Plasma Plasmin Generation and its Determinants in Third Trimester of Pregnancy

Background Pregnancy, especially in the third trimester, is associated with changes in the fibrinolytic system that supports clot formation and reduces hemorrhagic risk. Imbalance in the system may occur and can be assessed by plasmin generation (PG). Certain factors are known to affect PG. Aim To assess PG and its determinants during pregnancy using plasma D-dimer and plasmin-antiplasmin (PAP) complex levels. Methods Healthy pregnant women in the third trimester of pregnancy were systematically recruited. Using the ELISA method, venous blood samples were taken to assess D-Dimer and PAP complex plasma levels. IBM Statistical Package for Social Sciences (SPSS) version 21 was used for statistical analysis. Results We studied a total of 41 subjects with a mean age ±SD and gestational age ±SD of 30.68±4.69years and 34.78±3.34weeks, respectively. The mean ± SD values of the D-Dimer and PAP complex were 194 ± 24 ng/mL and 175 ± 11 ng/mL, respectively. D-Dimer and PAP complex positively correlated with age, GA, and BMI classification. However, only age was statistically significant (p-value 0.032 and 0.016, respectively). In addition, the multiple linear regression model showed that with every unit increase in age, D-Dimer and PAP complex increased by 2.0 (95% CI 0.4 – 3.6) ng/mL and 0.8 (95% CI 0.1 – 1.5) ng/mL respectively, after controlling for GA and BMI. Conclusion D-Dimer and PAP levels increased with increasing age during the third trimester of pregnancy, showing that the woman’s age is an independent determinant of PG in the third trimester.