Objective To explore the risk factors of venous thromboembolism (VTE) in the pregnancy and puerperium.

Methods A total of 38 pregnant women and puerperae diagnosed VTE in Changhai Hospital from 2010 to 2020 were recruited as the VTE group, and 199 pregnant women and puerperae without VTE at the same time in Changhai Hospital were randomly selected as the control group. A retrospective study was conducted in the two groups. The high-risk factors, Caprini score and VTE risk factor score from "Shanghai consensus on comprehensive prevention and treatment of obstetric venous thromboembolism" (Shanghai consensus) and laboratory indicators between the two groups were compared, and the risk factors of VTE were analyzed.

Results The incidence of VTE in the puerperium (65.79%, 25/38) and lower extremity deep venous thrombosis (44.74%, 17/38) was higher, followed by cerebral venous thrombosis (34.21%, 13/38). Two patients died of widely cerebral venous thrombosis with cerebral infarction and hemorrhagic transformation, and another one patient died of advanced breast cancer combinded with pulmonary embolism. There was significantly statistical difference in the VTE score between the two groups (P=0.001). Univariate logistic regression analysis showed that cesarean section, VTE score, hemoglobin, platelet count, D-dimer, prothrombin time, and activated partial thromboplastin time were associated with the occurrence of VTE (P < 0.01). Multivariate logistic regression analysis showed that VTE score, D-dimer, prothrombin time, and activated partial thromboplastin time, and hemoglobin were independent factors of VTE in the pregnancy and puerperium (P < 0.01).

Conclusions The VTE score of pregnancy and the puerperium from the Shanghai consensus, D-dimer, prothrombin time, and activated partial prothrombin time, and hemoglobin could be used to predict VTE in the pregnancy and puerperium, and the VTE score has important clinical significance for the prevention of VTE in the pregnancy and puerperium.