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People with sickle cell disease (SCD) are at an increased risk of venous thromboembolism (VTE). Women, in particular, with SCD may be at a higher risk of blood clots than their male counterparts due to other risk factors, such as contraceptives or hormone therapies containing estrogen.

People with sickle cell disease (SCD) face the possibility of various complications, including acute pain episodes, end-organ damage, and anemia. Another notable complication of SCD is venous thromboembolism (VTE). Approximately 25% of individuals with SCD experience VTE. However, the risk factors for VTE in patients with SCD are not completely understood.

Clinical investigators examined the link between medical history, biological sex, and VTE in a retrospective, cross-sectional study. The study, which is published in the Journal of Women’s Health, gathered data from a chart review of patients with SCD who had visited an outpatient hematology clinic of Penn Medicine over a specified five-year period. Researchers investigated the demographics and medical history of patients with and without a history of VTE.

Of the 597 patients with SCD identified in the chart review, nearly 25% had experienced VTE at least once. In addition, 100 of those patients with SCD who had a history of VTE were female and 47 were male. According to results from a regression model, being female was independently linked to a history of VTE. Other factors associated with a history of VTE included pulmonary hypertension, the use of hydroxyurea, and a history of stroke. Around 19% of the females with SCD and a history of VTE were noted to have a history of oral contraceptive use.

Overall, females were twice as likely to experience VTE than males. As such, a sex disparity among people with SCD may be a contributing factor to complications involving blood clots. These findings highlight the need for healthcare providers to closely evaluate the medical history and contraceptive use of women with SCD who may be at a greater risk of VTE. Progesterone-only contraceptives may be an option for women with SCD seeking to use a birth control method.

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Roe, A. H., McAllister, A., Kete, C., Pishko, A., Whitworth, H., Schreiber, C. A., & Sayani, F. A. (2022). Sex as an Independent Risk Factor for Venous Thromboembolism in Sickle Cell Disease: A Cross-Sectional Study. J Womens Health (Larchmt). https://doi.org/10.1089/jwh.2022.0046

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