Premium
Pregnancy‐related venous thromboembolism and HIV infection
Author(s) -
Schapkaitz Elise,
Libhaber Elena,
Rhemtula Haroun,
Gerber Annika,
Jacobson Barry F.,
Chauke Lawrence,
Büller Harry R.
Publication year - 2021
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.13596
Subject(s) - medicine , odds ratio , pregnancy , confidence interval , risk factor , case control study , venous thrombosis , obstetrics , thrombosis , genetics , biology
Objective To assess risk factors for venous thromboembolism (VTE) in African women in order to guide thromboprophylaxis. Methods 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. Results 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. Conclusion 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.