Analysis Of Risk Factors For Occurrence And Outcome Of Deep Vein Thrombosis In Pregnant Women

Objective:The aim of this study was to investigate maternal risk factors for the development of deep vein thrombosis（DVT）and factors influencing the outcome of DVT,so as to establish a basis for early clinical intervention to reduce its adverse effects on the mother and baby.Methods:Selected pregnant women who had a regular birth test and were admitted to the department of obstetrics in our hospital between January2021 and January 2022,and their maternal information was collected by electronic hospital medical record system and telephone follow-up,the contents are as follows:（1）Basic information:age bracket,weight,height,history of pregnancy,gestational week at gestation,previous VTE history,family history,past smoking and alcohol consumption,mode of delivery,assisted reproductive technology,multiple pregnancy,complications in pregnant and puerperal period;（2）Laboratory indexes:C-reactive protein（CRP）,hemoglobin（HGB）,albumin（ALB）,platelet（PLT）,D-dimer（DD）,thrombin time（TT）,prothrombin time（PT）,Activated partial thromboplastin time（APTT）,fibrinogen（FIB）,and ALB,CRP,HGB,PLT values within 48hours after parturition;（3）The conclusions of lower limb color doppler ultrasound（CUS）in the first day after parturition;（4）The treatment methods of pregnant women with DVT,the time and results of reexamination of CUS,etc.A total of 891 pregnant women with complete information were finally collected.The information of the collected data was entered into an Excel spreadsheet,and the SPSS 26.0 software was used for statistically analyzing the collected data:For measurement data,obeyed normal distribution and expressed it as mean±standard deviation,and independent sample t-test was applied to comparison between Inter-group.If they didn’t obey the normal distribution,they would use M(P₂₅-P₇₅)to express their dissatisfaction,and independent sample Wilcoxon rank sum test was applied to comparison between Inter-group;For counting data,the constituent ratio or rate shall was used,and the chi-square test or Fisher’s exact probability method shall was applied to comparison among groups;For the risk factors affecting the occurrence and outcome of DVT,Multi-factor stepwise logistic regression analysis was exploited,α_in=0.05,α_out=0.10.The test level for the other hypothesis tests was 0.05.Results:1.Of the 891 cases,58 were pregnant women who developed DVT,all detected by routine color Doppler ultrasound of both lower extremities during the puerperium.Among them,primigravida（55.17%）were the most common,with left-sided lower extremities（55.17%）and myenteric veins（81.03%）occurring more often.2.In the analysis of relevant ingredients that affected the occurrence of DVT:In univariate analysis:（1）the essential features and complications in pregnant and puerperal period:age bracket,mode of delivery,previous history of VTE,gestational age at delivery and hypertensive disorders during pregnant period in connection with the incidence of perinatal DVT（P<0.05）.（2）Laboratory indexes:PT,FIB,prenatal CRP,prenatal HGB/ALB,postpartum PLT,the antenatal postpartum CRP difference,PT group and prenatal PLT group showed some correlation with the occurrence of peripartum DVT（P<0.05）.In the light of multivariate stepwise logistic regression analysis:（1）the essential features and complications in pregnant and puerperal period:severe preeclampsia was a protective factor for the development of DVT（P<0.05）;（2）Laboratory indexes:prenatal HGB/ALB values were independent risk factors for the development of DVT（P<0.05）;antenatal PLT values in connection with the occurrence of DVT（P<0.05）,and were represented by antenatal PLT≤169×10⁹/L level for the reference group,（169-248）×10⁹/L and≥248×10⁹/L were risk factors for the development of DVT（P<0.05）,and the higher values were associated with a greater risk of DVT.3.In the analysis of relevant factors affecting the outcome of DVT:（1）the essential features and complications in pregnant and puerperal period:There was a certain correlation between the number of births and thrombotic sites and the outcome of DVT（P<0.05）.（2）Laboratory indexes:The prenatal postnatal HGB difference and the prenatal postnatal PLT difference grouping were specifically associated with DVT outcome（P<0.05）.In the light of multivariate stepwise logistic regression analysis:（1）the essential features and complications in pregnant and puerperal period:Two or more pregnancies were the protective factors of the thrombus residual group（P<0.05）;（2）Laboratory indexes:Compared with the reference range of PLT difference before and after（6-40）×10⁹/L,it is less than 6×10⁹/L was a protective factor of thrombus residue group（P<0.05）.Conclusion:1.Perinatal DVT is commonly found in primiparous community,and the incidence of DVT in the left lower above the average,and it is more likely to occur in intermuscular veins.2.For DVT occurrence:prenatal HGB/ALB value and prenatal PLT grouping are important factors that affect the formation of DVT;pregnant women with severe preeclampsia do not increase the risk of DVT.3.For DVT occurrence:the smaller the difference between PLT before and after delivery,the greater the possibility of complete disappearance of DVT;the risk of thrombosis residue after DVT formation in postparous women is smaller than that of nulliparous women.