Unveiling hepatic involvement in de novo preeclampsia; In light of FIB-4 index and APRI

Preeclampsia often affects multiple organ systems, including the liver. Noninvasive markers such as the fibrosis-4 (FIB-4) index and aspartate aminotransferase to platelet ratio index (APRI) are frequently employed to evaluate liver fibrosis in chronic liver diseases. The objective of this research was to examine the alterations in FIB-4 index and APRI in newly developed preeclampsia and evaluate their diagnostic capability in identifying liver involvement. This retrospective cross-sectional investigation, spanning from 2018 to 2024, was carried out at Giresun Obstetrics and Pediatrics Training and Research Hospital. The study involved 198 women with de novo preeclampsia and 195 healthy pregnant women serving as a control group. The researchers compared laboratory findings and maternal-fetal outcomes between these 2 cohorts. Both APRI and FIB-4 indices were found to be significantly elevated in the de novo preeclampsia group when compared to controls (P < .001). For predicting de novo preeclampsia, the optimal threshold for APRI was established at 0.24 (sensitivity 62.1%, specificity 61.4%), while for FIB-4 it was determined to be 0.65 (sensitivity 67.2%, specificity 78.5%). The area under curve values for these indices did not differ significantly. Regression analysis indicated that both APRI and FIB-4 indices were significantly linked to de novo preeclampsia. This study suggests that APRI and FIB-4 may be useful as noninvasive tools for detecting liver dysfunction in preeclampsia cases. However, further extensive prospective studies are required to validate these observations and determine standardized cutoff values for routine clinical use.