My Tran Thi Kieu, Ha Hoang Thi, Truong Nguyen Huu, Thiet Dao Thi, Ha Nguyen Khanh, Xoay Tran Dang, Olson Linus, Khanh Bach Quoc
Division of Hematology, Hanoi Medical University, Hanoi 100000, Vietnam.
National Institute of Hematology and Blood Transfusion, Hanoi 100000, Vietnam.
Diseases. 2025 Jul 3;13(7):210. doi: 10.3390/diseases13070210.
Pregnancies in patients with systemic lupus erythematosus (SLE) have always been considered high-risk. D-dimer is known for its role in excluding the diagnosis of thrombosis and has been associated with lupus reactivation; however, its physiological elevation during pregnancy limits its utility in this population. Fibrin monomer (FM) has been shown in multiple studies to remain stable in pregnant women. The objectives of this study were to evaluate D-dimer and FM levels, as well as to assess the role of FM in SLE activity during pregnancy.
The subjects included 76 pregnant women with SLE diagnosed according to the Systemic Lupus International Collaborating Clinics (SLICC) 2012 criteria. The assessment of disease activity was in accordance with the Systemic Lupus Erythematosus Pregnancy Disease Activity Index (SLEPDAI) Results: The log-transformed D-dimer (LtDD) and FM (LtFM) concentrations in the pregnant women with lupus were 1.229 (0.722-1.953) and 4.17 (3.01-5.34) µg/mL, respectively. A multivariate regression indicated that 59.1% of the variation in LtDD was influenced by the gestational age and SLEPDAI, while only 18.3% of the fluctuation in LtFM was affected by these factors. The concentration of LtFM was an independent factor in predicting SLE flare and disease activity level according to the SLEPDAI in pregnant women.
In conclusion, this study's findings suggest that elevated levels of both D-dimer and FM were observed in pregnant patients with SLE. However, only FM levels can be used as a prognostic factor in assessing the risk of SLE reactivation during pregnancy.
系统性红斑狼疮（SLE）患者的妊娠一直被视为高危妊娠。D-二聚体以其在排除血栓形成诊断中的作用而闻名，并且与狼疮复发有关；然而，其在孕期的生理性升高限制了它在该人群中的应用。多项研究表明，纤维蛋白单体（FM）在孕妇中保持稳定。本研究的目的是评估D-二聚体和FM水平，并评估FM在孕期SLE活动中的作用。
研究对象包括76例根据2012年系统性红斑狼疮国际协作临床中心（SLICC）标准诊断的SLE孕妇。疾病活动度评估采用系统性红斑狼疮妊娠疾病活动指数（SLEPDAI）。结果：狼疮孕妇的对数转换D-二聚体（LtDD）和FM（LtFM）浓度分别为1.229（0.722 - 1.953）和4.17（3.01 - 5.34）μg/mL。多因素回归分析表明，LtDD变化的59.1%受孕周和SLEPDAI影响，而LtFM波动中只有18.3%受这些因素影响。根据SLEPDAI，LtFM浓度是预测孕妇SLE病情复发和疾病活动水平的独立因素。
总之，本研究结果表明，SLE孕妇中观察到D-二聚体和FM水平均升高。然而，只有FM水平可作为评估孕期SLE复发风险的预后因素。
