Thrombosis research · 2026
The influence of thrombophilia and low molecular weight heparin on D-Dimer levels in women with high-risk pregnancy.
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Frenzel Elisa, Keller Maren, Weise Maria, Klöter Tristan, Federbusch Martin, Heinemann Mitja, Metze Michael, Petros Sirak, Pfrepper Christian
Аннотация
INTRODUCTION: Pregnancy is a hypercoagulable state that raises the risk of venous thromboembolism VTE), particularly in women with thrombophilia. D-Dimer levels increase during the activation of the coagulation cascade and are used to exclude VTE in non-pregnant women. This study aimed to analyze the influence of thrombophilia and the use of low molecular weight heparin (LMWH) on D-dimer levels in pregnant women.
METHODS: We retrospectively analyzed data from pregnant women presenting at the hemostaseology outpatient clinic of the University Hospital of Leipzig between July 2016 and June 2023. The women were seen at intervals of four to six weeks and D-dimer concentrations were measured at every visit.
RESULTS: A total of 301 women were included in the study, of whom 121 were diagnosed with thrombophilia. The concentration of D-dimer increased continuously throughout pregnancy both in women with and without LMWH. Patients diagnosed with thrombophilia had similar D-Dimer levels compared to women without thrombophilia, irrespective of LMWH administration. Women with heterozygous Factor-V-Leiden mutation who did not receive thromboprophylaxis had higher D-Dimer levels during most of their pregnancy than those without thrombophilia. The initiation of LMWH led to a significant reduction of D-dimers in early pregnancy, and patients started on LMWH prophylaxis early in pregnancy had lower D-dimers later in pregnancy.
CONCLUSION: This is one of the largest studies evaluating D-dimer concentrations in women with high-risk pregnancies. Further studies with clinical endpoints are required to evaluate the role of D-dimers in deciding whether to initiate LMWH prophylaxis.
METHODS: We retrospectively analyzed data from pregnant women presenting at the hemostaseology outpatient clinic of the University Hospital of Leipzig between July 2016 and June 2023. The women were seen at intervals of four to six weeks and D-dimer concentrations were measured at every visit.
RESULTS: A total of 301 women were included in the study, of whom 121 were diagnosed with thrombophilia. The concentration of D-dimer increased continuously throughout pregnancy both in women with and without LMWH. Patients diagnosed with thrombophilia had similar D-Dimer levels compared to women without thrombophilia, irrespective of LMWH administration. Women with heterozygous Factor-V-Leiden mutation who did not receive thromboprophylaxis had higher D-Dimer levels during most of their pregnancy than those without thrombophilia. The initiation of LMWH led to a significant reduction of D-dimers in early pregnancy, and patients started on LMWH prophylaxis early in pregnancy had lower D-dimers later in pregnancy.
CONCLUSION: This is one of the largest studies evaluating D-dimer concentrations in women with high-risk pregnancies. Further studies with clinical endpoints are required to evaluate the role of D-dimers in deciding whether to initiate LMWH prophylaxis.