Pregnancy‐related thromboembolism in women with sickle cell disease: An analysis of National Medicaid Data

• Published in: American journal of hematology 2023-11, Vol.98 (11), p.1677-1684
• Main Authors: Agarwal, Shreya, Stanek, Joseph R., Vesely, Sara K., Creary, Susan E., Cronin, Robert M., Roe, Andrea H., O'Brien, Sarah H.
• Format: Article
• Language: English
• Subjects: Aged; Anemia, Sickle Cell - complications; Anemia, Sickle Cell - epidemiology; Anticoagulants; Eclampsia; Female; Genotypes; Hematology; Hemoglobin; Humans; Medicaid; Medicare; Population studies; Postpartum; Pregnancy; Risk factors; Sickle cell disease; Thromboembolism; Thrombosis; United States - epidemiology; Venous Thromboembolism - epidemiology; Venous Thromboembolism - etiology
• ISSN: 0361-8609; 1096-8652; 1096-8652
• DOI: 10.1002/ajh.27045

Pregnancy and sickle cell disease (SCD) both individually carry a risk of thromboembolism (TE). Pregnancy in people with SCD may further enhance the prothrombotic effect of the underlying disease. The objectives of this study were to determine the rate and risk factors for arterial and venous thrombosis in pregnant people with SCD. Administrative claims data from the United States Centers for Medicare and Medicaid Service Analytic eXtract from 2006 to 2018 were used. The study population included people with SCD from the start of their first identified pregnancy until 1 year postpartum and a control cohort of pregnant people without SCD of similar age and race. Outcomes of interest were identified with ICD‐9 or 10 codes. Logistic regression analyses were used to analyze risk factors. We identified infant deliveries in 6388 unique people with SCD and 17 110 controls. A total of 720 venous thromboembolism (11.3%) and 335 arterial TE (5.2%) were observed in people with SCD compared to 202 (1.2%) and 95 (0.6%) in controls. People with SCD had an 8–11 times higher odds of TE compared to controls (p