ORIGINAL RESEARCH article
Front. Med.
Sec. Obstetrics and Gynecology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1617052
Risk factors of pulmonary embolism in postpartum women
Provisionally accepted
- 1Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- 2Taicang Hospital of Traditional Chinese Medicine, Taicang, China
- 3Shanghai Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- 4Xiamen Fifth Hospital, Xiamen, Fujian Province, China
- 5Shanghai First Maternity and Infant Hospital, Shanghai, Shanghai Municipality, China
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Abstract Introduction: Pulmonary embolism (PE) is a potentially fatal complication, especially in postpartum women. Objective: To explore the risk factors of PE in postpartum women. Methods: A retrospective cohort study consisted of 130 postpartum women with PE (PE Group) and 192 postpartum women without PE (non-PE Group) were analyzed. Results: The PE group was older, with 37.7% had multiple deliveries, and the inter-pregnancy interval was mostly 1 - 3 years (P < 0.05). The incidence of prophylactic anticoagulation, anemia, prenatal fever, emergency cesarean section, twins, postpartum acute infection, intraoperative bleeding, postpartum hemorrh and venous thromboembolism (VTE) were significantly higher in the PE group, abnormal clinical manifestations and echocardiographic measures were more common (P < 0.05). The levels of creatinine, urea nitrogen, fibrinogen, total protein and albumin in the PE group were significantly lower, while total bilirubin, d-dimer and B-type Natriuretic Peptide (BNP) were significantly higher (P < 0.05). The ROC curve analysis showed the best cutoff point for d-dimer level within postpartum women was 2.24 mg/L (specificity 90.1%, sensitivity 88.9%). On multivariate analysis, VTE and abnormal echocardiography were independent risk factors for PE (P < 0.05). The d-dimer level (OR 1.363, 95% CI 1.716 - 8.907, P = 0.001) was specific marker for clinical monitoring of PE. Conclusions: It was necessary to strengthen the clinical monitoring of PE-related risk factors in postpartum women, especially in those with VTE, abnormal echocardiography and d-dimer level > 2.24 mg/L.
Keywords: Pulmonary Embolism, postpartum woman, Risk factors, Retrospective study, D-dimer level
Received: 23 Apr 2025; Accepted: 12 Sep 2025.
Copyright: © 2025 Cui, Wu, Tong, Feng, Qin and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xueling Wu, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200000, China
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