ResearchGeneral gynecologyHormonal contraception, sickle cell trait, and risk for venous thromboembolism among African American women
Section snippets
Materials and Methods
The study design has been described elsewhere.4, 5 For this report, cases were African American women 18-49 years of age with a recently diagnosed first episode of deep vein thrombosis and/or pulmonary embolism hospitalized at 1 of 2 university hospitals in Atlanta, GA. Cases were restricted to women without an underlying provocation for their VTE (arising in the absence of cancer; after surgery, a recent traumatic injury, or prolonged immobilization; during pregnancy; or in conjunction with
Results
The analysis includes 60 African American cases and 196 African American control subjects. In the entire case-control study, among 1867 potential cases sought for inclusion in the study, 61% participated. We mailed letters to 2956 potential control subjects of which we located 2095; 1942 of these subjects were eligible for inclusion as controls. Of these 1942 potential control subjects, 67% participated in the study.
The mean age of cases and controls was 36 and 38 years, respectively. The mean
Comment
This study indicates that current HC use is a risk factor for VTE among African Americans as it is among whites. The study findings also suggest that there may be synergy between HC use and SCT, in that the joint effect of the 2 exposures is considerably greater than the multiplicative effect of each (12.3 vs 2.6 × 1.9 = 4.9). However, because there are few current HC users with SCT, the OR for HC use among women with SCT is imprecise and, therefore, the difference in the ORs for subjects with
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“Dual-gene” malaria-resistance: Therapeutically-rational exchange (T-REX) of group-O sickle trait and group-O C-traittrait red blood cells can be evaluated in Benin and Nigeria
2020, Transfusion and Apheresis ScienceCitation Excerpt :Despite this apparent paradox, it seems most prudent that when clinicians want to use HbAS RBCs therapeutically, they only use group-O HbAS RBCs when treating Pf-malaria patients who have a history of thrombosis – in “an abundance of caution.” Also thrombosis-related, Austin et al. concluded that women with HbAS RBCs who use hormonal contraception are at increased risk for venous thrombotic events [14]. Although the women they studied were not infected with Pf, it again seems prudent that when using HbAS RBCs therapeutically, only group-O HbAS RBCs be used when treating Pf-infected women who are taking birth-control hormones.
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Dr Whitsett is currently affiliated with New York Blood Services and Mount Sinai School of Medicine, New York, NY.
Reprints not available from the authors.
This study was supported in part by a Grant from the Centers for Disease Control and Prevention through the Associations of Schools of Public Health/Centers for Disease Control and Prevention Cooperative Agreement mechanism.
Cite this article as: Austin H, Lally C, Benson JM, et al. Hormonal contraception, sickle cell trait, and risk for venous thromboembolism among African American women. Am J Obstet Gynecol 2009;200:620.e1-620.e3.