D-dimer during pregnancy: establishing trimester-specific reference intervals

Pregnancy is associated with an increased risk of venous thromboembolism (VTE). D-dimer is a biomarker used as an exclusion criterion of VTE disease, but its usefulness during pregnancy shows limitations because D-dimer levels physiologically increase through pregnancy. The aim of our study was to f...

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Bibliographic Details
Published in:Scandinavian journal of clinical and laboratory investigation 2018-08, Vol.78 (6), p.439-442
Main Authors: Gutiérrez García, Irene, Pérez Cañadas, Pablo, Martínez Uriarte, Juan, García Izquierdo, Olivia, Angeles Jódar Pérez, María, García de Guadiana Romualdo, Luis
Format: Article
Language:English
Subjects:
Adult
Biomarkers - blood
Blood Chemical Analysis
D-dimer
Female
Fibrin Fibrinogen Degradation Products - analysis
gestational age-specific reference intervals
Humans
Pregnancy
Pregnancy Trimesters - blood
Prospective Studies
Reference Values
trimesters
venous thromboembolism
Venous Thromboembolism - blood
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Summary:Pregnancy is associated with an increased risk of venous thromboembolism (VTE). D-dimer is a biomarker used as an exclusion criterion of VTE disease, but its usefulness during pregnancy shows limitations because D-dimer levels physiologically increase through pregnancy. The aim of our study was to follow the changes of D-dimer levels and to establish trimester-specific reference intervals during normal pregnancy. This is a longitudinal prospective study in which the reference population finally included 102 healthy pregnant women. Plasma D-dimer levels were measured during the three trimesters of pregnancy, using a latex-based immunoturbidimetric assay. Reference intervals were calculated according to the Clinical and Laboratory Standards Institute recommendations. D-dimer levels increased progressively and significantly through pregnancy and peaked in the third trimester, in which D-dimer levels were above the conventional cut-off point (500 µg/L) in 99% of pregnant women. The following reference intervals were defined: first trimester: 169-1202 µg/L, second trimester: 393-3258 µg/L and third trimester: 551-3333 µg/L. The study provides reference intervals of D-dimer during the pregnancy using latex-based immunoturbidimetry on the ACL 300 TOP automated coagulation analyser. Further prospective studies of pregnant women with clinical suspicion of VTE are needed to validate these results.
ISSN:0036-5513
1502-7686
DOI:10.1080/00365513.2018.1488177