Bitsadze Victoria, Nikolaeva Mariya Gennadevna, Mousty Ève, Khizroeva Jamilya, Laurent Jérémy, Ripart Sylvie, Kudryavtseva Ekaterina, Collen Lorris Le, Shatilina Anastasia, Allal Salim, Lyadnova Elizaveta, Fortier Mathieu, Bouvier Sylvie, Chea Mathias, Zainulina Marina Sabirovna, Perez-Martin Antonia, Makatsariya Alexander, Gris Jean-Christophe
Department of Obstetrics, Gynaecology and Perinatal Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
Department of Obstetrics and Gynaecology, Altai State Medical University, Barnaul, Russian Federation.
Thromb Haemost. 2025 Jul;125(7):643-656. doi: 10.1055/a-2484-0923. Epub 2024 Dec 18.
In young women with venous thromboembolism (VTE) related to weak transient risk factors, it remains unknown whether stress levels and intimate partner violence (IPV) are associated with recurrence. The VTE-WEAK study aims to investigate the association between perceived stress and IPV with a recurrence of VTE in women with a first episode of VTE due to combined oral contraceptives, pregnancy-puerperium, minor trauma/fracture, brief surgery, infection or brief immobility, and not using antithrombotic prophylaxis.
We performed a multicenter, international, observational, retrospective study on women referred for thrombophilia screening who were subsequently monitored. Patients were aged 18 to 55 years old and free of high-risk thrombophilia. When a recurrence of VTE was suspected for the first time, the perceived stress level and IPV were evaluated using self-administrated PSS-10 and Woman Abuse Screening Tool (WAST) questionnaires.
We monitored 7,754 women over 43,880 patients-years. A first suspected recurrence occurred in 4,772 women, among whom 1,316 had an objectively confirmed recurrence. The perceived stress level and an IPV situation were both independent risk factors for recurrence: moderate stress: adjusted odds ratio (aOR) 1.630 (1.415-2.468); high perceived stress: aOR 10.03 (7.528-13.36); IPV: 1.953 (1.546-2.468), < 0.0001.
The perceived level of stress and IPV are associated with a recurrence of VTE when suspected. The mechanisms and clinical consequences of a possible stress coagulopathy require investigation.
在患有与短暂性弱风险因素相关的静脉血栓栓塞症（VTE）的年轻女性中，压力水平和亲密伴侣暴力（IPV）是否与复发相关仍不清楚。VTE-WEAK研究旨在调查在因复方口服避孕药、妊娠-产褥期、轻微创伤/骨折、小型手术、感染或短期制动而首次发生VTE且未使用抗血栓预防措施的女性中，感知压力和IPV与VTE复发之间的关联。
我们对转诊进行血栓形成倾向筛查并随后接受监测的女性进行了一项多中心、国际性、观察性、回顾性研究。患者年龄在18至55岁之间，无高危血栓形成倾向。首次怀疑VTE复发时，使用自我管理的PSS-10和妇女虐待筛查工具（WAST）问卷评估感知压力水平和IPV。
我们在43,880患者年中监测了7,754名女性。4,772名女性首次怀疑复发，其中1,316名经客观证实复发。感知压力水平和IPV情况均为复发的独立危险因素：中度压力：调整后的优势比（aOR）为1.630（1.415 - 2.468）；高感知压力：aOR为10.03（7.528 - 13.36）；IPV：1.953（1.546 - 2.468），P < 0.0001。
怀疑VTE复发时，感知压力水平和IPV与之相关。可能的应激性凝血病的机制和临床后果需要研究。
