{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T15:05:23Z","timestamp":1780067123883,"version":"3.54.0"},"reference-count":33,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2015,7,21]],"date-time":"2015-07-21T00:00:00Z","timestamp":1437436800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000019","name":"National Hemophilia Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000019","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:p>Oral contraceptive (OCP) induced changes on coagulation are complex with high inter\u2010individual variability. The precise reason for differences in this variability is unknown. We hypothesized that global coagulation assays better delineate these changes and variability in hypercoagulability may be the result of differences in estrogen metabolism and thrombophilia. Fifty\u2010two adolescents initiating OCPs were prospectively enrolled; 33 subjects completed the study. Samples were analyzed prior to and after OCPs for procoagulant and anticoagulant factor activities and thrombin generation (TG) +\/\u2010thrombomodulin. Participants were genotyped for common thrombophilia and estrogen receptor\u2010\u03b1 (ESR\u2010\u03b1) single nucleotide polymorphisms (SNPs). SNP genotypes were compared to coagulation parameters; TG parameters and differences pre and post OCPs were examined. At baseline, a striking finding was elevated FVIII levels. FVL was absent in all and F2 G20210A was present in one participant. The ESR\u2010\u03b1 polymorphism was present in heterozygous state in 59% and homozygous state in 21% participants. There were no differences in VWF levels and FVIII: C after being on OCPs. Protein S levels decreased with OCPs. Sixty percent of participants showed evidence of hypercoagulability on TG testing on OCPs. Higher thrombin peak and endogenous thrombin potential (ETP) were seen on TG after OCPs. With thrombomodulin, ETP and thrombin peak did not decrease after OCPs, signifying \u2018thrombomodulin resistance\u2019. We demonstrated that OCPs induce a state of \u201cvariable\u201d hypercoagulability in adolescents, predominantly through the protein S pathway. Genetic and nongenetic factors may account for the variable increase in hypercoagulability. Further research is needed to understand this. Am. J. Hematol. 90:725\u2013731, 2015. \u00a9 2015 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ajh.24064","type":"journal-article","created":{"date-parts":[[2015,5,25]],"date-time":"2015-05-25T20:02:13Z","timestamp":1432584133000},"page":"725-731","source":"Crossref","is-referenced-by-count":32,"title":["Hypercoagulability in adolescent girls on oral contraceptives\u2010global coagulation profile and estrogen receptor polymorphisms"],"prefix":"10.1002","volume":"90","author":[{"given":"Ayesha","family":"Zia","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Hematology Oncology The University of Texas Southwestern Medical Center Dallas Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael U.","family":"Callaghan","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, the Carman Ann Adams Department of Pediatrics Wayne State University School of Medicine Detroit 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