Negative correlation between D-dimer and homocysteine levels during pregnancy and the postpartum period: a prospective study.
OBJECTIVE
There have been conflicting data about the role of increased levels of homocysteine (Hcy) on haemostatic system. We aim to investigate prospectively the relation between serum Hcy levels and changes in haemostatic system in pregnancy and postpartum period.


METHODS
Sixty-eight healthy pregnant women were included in the study. Blood samples were obtained in the 11th gestational week, 25th gestational week, 32nd gestational week and postpartum 4th week. The haemoglobin levels, white blood cell count (WBC), platelet count, activated partial thromboplastin time (aPTT), prothrombin time (PT), fibrinogen, D-dimer, Hcy, vitamin B12, and folate levels were measured.


RESULTS
Serum Hcy levels were negatively correlated with D-dimer levels (r = -0.57, p < 0.0001). The highest levels of D-dimer (1046.62 ± 322.01 ng/ml) were achieved in the third trimester and the lowest levels of serum Hcy (4.45 ± 1.23 mmol/l) were detected in the same trimester. In postpartum fourth week, D-dimer levels were decreased to normal levels (238.27 ± 198.59 ng/ml) while the serum Hcy levels were reached to the highest levels (7.99 ± 1.36 mmol/l).


CONCLUSIONS
The negative correlation between Hcy and D-dimer levels may be a compensatory mechanism to maintain the normal haemostatic balance in pregnancy. Hence, possible advantage of low Hcy levels in pregnancy may be to prevent undesired thrombosis.
Haliloglu
Berna
B
School of Medicine, Maltepe University, Department of Obstetrics and Gynecology, Istanbul, Turkey. bernadr23@hotmail.com
Aksungar
Fehime Benli
FB
Celik
Aygen
A
Ilter
Erdin
E
Coksuer
Hakan
H
Ozekici
Umit
U
D000328:Adult; D019281:Dimerization; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D049590:Postpartum Period / Q000097:blood*; D011247:Pregnancy / Q000097:blood*; D011446:Prospective Studies; D054556:Venous Thromboembolism / Q000209:etiology; D055815:Young Adult
D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D006710:Homocysteine