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Background <p>Postpartum women are at increased risk of venous thromboembolism (VTE). Existing risk scores, such as RCOG and Caprini, rely on clinical factors alone and may lack accuracy. D-dimer, a widely used biomarker for VTE in non-pregnant populations, may improve postpartum risk prediction, but evidence remains inconsistent.</p> Methods <p>A systematic search of PubMed, Embase, Web of Science, Cochrane Library, and CBM was performed through July 31, 2025. Studies assessing D-dimer alone for postpartum VTE were included. Data were extracted to construct 2 × 2 tables, and pooled estimates were calculated using a bivariate random-effects model.</p> Results <p>Six studies (14,024 women; 193 VTE cases), all from mainland China, were included. D-dimer cut-offs varied widely (0.56–5.55&#xa0;mg/L). The pooled sensitivity was 0.82 (95% CI: 0.63–0.93) and specificity was 0.69 (95% CI: 0.42–0.87). The pooled PLR was 2.61, NLR 0.26, and DOR 10.00. The SROC curve yielded an AUC of 0.84, indicating moderate diagnostic accuracy. Leave-one-out analysis confirmed robustness.</p> Conclusion <p>D-dimer shows moderate accuracy for predicting postpartum VTE and may be useful as an adjunct to clinical models, especially in resource-limited settings. However, heterogeneous cut-offs and restriction to Chinese populations limit generalizability. Larger multicenter studies are needed.</p>

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Diagnostic accuracy of D-dimer for predicting postpartum venous thromboembolism: a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月9日

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  • Xing Jin,
  • Zhiting Dong,
  • Limei Zhang,
  • Wei Zheng,
  • Qianying Zhu

摘要

Background

Postpartum women are at increased risk of venous thromboembolism (VTE). Existing risk scores, such as RCOG and Caprini, rely on clinical factors alone and may lack accuracy. D-dimer, a widely used biomarker for VTE in non-pregnant populations, may improve postpartum risk prediction, but evidence remains inconsistent.

Methods

A systematic search of PubMed, Embase, Web of Science, Cochrane Library, and CBM was performed through July 31, 2025. Studies assessing D-dimer alone for postpartum VTE were included. Data were extracted to construct 2 × 2 tables, and pooled estimates were calculated using a bivariate random-effects model.

Results

Six studies (14,024 women; 193 VTE cases), all from mainland China, were included. D-dimer cut-offs varied widely (0.56–5.55 mg/L). The pooled sensitivity was 0.82 (95% CI: 0.63–0.93) and specificity was 0.69 (95% CI: 0.42–0.87). The pooled PLR was 2.61, NLR 0.26, and DOR 10.00. The SROC curve yielded an AUC of 0.84, indicating moderate diagnostic accuracy. Leave-one-out analysis confirmed robustness.

Conclusion

D-dimer shows moderate accuracy for predicting postpartum VTE and may be useful as an adjunct to clinical models, especially in resource-limited settings. However, heterogeneous cut-offs and restriction to Chinese populations limit generalizability. Larger multicenter studies are needed.