Study on the value of thromboelastography in the assessment of thrombosis risk in perinatal women

Objective: This study aims to evaluate the clinical utility of thromboelastography (TEG) in assessing thrombotic risk among perinatal women. Methods: : A cluster sampling method was employed to select a cohort of 447 perinatal women who delivered at Foshan Women and Children Hospital between January 1, 2021, and December 27, 2022, for inclusion in the training set. The participants were stratified into two distinct groups based on their total scores from the 2020 Queensland Clinical Guideline thrombotic risk assessment tool: Group A, representing low-to-intermediate risk (score 0-2), included 346 individuals (77.40%, 346/447), while Group B, representing high risk (score ≥3), included 101 individuals (22.60%, 101/447). Comparative analyses of general characteristics and TEG parameters were conducted between Groups A and B. Statistically significant positive indicators were identified and subsequently incorporated into a multivariate logistic regression analysis.Results suggest,The risk of thrombosis in perinatal women was analyzed by a combined analysis of hypertension, age, current body mass index（BMI）, TEG common cup R value and 24-hour postpartum blood loss volume in the training set population,the AUC of ROC curve was 0.791 (P<0.05), and the ROC curve was statistically significant, with a sensitivity of 70.30% and a specificity of 77.20%.Calibration curves, developed using the Bootstrap resampling method, demonstrated robust model performance and substantial net benefit.Furthermore, a validation set comprising 207 eligible perinatal women who delivered at the same hospital between December 28, 2022, and February 14, 2025, was established.The validation set produced an area under the curve (AUC) of 0.847, with a sensitivity of 75.8% and a specificity of 85.6%, thereby affirming the model’s reliability. Conclusion: The combined integrated analysis of five factors, including — hypertensionhypertension, age, current BMI, TEG R value of thromboelastography and 24-hour postpartum blood loss volume—facilitates the effective identification of individuals at high risk.Validation results confirm that these objective indicators are user-friendly and hold considerable potential for clinical application, enabling the rapid screening of perinatal women at elevated thrombotic risk and supporting the timely implementation of preventive strategies.