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These adaptations involve alterations in coagulation and fibrinolysis, which can be further modified in complicated pregnancies such as gestational diabetes mellitus (GDM) and preeclampsia (PE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study investigated coagulation and fibrinolysis parameters in healthy pregnancies across different gestational stages and compared them to GDM and PE in the third trimester.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective study, 293 pregnant women undergoing prenatal check\u2010ups were enrolled. Coagulation parameters (prothrombin time, PT; activated partial thromboplastin time, APTT; thrombin time, TT; and fibrinogen, FIB) and fibrinolysis parameters (fibrin\/fibrinogen degradation products, FDP; D\u2010dimer; plasminogen activator inhibitor\u20101, PAI\u20101; tissue plasminogen activator, tPA; and plasmin\u2010\u03b12\u2010plasmin inhibitor complex, PIC) were measured and compared across groups: non\u2010pregnant controls, healthy pregnancies (first trimester, third trimester, delivery), GDM, and PE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In normal pregnancy, all gestational stages showed significantly shortened PT, APTT, and TT and elevated FIB, FDP, D\u2010dimer, PAI\u20101, and tPA compared to non\u2010pregnant controls. FDP and D\u2010dimer increased progressively with gestation. Compared to the third trimester, GDM was characterized by significantly higher PAI\u20101 and tPA but lower PIC, whereas PE was characterized by significantly higher PAI\u20101 and PIC, prolonged APTT, and lower tPA. Furthermore, among healthy women at delivery and those with GDM, overweight and obesity were associated with significantly increased PAI\u20101 levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>As pregnancy progresses, enhanced coagulation with hypofibrinolysis occurs in normal pregnancy, and further hypofibrinolysis is the primary thrombotic driver in GDM and obesity. PE presents a more complex alteration in both coagulation and fibrinolytic pathways.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ijlh.70207","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T01:19:41Z","timestamp":1785201581000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Coagulation and Fibrinolysis in Normal Pregnancy and Complicated Pregnancy"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6151-1635","authenticated-orcid":false,"given":"Yang","family":"Su","sequence":"first","affiliation":[{"name":"The Department of Laboratory Medicine Peking University Third Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6453-7328","authenticated-orcid":false,"given":"Yao","family":"Wei","sequence":"additional","affiliation":[{"name":"The Department of Laboratory Medicine Peking University Third Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2854-9092","authenticated-orcid":false,"given":"Cheng","family":"Liu","sequence":"additional","affiliation":[{"name":"The Department of Laboratory Medicine Peking University Third Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yafei","family":"Gao","sequence":"additional","affiliation":[{"name":"The Department of Psychiatry Peking University Sixth Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolong","family":"Ma","sequence":"additional","affiliation":[{"name":"The Department of Laboratory Medicine Peking University Third Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1386-0250","authenticated-orcid":false,"given":"Yongxin","family":"Li","sequence":"additional","affiliation":[{"name":"The Department of Laboratory Medicine Peking University Third Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6225-9913","authenticated-orcid":false,"given":"Rui","family":"Qiao","sequence":"additional","affiliation":[{"name":"The Department of Laboratory Medicine Peking University Third Hospital  Beijing China"},{"name":"The State Key Laboratory of Vascular Homeostasis and Remodeling Peking University Third Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.14382"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.2147\/vhrm.S404537"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms26199339"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc09\u20101848"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2021.09.008"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13741\u2010021\u201000225\u20100"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jri.2022.103490"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/plac.1999.0446"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404\u2010011\u20102137\u2010x"},{"key":"e_1_2_13_11_1","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1182\/blood.V74.4.1332.1332","article-title":"Changes in the Plasma Levels of Type 1 and Type 2 Plasminogen Activator Inhibitors in Normal Pregnancy and in Patients With Severe Preeclampsia","volume":"74","author":"Estell\u00e9s A.","year":"1989","journal-title":"Blood"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000015903"},{"issue":"1","key":"e_1_2_13_13_1","first-page":"S23","article-title":"What Role Does the Measurement of Fibrinogen and Its Derivatives Have in the Diagnosis of Disseminated Intravascular Coagulation?","volume":"16","author":"Dempfle C.\u2010E.","year":"2002","journal-title":"Blood Reviews"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20102007\u2010994069"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.4103\/0974\u20102727.180790"},{"key":"e_1_2_13_16_1","first-page":"35","article-title":"Value of Coagulation Function and Fibrinolytic System Assessment in Patients With Gestational Diabetes Mellitus","volume":"27","author":"Liu B. 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