Aims: Impact of gestational diabetes mellitus on the coagulation system, dynamics involved at a pathophysiological level and the exact mechanism remain unclear.
To evaluate association between diabetes-related parameters and haemostatic factors in order to search for a tendency of thrombosis in gestational diabetes mellitus.
Methods and Material: Nineteen pregnant women who had gestational diabetes mellitus, 16 healthy pregnant and 13 healthy non-pregnant controls admitted to the Endocrinology outpatient clinics were enrolled in the study. Fasting and postprandial glucose, haemoglobin A1c and insulin levels, and insulin resistance; fructosamine, thrombin activatable fibrinolysis inhibitor, tissue factor pathway inhibitor, plasminogen activator inhibitor type-1, tissue type plasminogen activator, fibrinogen, plasminogen and haemoglobin levels, platelet counts, prothrombin time, activated partial thromboplastin time were studied. One-Way analysis of variance, Kruskal Wallis and post hoc Tukey HSD or Conovers non-parametric multiple comparison tests for comparison of the study groups.
Results: Prothrombin time and activated partial thromboplastin time were significantly lower in gestational diabetes mellitus patients compared to controls (P<0.05), while fibrinogen and plasminogen levels were significantly higher in this group compared to both non-pregnant and healthy pregnant controls (P<0.05 for each). Thrombin activatable fibrinolysis inhibitor, tissue factor pathway inhibitor, plasminogen activator inhibitor type-1 and tissue type plasminogen activator levels were not significantly different among groups.
Conclusions: Our findings indicate tendency to develop thrombosis in gestational diabetes mellitus similar to diabetes mellitus; but more comprehensive studies with larger sample size are needed to determine the relationship between gestational diabetes mellitus and haemostasis. Levels of coagulation factors may vary in different stages of pregnancy and postpartum period with diverse etiopathogenesis. Similar to previously reported studies, our study suggests that GDM may play a role in the pathogenesis leading to a thrombotic tendency similar to diabetes mellitus.