Gestational diabetes mellitus is associated with antenatal hypercoagulability and hyperfibrinolysis: a case control study of Chinese women

Abstract

Background: To determine the relationship between gestational diabetes mellitus (GDM) and coagulation/ brinolysis abnormality in antenatal Chinese women. Methods: Case control study. Fifty 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/ brinolysis activity(CFA) parameters was assessed using thromboelastography and routine CFA parameters respectively. Univariate and multiple regression analyses were used to evaluate the associations between GDM and CFA parameters. Results: The women with GDM were signi cantly older than those without GDM (30.3 vs. 28.6 years, P=0.012). Compared with the NGDM group, the GDM group had a signi cantly higher prevalence of cesarean delivery (56.0% vs. 37.9%, P=0.027) and higher values of brinogen (FIB) (4.7vs. 4.3 g/L P=0.001), activated partial thromboplastin time (APTT) (30.9 vs. 29.5 seconds P=0.010).There were no signi cant differences in the prevalence of maternal thrombotic events or neonatal events.GDM was signi cantly associated with higher APTT (β 1.41seconds, 95% CI 0.29-2.53), FIB (β 0.38g/L, 95% CI 0.14-0.61), and 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 signi cantly associated with hypercoagulability and secondary hyper brinolysis in these antenatal Chinese women.has been no assessment of the relationship between GDM and CFA, assessed using TEG, in pregnant Chinese women. Therefore, in this study, we aimed to evaluate the relationship between GDM and measures of CFA, after adjustment for potential confounding factors.

Distribution of complete blood count constituents in gestational diabetes mellitus

“…[5,6] Studies have revealed increased circulating levels of the inflammatory markers, fibrinogen, C-reactive protein and leukocyte, in GDM women, thereby showing that the maternal inflammatory response is established during the earliest phases of implantation. [4,7,8] Platelets and erythrocytes, like leukocytes, also play an important role in the inflammatory response. Activated platelets can release considerable quantities of chemokines and express a multitude of immune receptors on their membranes that are involved with inflammation by binding to neutrophils.…”

“…In women, GDM tends to present with an inflammatory response, which is likely to play a role in insulin resistance [5,6] . Studies have revealed increased circulating levels of the inflammatory markers, fibrinogen, C-reactive protein and leukocyte, in GDM women, thereby showing that the maternal inflammatory response is established during the earliest phases of implantation [4,7,8] …”

Rotational thromboelastometry (ROTEM®) in gestational diabetes mellitus and coagulation in healthy term pregnancy: A prospective observational study in Australia

“…Our findings are contrary to findings by Liu et al, who demonstrated using TEG and conventional coagulation tests, that GDM is associated with hypercoagulability and hyperfibrinolysis in a case control study. Again, this study did not report on the level of glycaemic control in their GDM group 29 . However, women in the GDM group ( n = 50) were significantly older and heavier in weight than those without GDM ( n = 132) (30.3 vs 28.6 years; 61.8 vs 56.0 kg).…”

“…Again, this study did not report on the level of glycaemic control in their GDM group. 29 However, women in the GDM group (n = 50) were significantly older and heavier in weight than those without GDM (n = 132) (30.3 vs 28.6 years; 61.8 vs 56.0 kg). Both increased age 30,31 and BMI [16][17][18][19][20][21][22] are associated with increased hypercoagulability, and these factors could have contributed to the greater magnitude of hypercoagulability in the GDM group.…”

Application Value of Predictive Model Based on Maternal Coagulation Function and Glycolipid Metabolism Indicators in Early Diagnosis of Gestational Diabetes Mellitus

“…Endothelial damage caused by high blood glucose activates the internal coagulation system in pregnant women with GDM ( 21 , 22 ), and some studies have also shown that the level of coagulation factor XII in pregnant women with GDM was significantly higher than healthy pregnant women ( 23 ). The reason might be that endothelial damage caused by high blood glucose activates the internal coagulation system in pregnant women with GDM.…”