# Association between activated partial thromboplastin time and septic shock in pregnant women: a retrospective cohort study

## TL;DR

This study found that abnormal activated partial thromboplastin time (APTT) levels in pregnant women with infections are linked to a higher risk of septic shock.

## Contribution

The study reveals a U-shaped relationship between APTT levels and septic shock risk in pregnant women, suggesting APTT monitoring could aid in risk assessment.

## Key findings

- APTT levels both below and above the normal range were associated with increased septic shock risk.
- Each 1-second increase in APTT was linked to an 8.7% higher risk of septic shock.
- A critical APTT threshold of 27.564 seconds was identified for risk assessment.

## Abstract

Maternal sepsis is a life-threatening infectious complication, with septic shock linked to high mortality. Coagulopathy is a key feature, but the association between activated partial thromboplastin time (APTT) and maternal septic shock remains unclear. This retrospective study included 1,631 pregnant women with infection admitted from January 2017 to March 2023. Based on admission APTT levels, patients were divided into three groups: <28 s (n = 697), 28–42 s (n = 915), and >42 s (n = 19). A U-shaped relationship was observed between APTT and septic shock risk. Compared to the reference group (APTT 28–42 s), the group with APTT >42 s had a higher incidence of septic shock (57.9% vs. 11.8%), with a multivariable-adjusted odds ratio (OR) of 3.85 (95% CI, 0.94–15.78, p = 0.061). APTT <28 s was also associated with increased risk (adjusted OR 1.5; 95% CI, 1.02–2.2; p = 0.04). Threshold analysis identified 27.564 s as a critical point. In addition, each 1-s increase in APTT raised shock risk by 8.7%. Monitoring APTT may facilitate risk assessment in obstetric sepsis.