Bagot, C.N., Leishman, E., Onyiaodike, C.C., Jordan, F. and Freeman, D.J. (2017) Normal pregnancy is associated with an increase in thrombin generation from the very early stages of the first trimester. Thrombosis Research, 157, pp. 49-54. (doi: 10.1016/j.thromres.2017.06.027) (PMID:28692840)
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Abstract
Background: Pregnancy is a hypercoagulable state associated with an increased risk of venous thrombosis, which begins during the first trimester, but the exact time of onset is unknown. Thrombin generation, a laboratory marker of thrombosis risk, increases during normal pregnancy but it is unclear exactly how early this increase occurs. Methods: We assessed thrombin generation by Calibrated Automated Thrombography in women undergoing natural cycle in vitro fertilization, who subsequently gave birth at term following a normal pregnancy (n = 22). Blood samples were taken just prior to conception and repeated five times during very early pregnancy, up to Day 59 estimated gestation. Results: Mean Endogenous Thrombin Potential (ETP), peak thrombin generation and Velocity Index (VI) increased significantly from pre-pregnancy to Day 43 gestation (p = 0.024–0.0004). This change persisted to Day 59 gestation. The mean of the percentage change from baseline, accounting for inter-individual variation, in ETP, peak thrombin and VI increased significantly from pre-pregnancy to Day 32 gestation (p = 0.0351–<0.0001) with the mean increase from baseline persisting to Day 59 gestation. Conclusion: Thrombin generation increases significantly during the very early stages of normal pregnancy when compared to the pre-pregnancy state. The increased risk of venous thrombosis therefore likely begins very early in a woman's pregnancy, suggesting that women considered clinically to be at high thrombotic risk should start thromboprophylaxis as early as possible after a positive pregnancy test.
Item Type: | Articles |
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Additional Information: | The study was funded by the charity, Wellbeing of Women (Wellbeing of Women/RCOG Research Grant; RG939/07). |
Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Freeman, Dr Dilys and Jordan, Mrs Fiona and Bagot, Dr Catherine |
Authors: | Bagot, C.N., Leishman, E., Onyiaodike, C.C., Jordan, F., and Freeman, D.J. |
College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing |
Journal Name: | Thrombosis Research |
Publisher: | Elsevier |
ISSN: | 0049-3848 |
ISSN (Online): | 1879-2472 |
Published Online: | 29 June 2017 |
Copyright Holders: | Copyright © 2017 Elsevier Ltd. |
First Published: | First published in Thrombosis Research 157: 49-54 |
Publisher Policy: | Reproduced in accordance with the publisher copyright policy |
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