Assessment of post-partum haemorrhage risk among women with moderate thrombocytopenia

Br J Haematol. 2022 May;197(4):482-488. doi: 10.1111/bjh.18098. Epub 2022 Mar 10.

Abstract

It is unknown whether moderate thrombocytopenia represents a risk factor for post-partum haemorrhage (PPH). We assessed PPH risk among women with a platelet count of between 100 and 50 × 109 /l and stratified the risk for O/non-O blood group. We included consecutive women undergoing vaginal delivery or caesarean section with moderate thrombocytopenia. Women with >150 × 109 /l platelets at delivery were selected as controls and matched for age, type of birth and ethnicity. Odds ratios (ORs) with their 95% confidence intervals (95% CIs) were calculated as risk estimates. A total of 94 thrombocytopenic women and 94 controls were included in the study. The rate of PPH was significantly higher in thrombocytopenic women than in controls (37% vs. 10%, p < 0.001); there was a higher risk of PPH in the thrombocytopenic group when compared to the control group (adjusted OR 4.7, 95% CI 2.1-10.8, p < 0.01) and this association was stronger in blood group O carriers (adjusted OR 11.0, 95% CI 2.4-49.6, p < 0.01). In conclusion, our study shows that a moderate thrombocytopenia is a risk factor for PPH, especially in blood group O carriers.

Keywords: ABO blood-group system; delivery, obstetric; post-partum haemorrhage; risk factors; thrombocytopenia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Group Antigens*
  • Cesarean Section / adverse effects
  • Female
  • Humans
  • Leukopenia*
  • Male
  • Postpartum Hemorrhage* / epidemiology
  • Postpartum Hemorrhage* / etiology
  • Postpartum Period
  • Pregnancy
  • Risk Factors
  • Thrombocytopenia* / complications

Substances

  • Blood Group Antigens