The predictive value of D-dimer test for venous thromboembolism during puerperium in women age 35 or older: a prospectiv
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RESEARCH
Open Access
The predictive value of D-dimer test for venous thromboembolism during puerperium in women age 35 or older: a prospective cohort study Wen Hu†, Dong Xu†, Juan Li, Cheng Chen, Yuan Chen, Fangfang Xi, Feifei Zhou, Xiaohan Guo, Baihui Zhao* and Qiong Luo*
Abstract Background: This study aimed to investigate the predictive value of the D-dimer level for venous thromboembolism (VTE) events during puerperium of women age at 35 years or older, as well as to identify other risk factors associated with the occurrence of VTE. Methods: It was a prospective observational cohort study, from January 2014 to December 2018, which involved 12, 451 women age 35 or older who delivered at least 28 weeks of gestation at Women’s Hospital of Zhejiang University, School of Medicine. The maternal and fetal demographic characteristics, pregnancy complications, imaging finding and results of laboratory test within postpartum 24 h including D-dimer level, platelet counts and fibrinogen level were collected for analyses. Results: 30(2.4‰) women were identified as VTE, including 1 pulmonary embolism event and 29 deep venous thrombosis events. The receiver operating characteristic (ROC) curve analysis suggested the best cutoff point for Ddimer level within postpartum 24 h of women age 35 or older was 5.545 mg/L, with a specificity of 70.0% and a sensitivity of 75.4%. Besides, there was no statistical correlation between platelet counts and VTE, as well as between fibrinogen level and VTE. On multivariate analysis, D-dimer≥5.50 mg/L (OR = 5.874, 95%CI: 2.678–12.886) and emergency cesarean section (OR = 11.965, 95%CI: 2.732–52.401) were independently associated with VTE in puerperium of women age 35 or older. Conclusions: We concluded that D-dimer≥5.50 mg/L was an independent predictor of VTE in puerperium with maternal age 35 or older and D-dimer testing was a necessary examination for perinatal women. Keywords: D-dimer, Venous thromboembolism, Women age at 35 years or older, Puerperium
* Correspondence: [email protected]; [email protected] † Wen Hu and Dong Xu contributed equally to this work. Department of Obstetrics, Women’s Hospital, Zhejiang University, School of Medicine, 1st Xueshi Road, Hangzhou 310006, Zhejiang, China © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this
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