配的对照者。
产前与 VTE 相关的风险因素包括：合并内科疾病（比值比 [OR] 5.32，95%置信区间 [CI] 1.82-15.56）、人类免疫缺陷病毒（HIV）感染（OR 2.84，95%CI 1.50-5.41）和住院或不能活动（OR 5.33，95%CI 1.17-24.22）。产后，以下因素被确定为显著的危险因素：合并内科疾病（OR 23.72，95%CI 8.75-64.27）、住院或不能活动（OR 13.18，95%CI 5.04-34.49）、全身感染（OR 4.48，95%CI 1.28-15.68）、HIV 感染（OR 3.20，95%CI 1.49-6.87）、子痫前期和胎儿生长受限（OR 2.74，95%CI 1.18-6.36）和产后出血（OR 4.38，95%CI 1.75-10.97）。然而，抗逆转录病毒治疗、机会性感染和病毒载量>50 拷贝/ml 与 HIV 感染者的 VTE 风险无关。
HIV 是妊娠相关血栓形成的重要危险因素。这与传统的 HIV 危险因素无关。因此，建议进行未来的研究以探讨与 HIV 感染相关的血栓形成机制。
