Yan Liu1,2, Xiaofang Sun2, Junxian Tao2, Bin Song3, Wei Wu4, Ying Li2, Xing Sun4, Dan Lu5, Danmo Zhu5, Chao Liu1, Ji Cui6. 1. Department of Endocrinology of Jiangsu Province Hospital on Integration of Chinese and Western Medicine, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China. 2. Department of Endocrinology, Clinical Medical College, Yangzhou University, Yangzhou, China. 3. Department of Health Management, Clinical Medical College, Yangzhou University, Yangzhou, China. 4. Institute of Hematology, Clinical Medical College, Yangzhou University, Yangzhou, China. 5. Department of Obstetrics, Clinical Medical College, Yangzhou University, Yangzhou, China. 6. Department of Gynecology, Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China.
Abstract
BACKGROUND: To determine the relationship between gestational diabetes mellitus (GDM) and coagulation/fibrinolysis abnormality in antenatal Chinese women. METHODS: Case control study: 50 women had GDM and 132 did not (the NGDM group) grouping by the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Maternal plasma biochemistry and previous medical history were collected from perinatal health records. Antenatal coagulation/fibrinolysis activity (CFA) parameters were assessed using thromboelastography and routine CFA parameters, respectively. Univariate and multiple regression analyses were used to evaluate the associations between GDM and CFA parameters. Maternal age, platelet, ALT, ALP, urea nitrogen, and previous history of abortion were taken as the covariables. RESULTS: The women with GDM were significantly older than those without GDM (30.3 vs. 28.6 years, p = .012). Compared with the NGDM group, the GDM group had a significantly higher prevalence of cesarean delivery (56.0 vs. 37.9%, p = .027) and higher values of fibrinogen (FIB; 4.7 vs. 4.3 g/L, p = .001), activated partial thromboplastin time (APTT; 30.9 vs. 29.5 s, p = .010).There were no significant differences in the prevalence of maternal thrombotic events or neonatal events. GDM was significantly associated with higher APTT (β =1.41 s, 95% CI: 0.29-2.53), higher FIB (β = 0.38 g/L, 95% CI: 0.14-0.61), and higher percentage reduction in clot lysis after 30 min (LY30; β = 1.14%, 95% CI: 0.15-2.13) after adjustment for potential confounding factors. CONCLUSIONS: GDM is significantly associated with hypercoagulability and hyperfibrinolysis in these antenatal Chinese women.
BACKGROUND: To determine the relationship between gestational diabetes mellitus (GDM) and coagulation/fibrinolysis abnormality in antenatal Chinese women. METHODS: Case control study: 50 women had GDM and 132 did not (the NGDM group) grouping by the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Maternal plasma biochemistry and previous medical history were collected from perinatal health records. Antenatal coagulation/fibrinolysis activity (CFA) parameters were assessed using thromboelastography and routine CFA parameters, respectively. Univariate and multiple regression analyses were used to evaluate the associations between GDM and CFA parameters. Maternal age, platelet, ALT, ALP, urea nitrogen, and previous history of abortion were taken as the covariables. RESULTS: The women with GDM were significantly older than those without GDM (30.3 vs. 28.6 years, p = .012). Compared with the NGDM group, the GDM group had a significantly higher prevalence of cesarean delivery (56.0 vs. 37.9%, p = .027) and higher values of fibrinogen (FIB; 4.7 vs. 4.3 g/L, p = .001), activated partial thromboplastin time (APTT; 30.9 vs. 29.5 s, p = .010).There were no significant differences in the prevalence of maternal thrombotic events or neonatal events. GDM was significantly associated with higher APTT (β =1.41 s, 95% CI: 0.29-2.53), higher FIB (β = 0.38 g/L, 95% CI: 0.14-0.61), and higher percentage reduction in clot lysis after 30 min (LY30; β = 1.14%, 95% CI: 0.15-2.13) after adjustment for potential confounding factors. CONCLUSIONS: GDM is significantly associated with hypercoagulability and hyperfibrinolysis in these antenatal Chinese women.