{
    "abstract": "Antithrombin (AT) deficiency is a severe thrombophilia associated with increased rates of maternal morbidity, mortality, and greater healthcare resource utilization during pregnancy and postpartum.\nTwo large U.S. healthcare databases were queried for women aged 15-44 with delivery-related encounters: Cerner Real-World Data (CRWD, 01/01/2000-12/31/2021) and Premier Healthcare Database (PHD, 01/01/2016-01/01/2019). Individuals receiving cardiopulmonary bypass were excluded. Three cohorts were created: 1) Individuals who had AT levels tested any time between 9-months pre- through 3-months post-delivery (CRWD Test Cohort); 2) individuals prescribed AT concentrate (ATc) within 1-year pre- or 1-year post-delivery in CRWD (CRWD Medication Cohort); and 3) the same criteria as 2) applied to PHD (PHD Medication Cohort).\nThere were 5411 individuals in the CRWD Test Cohort, 13 in the CRWD Medication Cohort and 38 in the PHD Medication Cohort. Demographic and baseline clinical characteristics were similar across cohorts. AT level testing occurred pre-delivery in 47.9\u00a0% of the CRWD Test Cohort and 23.1\u00a0% of the CRWD Medication Cohort. ATc was administered during the delivery hospitalization to 0.1\u00a0%, 23.1\u00a0% and 50.0\u00a0% of the CRWD Test, CRWD Medication, and PHD Medication Cohorts, respectively. Across cohorts, 5.4-7.9\u00a0% of individuals experienced thrombosis during the delivery-related encounter. Mean (SD) total costs for delivery through 1-year post-delivery were $190,894 ($276,893) with $123,763 ($177,122) of total costs related to abnormal coagulation.\nOpportunities exist to enhance the care of pregnant individuals with low AT levels throughout pregnancy, aiming for optimal maternal outcomes.",
    "authors": [
        {
            "affiliation": "Duke University, Durham, NC, United States.",
            "firstname": "Jerome J",
            "initials": "JJ",
            "lastname": "Federspiel"
        },
        {
            "affiliation": "Grifols SSNA, Research Triangle Park, NC, United States.",
            "firstname": "Wilton",
            "initials": "W",
            "lastname": "Rodriguez"
        },
        {
            "affiliation": "Grifols SSNA, Research Triangle Park, NC, United States.",
            "firstname": "Jeffrey",
            "initials": "J",
            "lastname": "Spears"
        },
        {
            "affiliation": "Grifols SSNA, Research Triangle Park, NC, United States.",
            "firstname": "Michael",
            "initials": "M",
            "lastname": "Calloway"
        },
        {
            "affiliation": "Boston Strategic Partners, Inc., Boston, MA, United States.",
            "firstname": "Xuan",
            "initials": "X",
            "lastname": "Zhang"
        },
        {
            "affiliation": "Boston Strategic Partners, Inc., Boston, MA, United States.",
            "firstname": "Emily",
            "initials": "E",
            "lastname": "Farrar"
        },
        {
            "affiliation": "Boston Strategic Partners, Inc., Boston, MA, United States.",
            "firstname": "Rahul",
            "initials": "R",
            "lastname": "Rajkumar"
        },
        {
            "affiliation": "Boston Strategic Partners, Inc., Boston, MA, United States.",
            "firstname": "Kunal",
            "initials": "K",
            "lastname": "Lodaya"
        },
        {
            "affiliation": "Duke University, Durham, NC, United States. Electronic address: andra.james@duke.edu.",
            "firstname": "Andra H",
            "initials": "AH",
            "lastname": "James"
        }
    ],
    "conclusions": "Opportunities exist to enhance the care of pregnant individuals with low AT levels throughout pregnancy, aiming for optimal maternal outcomes.",
    "copyrights": "Copyright \u00a9 2024. Published by Elsevier Ltd.",
    "doi": "10.1016/j.thromres.2024.109070",
    "journal": "Thrombosis research",
    "keywords": [
        "Antithrombin III deficiency",
        "Health care economics",
        "Hematologic",
        "Pregnancy complications",
        "Venous thromboembolism"
    ],
    "methods": null,
    "publication_date": "2024-07-07",
    "pubmed_id": "38970992",
    "results": "There were 5411 individuals in the CRWD Test Cohort, 13 in the CRWD Medication Cohort and 38 in the PHD Medication Cohort. Demographic and baseline clinical characteristics were similar across cohorts. AT level testing occurred pre-delivery in 47.9\u00a0% of the CRWD Test Cohort and 23.1\u00a0% of the CRWD Medication Cohort. ATc was administered during the delivery hospitalization to 0.1\u00a0%, 23.1\u00a0% and 50.0\u00a0% of the CRWD Test, CRWD Medication, and PHD Medication Cohorts, respectively. Across cohorts, 5.4-7.9\u00a0% of individuals experienced thrombosis during the delivery-related encounter. Mean (SD) total costs for delivery through 1-year post-delivery were $190,894 ($276,893) with $123,763 ($177,122) of total costs related to abnormal coagulation.",
    "title": "Antithrombin testing and treatment in pregnancy: Their real-world relationship to clinical outcomes.",
    "xml": "<Element 'PubmedArticle' at 0x788501e1fa60>"
}