Reference intervals of D-dimer during the pregnancy and puerperium period on the STA-R evolution coagulation analyzer

Clin Chim Acta. 2013 Oct 21:425:176-80. doi: 10.1016/j.cca.2013.08.006. Epub 2013 Aug 15.


Background: Pregnant women are at a hyper-coagulable state with a higher risk of deep venous thromboembolism (VTE) and disseminated intravascular coagulation (DIC), which could be life threatening. We established gestational age-specific reference intervals for D-dimer, and estimate the role of D-dimer test in ruling out VTE and DIC in pregnant women.

Methods: We followed 1343 healthy pregnant women and 1042 uncomplicated postpartum women to establish gestational age-specific reference intervals of D-dimer during normal pregnancy. Eighty uncomplicated non-pregnant women were chosen as control group. D-dimer testing was also performed among the patients with pregnancy-related complications.

Results: D-dimer concentration increased progressively during the pregnancy and peaked at the first postpartum day, and then it began to decrease steadily and reach to non-pregnant concentrations on the 42nd postpartum day. The results of several cases that had clinical suspicion of VTE were compared with those of the reference group.

Conclusions: The study provides reference intervals of D-dimer during the pregnancy and postpartum period for women of Chinese Han ethnicity using latex-based immunoturbidimetry on the STA-R evolution coagulation analyzer. Further studies are needed to validate these reference ranges and assess the clinical utility of the reference intervals for D-dimer.

Keywords: D-dimer; Postpartum; Pregnancy; Reference interval; Venous thromboembolism.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Automation, Laboratory
  • Blood Coagulation Tests
  • Case-Control Studies
  • Disseminated Intravascular Coagulation / blood
  • Disseminated Intravascular Coagulation / diagnosis
  • Female
  • Fibrin Fibrinogen Degradation Products / metabolism*
  • Gestational Age
  • Humans
  • Nephelometry and Turbidimetry
  • Postpartum Period / blood*
  • Pregnancy / blood*
  • Reference Values
  • Venous Thrombosis / blood
  • Venous Thrombosis / diagnosis


  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D