Lee Kyung-Eun, Byeon Eun-Jeong, Kwon Mi-Ju, Ko Hyun-Sun, Shin Jae-Eun
Department of Obstetrics and Gynecology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
J Clin Med. 2025 Mar 17;14(6):2031. doi: 10.3390/jcm14062031.
In this study, we aimed to evaluate the impact of mild thrombocytopenia on the incidence of postpartum hemorrhage (PPH) and associated clinical outcomes in a cohort of pregnant women who delivered via cesarean section. Women who underwent cesarean delivery at two tertiary medical centers in Korea between January 2009 and December 2019 were included in this retrospective cohort study. Associations between groups and baseline characteristics were assessed using tests and chi-square tests. Logistic regression was performed to evaluate the increased risk of PPH. All analyses were conducted using R version 4.3.3. Of 15,549 women who gave birth, 6487 met the inclusion criteria; 485 (7.5%) were diagnosed with mild thrombocytopenia, whereas 6002 had normal platelet counts. Women with mild thrombocytopenia had a threefold higher risk of PPH (adjusted OR: 3.74; 95% CI: 1.36-10.30) compared to those with normal platelet counts. They were also more likely to require blood transfusions and experience a >4 g/dL drop in hemoglobin level (adjusted OR: 2.28 and 2.99, respectively). In the subgroup analysis, women with immune-related thrombocytopenia had lower platelet counts than other groups from the third trimester to 2 months postpartum. However, primary and secondary PPH outcomes did not differ significantly among the subgroups. Mild maternal thrombocytopenia before cesarean section was associated with a higher risk of PPH compared to normal platelet counts; however, the overall prognosis was similar regardless of the underlying cause.
在本研究中，我们旨在评估轻度血小板减少症对剖宫产分娩的孕妇队列中产后出血（PPH）发生率及相关临床结局的影响。本回顾性队列研究纳入了2009年1月至2019年12月期间在韩国两家三级医疗中心接受剖宫产的妇女。使用检验和卡方检验评估组间及基线特征之间的关联。进行逻辑回归以评估PPH风险的增加。所有分析均使用R 4.3.3版本进行。在15549名分娩妇女中，6487名符合纳入标准；485名（7.5%）被诊断为轻度血小板减少症，而6002名血小板计数正常。与血小板计数正常的妇女相比，轻度血小板减少症妇女发生PPH的风险高3倍（调整后的比值比：3.74；95%置信区间：1.36 - 10.30）。她们也更有可能需要输血，并且血红蛋白水平下降>4 g/dL（调整后的比值比分别为2.28和2.99）。在亚组分析中，从孕晚期到产后2个月，免疫相关性血小板减少症妇女的血小板计数低于其他组。然而，亚组之间原发性和继发性PPH结局无显著差异。与血小板计数正常相比，剖宫产术前轻度母体血小板减少症与PPH风险较高相关；然而，无论潜在原因如何，总体预后相似。
