Incidence of VTE in Pregnant Women with Sickle Cell Gene Mutation(s): A Retrospective Database Analysis

Shaukat, Rimsha; Blanc, Kimberly Le; Brown, Tyiesha; Robin, Alida; Martinez, Shidestini Chanta; Walton, Jacqueline; Gutta, Pranavteja; Shi, Runhua; Master, Samip; Mansour, Richard

doi:10.1182/blood-2022-160407

Cited by 3 publications

(4 citation statements)

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“…In this cohort study, pulmonary embolism (PE) was observed to be the most prevalent type of VTE event, aligning with previous findings in SCD patients [10,14,24]. Notably, thrombosis in situ in large pulmonary vessels has been reported in approximately 20% of patients diagnosed with ACS [25]. This prompts the question of whether thrombosis in situ is more prevalent in SCD patients due to the underlying vascular inflammation and nitrous oxide depletion [26].…”

Section: Discussionsupporting

confidence: 87%

Predisposing Factors and Incidence of Venous Thromboembolism among Hospitalized Patients with Sickle Cell Disease

Ziyadah,

Mansory,

Alahwal

et al. 2023

JCM

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Though patients with sickle cell disease (SCD) are at risk of developing venous thromboembolism (VTE), clear estimates of its incidence and predisposing factors in hospitalized SCD patients are not available. Therefore, this issue was addressed to facilitate an early diagnosis and initiate appropriate prophylactic and treatment strategies. A retrospective observational study was conducted on patients with SCD who were admitted to an academic center in Saudi Arabia over a 10-year period. We identified 1054 admissions of 394 patients with SCD. Of the 3% of patients identified with VTE, 50% experienced pulmonary embolism (PE), 34.3% exhibited deep vein thrombosis (DVT), 6.3% exhibited cerebral vein thrombosis, and 9.4% showed other forms of VTE. In pregnant SCD patients, 6.4% developed a VTE event during their hospital admission. Of the risk factors, high white blood cell count, length of stay, and presence of any additional risk factor for VTE was associated significantly with higher risk of VTE. In our study, this risk seems to be much lower, which is likely attributed to the use of VTE prophylactic strategies implemented in our center. Nevertheless, further studies are needed to establish the ideal prophylactic strategy in patients with SCD.

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Section: Discussionsupporting

confidence: 87%

Predisposing Factors and Incidence of Venous Thromboembolism among Hospitalized Patients with Sickle Cell Disease

Ziyadah,

Mansory,

Alahwal

et al. 2023

JCM

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“…47 In SCD, the incidence of pregnancyassociated VTE is found to be as high as 17%. 48 The prevalence of VTE has also been shown to be 3.5-fold greater among SCD pregnant women with complications such as VOC, ACS and pneumonia compared to those without these complications. 49…”

Section: Women and Pregnant Personsmentioning

confidence: 99%

“…In the general population, the incidence of VTE during pregnancy and postpartum is approximately 0.2% 46 and 0.18% respectively 47 . In SCD, the incidence of pregnancy‐associated VTE is found to be as high as 17% 48 . The prevalence of VTE has also been shown to be 3.5‐fold greater among SCD pregnant women with complications such as VOC, ACS and pneumonia compared to those without these complications 49 …”

Section: Thrombosis Risk In Various Scd Populationsmentioning

confidence: 99%

Evaluating thromboprophylaxis in the sickle cell disease population: Navigating the evidence gap

Davila,

O'Brien,

Mitchell

et al. 2024

Br J Haematol

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SummarySickle cell disease (SCD) arises from beta‐globin gene mutations, with global estimates indicating around 500 000 affected neonates in 2021. In the United States, it is considered rare, impacting fewer than 200 000 individuals. The key pathogenic flaw lies in mutant haemoglobin S, prone to polymerization under low oxygen conditions, causing erythrocytes to adopt a sickled shape. This leads to complications like vascular occlusion, haemolytic anaemia, inflammation and organ damage. Beyond erythrocyte abnormalities however, there is a body of literature highlighting the hypercoagulable state that is likely a contributor to many of the complications we see in SCD. The persistent activation of the coagulation cascade results in thromboembolic events, notably venous thromboembolism (VTE) which is independently associated with increased mortality in both adults and children with SCD. While the increased risk of VTE in the SCD population seems well established, there is a lack of guidelines for thromboprophylaxis in this population. This Wider Perspective will describe the hypercoagulable state and increased thrombosis risk in the SCD population, as well as advocate for the development of evidence‐based guidelines to aid in the prevention of VTE in SCD.

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“…Known risk factors for VTE in women with SCD include disease severity (assessed by frequency of hospitalization), pulmonary hypertension, avascular necrosis, acute chest syndrome, and vaso-occlusive crisis [ 8 , 18 , 19 ]. Pregnancy is a recognized risk factor for VTE in general, and this risk is substantially amplified in women with SCD [ 20 ], but the increased risk of VTE has been found to be independent of pregnancy [ 21 , 22 ]. This underscores the need to explore additional factors contributing to VTE in this specific population.…”

Section: Introductionmentioning

confidence: 99%

Disease severity drives risk of venous thrombotic events in women with sickle cell disease in a single-center retrospective study

Light,

Abrams,

Ilich

et al. 2024

Research and Practice in Thrombosis and Haemostasis

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Incidence of VTE in Pregnant Women with Sickle Cell Gene Mutation(s): A Retrospective Database Analysis

Cited by 3 publications

References 0 publications

Predisposing Factors and Incidence of Venous Thromboembolism among Hospitalized Patients with Sickle Cell Disease

Predisposing Factors and Incidence of Venous Thromboembolism among Hospitalized Patients with Sickle Cell Disease

Evaluating thromboprophylaxis in the sickle cell disease population: Navigating the evidence gap

Disease severity drives risk of venous thrombotic events in women with sickle cell disease in a single-center retrospective study

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