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/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.