The association of antenatal D-dimer and fibrinogen with postpartum hemorrhage and intrauterine growth restriction in preeclampsia

Abstract Background D-dimer and fibrinogen were verified to be altered in preeclampsia. This study was to evaluate the associations of D-dimer and fibrinogen plasma levels with postpartum hemorrhage or intrauterine growth restriction in preeclamptic women. Methods This was a retrospective study that recruited 278 preeclamptic women with singleton pregnancy from January 2016 to December 2019. Patients were allocated into five groups: mild preeclampsia (mPE) (n=68), mild preeclampsia with postpartum hemorrhage (mPE+PPH) (n=13), severe preeclampsia (sPE) (n=112), severe preeclampsia with postpartum hemorrhage (sPE+PPH) (n=17) and severe preeclampsia with intrauterine growth restriction (sPE+IUGR) (n=68). The antenatal D-dimer and fibrinogen plasma levels were analyzed among the groups. Logistic regression was used to determine the correlation between serum indexes and PPH or IUGR in preeclampsia. Results The antenatal D-dimer plasma levels were significantly higher in the sPE+PPH group than that in the sPE group (2.02 μg/ml versus 1.37 μg/ml, P = 0.001), but there was no difference in fibrinogen. Elevated D-dimer was associated with PPH among severe preeclamptic women (adjusted odds ratio (aOR) [95% CI]: 3.093 [1.527-6.264], P = 0.002). No differences in D-dimer and fibrinogen were found between the mPE and mPE+PPH groups or between the sPE and sPE+IUGR groups. Conclusions Elevated antenatal plasma D-dimer level may be associated with postpartum hemorrhage in severe preeclampsia, but not with intrauterine growth restriction. Future prospective clinical trials are needed to investigate the predictive value of D-dimer in postpartum hemorrhage in severe preeclampsia.

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Intrauterine Growth Restriction in Singleton Pregnancy-Surveillance and Delivery: An Overview

Current Women s Health Reviews ◽

10.2174/157340408784246340 ◽

2008 ◽

Vol 4 (2) ◽

pp. 124-132

Author(s):

Kjell Haram

Keyword(s):

Intrauterine Growth Restriction ◽

Growth Restriction ◽

Singleton Pregnancy ◽

Intrauterine Growth

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Associations of Intrauterine Growth Restriction Among Term Infants and Maternal Pregnancy Intendedness, Initial Happiness About Being Pregnant, and Sense of Control

PEDIATRICS ◽

10.1542/peds.111.s1.1171 ◽

2003 ◽

Vol 111 (Supplement_1) ◽

pp. 1171-1175

Author(s):

Sharon Durousseau ◽

Gilberto F. Chavez

Keyword(s):

Confidence Interval ◽

Psychosocial Factors ◽

Intrauterine Growth Restriction ◽

Odds Ratio ◽

Growth Restriction ◽

Sense Of Control ◽

Term Infants ◽

Mortality And Morbidity ◽

Intrauterine Growth ◽

Pregnancy Intendedness

Objective. Term infants (≥37 weeks’ gestation) who weigh <2500 g have intrauterine growth restriction (IUGR) and have a higher risk of mortality and morbidity. Little is known about how psychosocial factors affect the risk of IUGR. We examined the association between IUGR and maternal pregnancy intendedness, initial happiness about becoming pregnant, and maternal sense of control. Methods. We analyzed data from a survey of California mothers aged ≥15 years with term live births in 1999 and 2000 (N = 5961). Mothers were asked about pregnancy intendedness before pregnancy, initial happiness about becoming pregnant, and maternal sense of control, assessed by a standardized scale. We examined the association of having an infant with IUGR and these factors in univariate and multivariate analyses. Results. Mothers with low sense of control (3.0%) and average sense of control (2.7%) were more likely to have an infant with IUGR than mothers with high sense of control (1.8%; odds ratio: 1.8; 95% confidence interval: 1.2–2.9; and odds ratio: 1.6; 95% confidence interval: 1.0–2.5). After multivariate analysis, we found no significant association between sense of control and IUGR. We also found no significant association between IUGR and pregnancy intendedness and happiness about becoming pregnant. Conclusions. We found no statistically significant association between IUGR and maternal pregnancy intendedness, initial happiness about becoming pregnant, and maternal sense of control. Although research should continue to explore associations between psychosocial factors and IUGR, prenatal care programs should focus on known risk factors for IUGR.

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Risk Factors for Intrauterine Growth Restriction: 9 Years Analysis in Tertiary Care Hospital

Journal of BP Koirala Institute of Health Sciences ◽

10.3126/jbpkihs.v2i1.24973 ◽

2019 ◽

Vol 2 (1) ◽

pp. 77-82

Author(s):

Abha Shrestha ◽

N Pradhan ◽

B Kayastha

Keyword(s):

Risk Factors ◽

Intrauterine Growth Restriction ◽

Tertiary Care ◽

Adult Life ◽

Growth Restriction ◽

Optimal Time ◽

Care Hospital ◽

Singleton Pregnancy ◽

Maternal Risk ◽

Intrauterine Growth

Background: Intrauterine growth restricted (IUGR) fetuses are at higher risk of developing neonatal complications and also known to develop metabolic syndrome in adult life. So, an early antenatal detection, choosing the optimal time and method of delivery and intervention when required could minimize the risk significantly. Objective: To find out the prenatal outcome and the maternal and placental risk factors. Methods: A prospective study was conducted from January 2010 to January 2019, at a Teaching Hospital. A singleton pregnancy, above 28 weeks of gestation with clinical diagnosis of IUGR and confirmed by ultrasonography were included in the study. The statistical analysis was performed by Statistical Package of Social Sciences (SPSS) 23.0 software. Results: Maternal risk factors like low pregnancy body mass index, preeclampsia, anaemia, hypothyroidism and placental factors like retro placental hemorrhage were mainly responsible for intrauterine growth restriction. Conclusions: The early identification of risk factors and management of the same antenatal is an important issue to prevent adverse prenatal outcomes associated with IUGR.

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