Closing the gap in maternal care

Every year, thousands of women around the world suffer from preventable blood clots in the weeks after giving birth. For many, the barrier is a lack of access to a safe, affordable and practical treatment. 

That’s the problem Dr. Leslie Skeith, MD, a physician, University of Calgary researcher and member of the Libin Cardiovascular Institute, is working to solve.

Skeith is leading a large-scale international clinical trial that could transform how postpartum blood clots are prevented and, in doing so, help save lives around the world.

Postpartum venous thromboembolism (VTE), which involves blood clots in the legs or lungs, is a leading cause of maternal death globally and ongoing symptoms can impact those in the postpartum period. The risk of VTE is highest in the first six weeks after childbirth, especially for those who experienced additional risk factors like unplanned caesarean delivery, preeclampsia, infection or hemorrhage.

While injectable blood thinners can reduce that risk and are common in practice, they aren’t popular with patients as they require daily administration, training, and may come at an additional cost. These barriers may disproportionately affect patients in low-resource settings, as well as those navigating the demands of caring for a newborn.

Skeith’s research team, which includes a global network of researchers and health-care professionals, is exploring a simpler alternative.

Built on Skeith’s earlier work, published in The Lancet: Haematology, the Postpartum Aspirin to Reduce Thromboembolism Undue Morbidity (PARTUM) trial is testing whether low-dose Aspirin can be as effective as usual care injectable blood thinners in preventing postpartum blood clots. 

“Aspirin is convenient and affordable, and it is used to prevent blood clots in other areas of medicine, such as after orthopedic surgery,” says Skeith. “This could be a simple way to impact thousands around the world.”

PARTUM is supported by a $4.6 million grant from the Canadian Institutes of Health Research (CIHR) — the largest CIHR project grant ever awarded to a University of Calgary researcher. It spans 11 countries, including low- and middle-income regions such as Nigeria and Mexico, ensuring findings reflect the realities of diverse health systems and patient populations. The PARTUM trial is has also received funding by a multi-country European grant from the ERA4Health. 

Equity is not only reflected in who is included in the study, but also in how it is designed. PARTUM incorporates patient partners who contribute to study design, patient materials and decision-making — ensuring the research reflects real-world experiences and priorities.

Suzanne Dubois, who has intimate knowledge of the often-difficult journey associated with blood clot recovery, is a PARTUM patient partner. 

She was motivated to join the study by her experiences as a caregiver for her then-teen daughter, who developed blood clots after a long flight. Although her daughter wasn’t postpartum, Dubois provides a caregiver’s perspective on accessing diagnosis and care. 

“The experience was quite traumatic and affected my daughter’s long-term health,” says Dubois. 

Dubois is excited by the potential of PARTUM. 

“Blood clots are painful and can have long term impact on the lungs and heart,” she says. “Thrombosis can be a devastating disease when it does occur, and the potential to prevent thrombosis in postpartum patients with something as simple as Aspirin is amazing.” 

To learn more about the PARTUM trial and to find out how you can be involved, visit partumtrial.ca.