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Racial and ethnic disparities in eligibility for postpartum venous thromboembolism prophylaxis in the United States.
Campbell, Alexa I K; Xu, Yan; Skeith, Leslie; Federspiel, Jerome J.
Afiliación
  • Campbell AIK; Duke University School of Medicine, Durham, North Carolina, USA.
  • Xu Y; Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, Canada.
  • Skeith L; Division of Hematology and Hematological Malignancies, Department of Medicine, University of Calgary, Calgary, Canada.
  • Federspiel JJ; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina, USA; Division of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA. Electronic address: jjf7@duke.edu.
J Thromb Haemost ; 22(2): 545-552, 2024 Feb.
Article en En | MEDLINE | ID: mdl-37838240
BACKGROUND: Postpartum venous thromboembolism (VTE) incidence differs by race and ethnicity in the United States. However, it is unclear whether the eligibility criteria for postpartum VTE prophylaxis mirror this disparity. OBJECTIVE: To characterize the prevalence of risk factors and eligibility for postpartum VTE prophylaxis, among US Birthing people, stratified by race and ethnicity. METHODS: We analyzed the National Inpatient Sample from October 2015 to December 2019, using diagnosis and procedure codes to identify postpartum individuals and their VTE risk factors. We compared proportion of delivery hospitalizations meeting eligibility for thromboprophylaxis stratified by race or ethnicity, according to American College of Gynecology and Obstetrics, American College of Chest Physicians, Royal College of Obstetricians and Gynecologists (RCOG), and American Society for Hematology guidelines. RESULTS: Among a national estimate of 14 967 861 delivery hospitalizations in the United States, the proportion of individuals eligible for thromboprophylaxis using the RCOG, American College of Chest Physicians, American College of Gynecology and Obstetrics, and American Society for Hematology guidelines were 32.9%, 8.0%, 0.2%, and 0.2%, respectively. Using the RCOG criteria, non-Hispanic Black individuals had the highest proportion of thromboprophylaxis eligibility (39.7%), whereas it was lowest among Hispanic individuals (30.8%). Racial disparities in thromboprophylaxis eligibility were driven by differences in clinical risk factors (38.8% non-Hispanic Black population vs 30.5% Hispanic population) and cesarean section rates (35.9% vs 32.2%), rather than history of VTE (0.3% vs 0.1%), inherited thrombophilia (0.2% vs 0.2%), or sickle cell disease (0.4% vs <0.1%). CONCLUSION: Non-Hispanic Black individuals were most likely to qualify for postpartum thromboprophylaxis, attributable to clinical risk factors rather than inherited risk factors. An urgent need exists to better understand ethno-racial disparities in thromboprophylaxis use and to equitably address modifiable risk factors for postpartum VTE.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastornos Puerperales / Trombosis de la Vena / Tromboembolia Venosa Límite: Female / Humans / Pregnancy País/Región como asunto: America do norte Idioma: En Revista: J Thromb Haemost Asunto de la revista: HEMATOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastornos Puerperales / Trombosis de la Vena / Tromboembolia Venosa Límite: Female / Humans / Pregnancy País/Región como asunto: America do norte Idioma: En Revista: J Thromb Haemost Asunto de la revista: HEMATOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido