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Correlation of platelet parameters with adverse maternal and neonatal outcomes in severe preeclampsia: A case-control
Benjamin S Umezuluike1, Chidebe C Anikwe1, Oluomachi C Nnachi2
1Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, P.M.B 102 Abakaliki, Ebonyi state, Nigeria.
Insights
Platelet parameters like count and plateletcrit differ significantly in pre-eclampsia (PET). Increased platelet-large cell ratio (P-LCR) is a risk factor for eclampsia in PET patients.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Perinatal Medicine
Background:
- Pre-eclampsia (PET) is a serious pregnancy disorder characterized by oxidative stress, leading to endothelial damage and coagulopathy.
- Platelet activation in PET contributes to inflammation, vasoconstriction, and adverse pregnancy outcomes.
Purpose of the Study:
- To compare platelet indices between women with pre-eclampsia and normotensive pregnant women.
- To investigate the relationship between platelet parameters and adverse outcomes in pre-eclamptic women.
Main Methods:
- A case-control study involving 60 pre-eclamptic and 60 normotensive pregnant women.
- Platelet indices were analyzed using a hematological auto-analyzer at recruitment and before delivery.
- Statistical analysis was performed using IBM-SPSS version 22.
Main Results:
- Significant differences were observed in mean platelet count, platelet distribution width (PDW), and plateletcrit between severe pre-eclamptic and normotensive groups.
- Increased platelet-large cell ratio (P-LCR) was strongly associated with eclampsia.
- Lower odds of abruptio placentae and preterm birth were noted at higher mean plateletcrit levels.
Conclusions:
- Platelet count, plateletcrit, PDW, and P-LCR show significant differences between pre-eclamptic and normotensive women.
- Elevated P-LCR is identified as a risk factor for eclampsia in pre-eclampsia.
Background:
Pre-eclampsia (PET) is a potentially devastating multi-systemic disorder resulting in the generation of oxidative stress. Platelet activation causes vasoconstriction and release of inflammatory cytokines, resulting in an intensified inflammatory response, endothelial damage, and coagulopathy which culminate in adverse pregnancy outcomes.
Aim:
To compare the platelet parameters between preeclamptic and normotensive pregnant women and their relationship to adverse outcomes in women with pre-eclampsia.
Materials And Methods:
This was a case-control study of platelet indices of 60 pre-eclamptic and 60 normotensive pregnant women recruited at 28 weeks and followed till delivery. A blood sample was collected at entry into the study and just before delivery. The sample was analyzed within 1 h of collection using the Mythic 18 hematological auto-analyzer. Data were analyzed using IBM-SPSS version 22. A P-value of <0.05 was considered statistically significant.
Results:
The mean platelet count, Platelet distribution width (PDW), plateletcrit were statistically significantly different between normotensive and severe preeclamptic participants (p= <0.001). Statistically significant differences were not present in any of the platelet parameters between mild and severe PET. The odds of developing eclampsia was low at higher mean platelet count and plateletcrit levels above 161.36 ± 73.74 × 109/L [p = 0.02, AOR = 0.27, 95% CI (0.08-0.88)] and 0.13 ± 0.05% [p = 0.001, AOR = 0.22, 95% CI (0.08-0.58)] respectively. Eclampsia was strongly associated with P-LCR (platelet-large cell ratio) above 23.15 ± 4.92% [p = 0.004, AOR = 11.00, 95%CI (1.48-89.02)]. Abruptio placentae had low odds at lower levels of mean plateletcrit. Pre-term birth was significantly lower at mean plateletcrit levels above 0.14 ± 0.05%; admission into neonatal intensive care unit was strongly associated with a mean PLC ratio above 22.73 ± 5.91%.
Conclusion:
This study demonstrated significant differences in platelet count, plateletcrit, platelet distribution width, and P-LCR between pre-eclamptic and normotensive women. Increase in P-LCR is a risk factor for eclampsia although the effect size is low.
