Related Experiment Video
Updated: Jul 29, 2025
Author Spotlight: Modeling an Aspect of Preeclampsia in Female Mice Using Hypoxic Human Placenta-Derived Small Extracellular Vesicles
Published on: January 26, 2024
Incremental predictive value of platelet parameters for preeclampsia: results from a large prospective cohort study
Shan-Shan Lin1, Cheng-Rui Wang2, Dong-Mei Wei1,2
1Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China.
Insights
Adding platelet parameters like platelet count and plateletcrit to standard risk factors can improve preeclampsia (PE) prediction. While not accurate alone early in pregnancy, these markers enhance early detection rates for PE.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Reproductive Medicine
Background:
- Preeclampsia (PE) risk is linked to pregnancy platelet parameters, but their predictive power is unclear.
- This study aimed to assess the individual and combined predictive value of platelet count (PC), mean platelet volume (MPV), plateletcrit (PCT), and platelet distribution width (PDW) for PE.
Purpose of the Study:
- To evaluate the predictive capability of various platelet parameters for preeclampsia.
- To determine the incremental predictive value of these parameters when added to existing risk factors.
Main Methods:
- Utilized data from the Born in Guangzhou Cohort Study (30,401 pregnancies).
- Analyzed platelet parameters (PC, MPV, PCT, PDW) using ROC curves.
- Assessed incremental predictive value using Detection Rate (DR), Integrated Discrimination Improvement (IDI), and Continuous Net Reclassification Improvement (NRI) against a base model of maternal factors.
Main Results:
- Higher PC and PCT levels at 12-19 weeks were associated with later PE development.
- No single platelet parameter before 20 weeks reliably predicted PE (AUC < 0.70).
- Adding platelet parameters at 16-19 weeks significantly improved preterm PE prediction (DR increased from 22.9% to 31.4%, AUC improved to 0.849, NRI=0.793, IDI=0.0069).
- Modest improvements were also seen for term and total PE prediction.
Conclusions:
- Individual platelet parameters lack high accuracy for early PE prediction.
- Combining platelet parameters with established risk factors significantly enhances PE prediction accuracy, particularly for preterm PE.
Background:
Platelet parameters during pregnancy were associated with the risk of preeclampsia (PE), but the predictive value of these parameters for PE remained unclear. Our aim was to clarify the individual and incremental predictive value of platelet parameters, including platelet count (PC), mean platelet volume (MPV), plateletcrit (PCT), and platelet distribution width (PDW) for PE.
Methods:
This study was based on the Born in Guangzhou Cohort Study in China. Data on platelet parameters were extracted from medical records of routine prenatal examinations. Receiver operating characteristic (ROC) curve was performed to analyze the predictive ability of platelet parameters for PE. Maternal characteristic factors proposed by NICE and ACOG were used to develop the base model. Detection rate (DR), integrated discrimination improvement (IDI) and continuous net reclassification improvement (NRI) were calculated compared with the base model to assess the incremental predictive value of platelet parameters.
Results:
A total of 30,401 pregnancies were included in this study, of which 376 (1.24%) were diagnosed with PE. Higher levels of PC and PCT were observed at 12-19 gestational weeks in women who developed PE later. However, no platelet parameters before 20 weeks of gestation reliably distinguished between PE complicated pregnancy and non-PE complicated pregnancy, with all values of the areas under the ROC curves (AUC) below 0.70. The addition of platelet parameters at 16-19 gestational weeks to the base model increased the DR for preterm PE from 22.9 to 31.4% at a fixed false positive rate of 5%, improved the AUC from 0.775 to 0.849 (p = 0.015), and yielded a NRI of 0.793 (p < 0.001), and an IDI of 0.0069 (p = 0.035). Less but significant improvement in prediction performance was also observed for term PE and total PE when all the four platelet parameters were added to the base model.
Conclusions:
Although no single platelet parameter at the early stage of pregnancy identified PE with high accuracy, the addition of platelet parameters to known independent risk factors could improve the prediction of PE.
