Elevated levels of D-dimer tested by immunoturbidimetry are associated with the extent of severity of pre-eclampsia

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Abstract

Objective: To establish the association between increased levels of D-dimer and severity of pre-eclampsia. Methods: A nested, prospective cohort, analytical case–control study was conducted among women with pre-eclampsia between March 2017 and March 2018. Inclusion criteria were age over 18 years, gestational age of more than 20 weeks, a single pregnancy with a living fetus, and a diagnosis of pre-eclampsia. D-dimer was measured by immunoturbidimetry at the time of diagnosis of pre-eclampsia, applying cut-off points adjusted for gestational age. Statistical analysis involved unconditional logistic regression for the association of elevated D-dimer with severe pre-eclampsia adjusted by confounding variables. Results: There were 132 patients with pre-eclampsia, of which 44 were classed as controls and 88 were classed as having severe pre-eclampsia (case group). Cohort characteristics included: age between 18 and 45 years (mean 28.0 ± 6.3 years); presence of gestational hypertension (10.6%), chronic arterial hypertension (9.0%); and gestational diabetes (5.3%). In the case group, levels of D-dimer were significantly higher than in controls (19.3% vs 2.3%, odds ratio [OR] 10.30, 95% confidence interval [CI] 1.32–80.14, P=0.004) as well as significant in the unconditional logistic regression model adjusted for maternal age, parity, gestational age, and comorbidities (OR 10.02, 95% CI 1.28–78.68, P=0.028). Conclusion: Elevated levels of D-dimer and severe pre-eclampsia are strongly associated, reinforcing evidence that one of the physiopathologic bases of the condition is the activation of fibrinolysis and the coagulation system.

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Rodríguez-Peña, Y., & Ibáñez-Pinilla, M. (2020). Elevated levels of D-dimer tested by immunoturbidimetry are associated with the extent of severity of pre-eclampsia. International Journal of Gynecology and Obstetrics, 150(2), 241–247. https://doi.org/10.1002/ijgo.13163

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