Diagnostic Value of Combined Late-Pregnancy Measurements of Fasting Plasma Glucose, D-Dimer, High-Density Lipoprotein, and Low-Density Lipoprotein for Diagnosing Puerperal Venous Thromboembolism

Background: To investigate the diagnostic value of late-pregnancy measurements of fasting plasma glucose (FPG), D-dimer (D-D), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) for postpartum venous thromboembolism (VTE). Methods: A retrospective analysis was conducted on the clinical data of 203 postpartum women admitted to our hospital from January 2021 to June 2023. Based on the occurrence of VTE, they were categorized into a VTE group (n = 103) and a non-VTE group (n = 100). Univariate analysis and multivariate logistic regression were used to identify related factors. Pearson correlation analysis was conducted, and receiver operating characteristic (ROC) curves were applied to evaluate the diagnostic performance of individual and combined biomarkers. Results: No significant differences were observed between the two groups with respect to gestational age, gravidity, preeclampsia, gestational hypertension, fibrinogen (FIB), activated partial thromboplastin time (APTT), prothrombin time (PT), total cholesterol (TC), or triglycerides (TG) (p > 0.05). The VTE group presented with higher proportions of women aged ≥35 years, obesity, postpartum hemorrhage, gestational diabetes mellitus, and cesarean section, as well as higher Royal College of Obstetricians and Gynaecologists (RCOG) scores, levels of FPG, D-D, and LDL, compared with the non-VTE group. High-density lipoprotein (HDL) levels were significantly lower in the VTE group than in the non-VTE group (p < 0.05). Pearson correlation analysis showed that FPG, D-D, and LDL were positively correlated with the RCOG score, whereas HDL was negatively correlated with the RCOG score (p < 0.05). Multivariate logistic regression analysis indicated that age ≥35 years, obesity, postpartum hemorrhage, cesarean section, gestational diabetes mellitus, RCOG score, FPG, D-D, HDL, and LDL were independent influencing factors for postpartum VTE (p < 0.05). ROC curve analysis demonstrated that the combined detection of the four biomarkers had significantly higher area under the curve (AUC) and sensitivity than individual indicators (p < 0.05). Conclusion: The combined detection of FPG, D-D, HDL, and LDL demonstrates high sensitivity for diagnosing postpartum VTE and may be used for early diagnosis and prevention.