The Effect of Polycythemia Vera on Pregnancy Complications. The Analysis of an American Population Database With Over 9 Million Deliveries

Eur J Haematol. 2026 Jul 6. doi: 10.1111/ejh.70250. Online ahead of print.

ABSTRACT

OBJECTIVES: Polycythemia Vera (PV) is characterized by overproduction of erythrocytes, leading to a hypercoagulable state. Evidence regarding associations between PV and pregnancy outcomes is limited. The aim of our study was to provide robust evidence regarding the prevalence of pregnancy complications in women with PV.

METHODS: We conducted a retrospective cohort study using the HCUP-NIS database, a large American database, between 2004 and 2014. Pregnancies in women with PV were identified via ICD-9 codes. All other pregnancies formed the control group.

RESULTS: Our cohort included 104 pregnancies with PV and 9 096 684 controls. Baseline characteristics associated with PV included older age, white race, insurance through Medicaid, tobacco smoking during pregnancy, chronic hypertension, multiple gestation, and thyroid disease. Results indicated that PV was significantly associated with preeclampsia (aOR = 2.27; 95% CI = 1.04-4.97), preterm premature rupture of membranes (aOR = 4.47; 95% CI = 1.78-11.21), blood transfusion (aOR = 3.34; 95% CI = 1.17-9.55), baby with small for gestational age (aOR = 3.31; 95% CI = 1.55-7.08), and congenital anomalies (aOR = 10.93; 95% CI = 4.40-27.11). Maternal death (aOR = 108.79; 95% CI = 14.37-823.88), wound complications (aOR = 4.53; 95% CI = 1.10-18.69), and intrauterine fetal demise (aOR = 4.80; 95% CI = 1.17-19.70) were statistically significant but must be interpreted cautiously due to rarity. Other outcomes did not differ.

CONCLUSIONS: PV is associated with several pregnancy complications. Women with PV should receive assiduous care during pregnancy to prevent these complications.

PMID:42409760 | DOI:10.1111/ejh.70250