An Increased Plasma D-Dimer Levels During Different Stages of Normal and Complicated Pregnancies Among Women in Bisha, Saudi Arabia.

Abstract

Introduction: Hypercoagulability is one of the most reported state among Pregnant women. During pregnancy, the concentrations of D-dimer increase in a trimester-dependent- manner. The presence of gestational diabetes (GD) and gestational hypertension (GH) lead to further elevation in D-dimer levels. Pregnant women are at an increased risk of developing Venous thromboembolism (VTE), which can be fatal for both the mother and fetus. Elevated D-dimer levels during pregnancy could result in misdiagnosing other thrombotic diseases, emphasizing the need for further confirmatory testing for VTE. It is crucial to observe the plasma D-dimer concentrations among pregnant women at maternity and children's hospitals as it plays a role in guiding the anticoagulant treatments and minimizing the incidence of VTE among pregnant women.

Aim: The main objective of the current study was to detect the changes in the plasma D-dimer concentrations in healthy and complicated pregnancies across different gestational trimesters among women at the Maternity and Children's Hospital, Bisha, Saudi Arabia.

Methods: A cross-sectional study was conducted from March 2022 to March 2023, involving the analysis of plasma samples collected from 230 pregnant and non-pregnant women. Three samples were collected from each subject in each trimester. D-dimer measurement was conducted using an ACL Elite Pro Automated analyzer.

Results: The findings of this study show that D-dimer levels increased progressively throughout the pregnancy trimesters across all study groups. The increase was more noticeable among women with gestational diabetes (278.39 ± 29.808 ng/mL) and gestational hypertension (320.63 ± 12.157 ng/mL), suggesting that these complications influence D-dimer levels more significantly than healthy and multiple pregnancies. Notably, a positive correlation was found between age and D-dimer levels across all groups (p < 0.05), with the highest mean levels in the 41-48 age group.

Conclusion: D-dimer levels rise progressively throughout pregnancy and are significantly elevated in women with gestational diabetes and hypertension. These findings underscore the importance of interpreting D-dimer values in the context of gestational age and pregnancy complications. Additionally, maternal age influences D-dimer concentrations, emphasizing the need to interpret results within the context of age-related physiological changes during pregnancy.