Department of Obstetrics and Gynecology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Darüşşafaka, Büyükdere Cad. No: 40, Sarıyer, 34457, Istanbul, Turkey.
BMC Pregnancy Childbirth. 2020 Dec 2;20(1):752. doi: 10.1186/s12884-020-03455-0.
If not detected and treated, gestational diabetes mellitus (GDM) can cause serious pregnancy complications such as macrosomia, preeclampsia, and fetal/neonatal mortality. Many studies have examined underlying contributing factors for GDM, including hypercoagulation. Factor XII (FXII) is a coagulation factor that increases throughout normal pregnancies, and we evaluated the relationship of GDM with FXII, FXIIa (activated FXII), and other coagulation parameter levels. GDM and macrosomia are closely related, but it is not known whether FXII could be an independent causal factor for macrosomia.
In this prospective study, blood samples were taken from 69 pregnant women at the time of term delivery to determine levels of FXII, FXIIa, and other coagulation parameters. Based on the results, pregnancies fell into GDM, non-diabetic with macrosomia (M), or healthy (C [control]).
FXII concentration levels were significantly higher in GDM patients compared with the M and C groups. There were no significant differences when comparing FXIIa, activated partial thromboplastin time, prothrombin time (PT), and international normalized ratio. The GDM group saw a significant negative correlation between FXII concentrations and maternal pregestational body mass index (BMI) and BMI before delivery. In the M group, a positive correlation was observed between FXII concentrations and newborn weight and newborn weight percentile.
An increase in FXII levels was observed in patients with gestational diabetes. Associations between coagulation parameters and GDM should be further analyzed to define the mechanisms of GDM and possible treatment modalities.
Our study has been registered at clinicaltrials.gov ( NCT03583216 ). Registered on July 11, 2018.
如果不加以检测和治疗，妊娠糖尿病（GDM）可能会导致严重的妊娠并发症，如巨大儿、子痫前期和胎儿/新生儿死亡。许多研究已经研究了 GDM 的潜在致病因素，包括高凝状态。因子 XII（FXII）是一种在正常妊娠中增加的凝血因子，我们评估了 GDM 与 FXII、FXIIa（激活的 FXII）和其他凝血参数水平的关系。GDM 和巨大儿密切相关，但尚不清楚 FXII 是否可以成为巨大儿的独立致病因素。
在这项前瞻性研究中，我们在分娩时从 69 名孕妇采集血液样本，以确定 FXII、FXIIa 和其他凝血参数的水平。根据结果，妊娠分为 GDM、非糖尿病巨大儿（M）和健康对照（C）。
与 M 组和 C 组相比，GDM 患者的 FXII 浓度水平显著升高。FXIIa、活化部分凝血活酶时间、凝血酶原时间（PT）和国际标准化比值无显著差异。GDM 组 FXII 浓度与产妇孕前体重指数（BMI）和分娩前 BMI 呈显著负相关。在 M 组中，观察到 FXII 浓度与新生儿体重和新生儿体重百分位呈正相关。
在妊娠糖尿病患者中观察到 FXII 水平升高。应进一步分析凝血参数与 GDM 之间的关系，以明确 GDM 的发病机制和可能的治疗方法。
我们的研究已在 clinicaltrials.gov 注册（NCT03583216）。于 2018 年 7 月 11 日注册。
