Scimago Lab
powered by Scopus
Formerly the IP & Science
business of Thomson Reuters


eISSN: 1643-3750

Get your full text copy in PDF

Coagulation and fibrinolysis variables in pregnant women with type 1 diabetes mellitus

Agata Bronisz, Danuta Rosc, Marek Bronisz, Wieslaw Szymanski, Roman Junik

Med Sci Monit 2008; 14(11): CR574-579

ID: 869445

Background: Many studies have reported changes in the hemostatic system in patients with type 1 diabetes in whom coagulation processes predominate over fibrinolytic activity. The aim of this study was to assess some of the hemostatic variables during pregnancy women with in type 1 diabetes.
Material and Method: The current study included 31 pregnant diabetic women and 24 healthy pregnant women. At 12, 24, and 36 weeks of gestation, we determined blood concentrations of the following: platelet count, fibrinogen, tissue plasminogen activator antigen, and plasminogen activator inhibitor-1.
Results: When we compared pregnant diabetic women in the third trimester with those in the first trimester, we observed a statistically significant decrease in the platelet count (172.0+/-9.0 vs 200.6+/-9.8 G/L, P<0.05) and a statistically significant increase in the levels of fibrinogen (3.5+/-0.2 vs 2.9+/-0.2 g/L, P<0.05), tissue plasminogen activator antigen (14.9+/-2.2 vs 4.7+/-0.6 ng/mL, P<0.001), and plasminogen activator inhibitor-1 (17.2+/-2.8 vs 4.0+/-1.0 IU/mL, P<0.001). Similar fibrinogen, tissue plasminogen activator: A, and plasminogen activator inhibitor-1 changes were observed in pregnant women (3.8+/-0.3 vs 2.9+/-0.2 g/L, P<0.05; 7.7+/-0.9 vs 5.2+/-0.3 ng/mL, P<0.05; and 17.6+/-2.1 vs 5.1+/-1.1 IU/mL, P<0.05, respectively). Tissue plasminogen activator antigen was the only variable to significantly increase during the third trimester in pregnant diabetic women with microangiopathy compared with women without microangiopathy (21.0+/-3.2 vs 8.4+/-1.7 ng/mL, P<0.01).
Conclusions: (1) In patients with type 1 diabetes without microangiopathy and with good metabolic control, fibrinogen and tissue plasminogen activator antigen concentrations and changes in the activity of plasminogen activator inhibitor-1 are similar to those found in patients with a normal pregnancy; (2) the marked decrease in platelet count in patients with type 1 diabetes during pregnancy may be an additional source of plasminogen activator inhibitor-1; and (3) during pregnancy, diabetic microangiopathy leads to a greater increase of tissue plasminogen activator antigen concentration as a marker of endothelial cell injury.

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
I agree