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Kassahun W, Kidanewold A, Koira G, Biresaw G, Shiferaw M. Hematological predictors of preeclampsia among pregnant women attending ante-natal clinic at Arba Minch General Hospital, South Ethiopia: A comparative cross-sectional study. Pract Lab Med 2024; 39:e00362. [PMID: 38318431 PMCID: PMC10840323 DOI: 10.1016/j.plabm.2024.e00362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/01/2024] [Accepted: 01/18/2024] [Indexed: 02/07/2024] Open
Abstract
Background Preeclampsia is a kind of pregnancy-related hypertension that affects 5.47 % of pregnancies in Ethiopia and 18.25 % of pregnant women who visit Arba Minch public health facilities for antenatal care. This study sought to identify hematological preeclampsia markers in pregnant women who received prenatal care at Arba Minch General Hospital. Methodology An institution-based comparative cross-sectional study was done from July 22 to October 30, 2021 at Arba Minch General Hospital. A total of 136 pregnant women were included in the study (46 with preeclampsia and 90 without preeclampsia). Epidata version 4.4. was used to enter data, and SPSS version 25.0 and Stata version17 were used for analysis. An independent sample t-test was used to examine the hematological parameter differences between study groups. Potential hematological markers were determined using receiver operating characteristic (ROC) analysis of the area under the curve (AUC). Statistical significance was defined if P value less than 0.05. Results A total of 136 pregnant women were studied. The complete blood count analysis showed that there were means differences in Red Cell Distribution (RDW) (p < 0.036), neutrophil-to-lymphocyte ratio (NLR) (p < 0.016) and relative lymphocyte count (Lymp%) (p < 0.047). The ROC analysis of the AUC for RDW, NLR and Lymp% resulted in 0.607, 0.609, 0.600 respectively. Conclusion RDW, NLR and Lymphocyte count could be potential candidate tools for the diagnosis and screening of preeclampsia. However, the robustness of the markers should be tested with prospective studies assessing changes present in each trimester.
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Affiliation(s)
| | - Aschalew Kidanewold
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Arba Minch University, Ethiopia
| | - Getahun Koira
- Department of Gynecology and Obstetrics, School of Medicine, College of Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Gelila Biresaw
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Arba Minch University, Ethiopia
| | - Mulu Shiferaw
- Biomedical Team, School of Medicine, College of Health Sciences, Woldia University, Woldia, Ethiopia
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Qiang T, Ding X, Ling J, Fei M. Is platelet to lymphocyte ratio predictive of preeclampsia? A systematic review and meta-analysis. J OBSTET GYNAECOL 2023; 43:2286319. [PMID: 38014649 DOI: 10.1080/01443615.2023.2286319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 11/13/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND To evaluate the value of the platelet-to-lymphocyte ratio (PLR) in predicting preeclampsia (PE) in pregnant women. METHODS PubMed, EMBASE and Web of Science databases were searched for observational studies (cohort, case-control or cross-sectional) that reported pre-treatment maternal PLR values in women with and without PE. The analysis was done using a random effects model. Pooled effect sizes were reported as weighted mean difference (WMD) with 95% confidence intervals (CIs). Newcastle-Ottawa Scale (NOS) was used to evaluate the risk of bias. RESULTS Twenty-five studies with 7755 patients were included in this meta-analysis. PLR was comparable in patients with PE and healthy pregnant women (WMD -2.97; 95% CI: -11.95 to 6.02; N = 16). Patients with mild (WMD -3.00; 95% CI: -17.40 to 11.41; N = 12) and severe PE (WMD -5.77; 95% CI: -25.48 to 13.94; N = 14) had statistically similar PLR, compared to healthy controls. CONCLUSIONS Our findings show similar PLR in PE and healthy pregnancies. PLR, therefore, may not be used to differentiate between PE and normal pregnancy or for assessing the severity of PE. The majority of included studies were case-control, potentially introducing bias, and we identified evidence of publication bias as well.
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Affiliation(s)
- Tianyong Qiang
- Clinical Laboratory, Huzhou Nanxun District Hospital of Traditional Chinese Medicine, Huzhou, China
| | - Xiuqin Ding
- Department of Gynaecology and Obstetrics, Huzhou Nanxun District People's Hospital, Huzhou, China
| | - Jiajia Ling
- Clinical Laboratory, Huzhou Nanxun District Hospital of Traditional Chinese Medicine, Huzhou, China
| | - Meirong Fei
- Department of Gynaecology and Obstetrics, Huzhou Nanxun District People's Hospital, Huzhou, China
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Mohamed RA, Ali IA. Role of neutrophil / lymphocyte ratio, uric acid / albumin ratio and uric acid / creatinine ratio as predictors to severity of preeclampsia. BMC Pregnancy Childbirth 2023; 23:763. [PMID: 37904105 PMCID: PMC10614385 DOI: 10.1186/s12884-023-06083-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 10/21/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Pre-eclampsia (PE) is an intractable obstetric disorder with high mortality and morbidity, affecting 6-8% of pregnancies worldwide. As its etiology and pathogenesis remain unclear, there are no specific prevention or treatment options. This study aimed to determine the association between neutrophil to lymphocyte ratio (NLR), uric acid to albumin ratio (UAR) and uric acid to creatinine ratio (UA/Cr) and severity of pre-eclampsia. METHODS A cross-sectional hospital-based study was conducted among pre-eclamptic women in Kosti Maternity Hospital from September to December 2022. Forty-five pre-eclamptic women were enrolled in this study and were classified according to the WHO classification of PE into mild PE (23 PE patients) and severe PE (22 PE patients). Data were collected using a semi-structured questionnaire covering medical history and clinical assessment. A blood sample was taken from each participant for measurements of the complete blood count (CBC), liver functions test (LFT) with enzymes, renal functions test (RFT) with electrolytes, and uric acid by standard techniques. RESULTS NLR was found to be statistically significantly higher in mothers with severe PE (6.3-9.9) than in those with mild PE (2.2-1.5) (p-value 0.048). Alanine aminotransferase (ALT) was significantly higher in women with severe PE than in those with mild PE (p-value = 0.02). The total means of platelet-lymphocyte ratio (PLR), UA/Cr, and UAR were insignificantly higher in women with severe PE compared with those with mild PE (p-values 0.666, 0.427, and 0.525, respectively). The means of uric acid and serum creatinine showed insignificant statistical elevation in women with severe PE compared with mild PE (p-values of 0.27 and 0.44, respectively). Serum albumin was found to be insignificantly lower in mothers with severe PE (3.3 ± 0.6 g/dl) than in those with mild PE (3.6 ± 0.6 g/dl); p-value = 0.21. CONCLUSIONS PE showed a significant statistical increase in WBC, neutrophils, alanine transaminase (ALT), and NLR in severe PE compared to mild PE and a significant statistical decrease in lymphocyte count in severe PE compared to mild PE. The measurement of NLR may be a useful laboratory marker for predicting the severity of PE.
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Affiliation(s)
| | - Ibrahim Abdelrhim Ali
- Department of Physiology, Faculty of Medicine, The National Ribat University, Khartoum, Sudan.
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4
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Woldeamanuel GG, Tlaye KG, Wu L, Poon LC, Wang CC. Platelet count in preeclampsia: a systematic review and meta-analysis. Am J Obstet Gynecol MFM 2023; 5:100979. [PMID: 37098392 DOI: 10.1016/j.ajogmf.2023.100979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/13/2023] [Accepted: 04/18/2023] [Indexed: 04/27/2023]
Abstract
OBJECTIVE Many studies have reported the association between platelets and preeclampsia. However, sample sizes were small, and their findings were inconsistent. We conducted a systematic review and meta-analysis to evaluate the association in pooled samples and in detail. DATA SOURCES A systematic literature search was performed using Medline, Embase, ScienceDirect, Web of Science, Cochrane Library, NICHD-DASH, LILACS, and Scopus from inception to April 22, 2022. STUDY ELIGIBILITY CRITERIA Observational studies comparing platelet count between women with preeclampsia and normotensive pregnant women were included. METHODS The mean differences with 95% confidence interval in platelet count were calculated. Heterogeneity was assessed using I2 statistics. Sensitivity and subgroup analyses were conducted. Statistical analysis was performed using RevMan 5.3 and ProMeta 3 software. RESULTS A total of 56 studies comprising 4892 preeclamptic and 9947 normotensive pregnant women were included. Meta-analysis showed that platelet count was significantly lower in women with preeclampsia than in normotensive controls (overall: mean difference, -32.83; 95% confidence interval, -40.13 to -25.52; P<.00001; I2=92%; mild preeclampsia: mean difference, -18.65; 95% confidence interval, -27.17 to -10.14; P<.00001; I2=84%; severe preeclampsia: mean difference, -42.61; 95% confidence interval, -57.53 to -27.68; P<.00001; I2=94%). Significantly lower platelet count was also observed in the second trimester (mean difference, -28.84; 95% confidence interval, -44.59 to -13.08; P=.0003; I2=93%), third trimester (mean difference, -40.67; 95% confidence interval, -52.14 to -29.20; P<.00001; I2=92%), and before the diagnosis of preeclampsia (mean difference, -18.81; 95% confidence interval, -29.98 to -7.64; P=.009; I2=87%), but not in the first trimester (mean difference, -15.14; 95% confidence interval, -37.71 to 7.43; P=.19; I2=71%). Overall, the pooled sensitivity and specificity of platelet count were 0.71 and 0.77, respectively. The area under the curve was 0.80. CONCLUSION This meta-analysis confirmed that platelet count was significantly lower in preeclamptic women, irrespective of severity and presence or absence of associated complications, even before the onset of preeclampsia and in the second trimester of pregnancy. Our findings suggest that platelet count may be a potential marker to identify and predict preeclampsia.
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Affiliation(s)
- Gashaw Garedew Woldeamanuel
- Department of Obstetrics and Gynaecology, Li Ka Shing Institute of Health Sciences, School of Biomedical Sciences, Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong SAR
| | - Kenean Getaneh Tlaye
- Department of Obstetrics and Gynaecology, Li Ka Shing Institute of Health Sciences, School of Biomedical Sciences, Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong SAR
| | - Ling Wu
- Department of Obstetrics and Gynaecology, Li Ka Shing Institute of Health Sciences, School of Biomedical Sciences, Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong SAR
| | - Liona C Poon
- Department of Obstetrics and Gynaecology, Li Ka Shing Institute of Health Sciences, School of Biomedical Sciences, Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong SAR
| | - Chi Chiu Wang
- Department of Obstetrics and Gynaecology, Li Ka Shing Institute of Health Sciences, School of Biomedical Sciences, Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong SAR.
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Walle M, Gelaw Y, Getu F, Asrie F, Getaneh Z. Preeclampsia has an association with both platelet count and mean platelet volume: A systematic review and meta-analysis. PLoS One 2022; 17:e0274398. [PMID: 36103491 PMCID: PMC9473393 DOI: 10.1371/journal.pone.0274398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 08/26/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Preeclampsia (PE) is a pregnancy-specific disorder characterized by endothelial dysfunction, and activation of the coagulation system. Alteration of PLT parameters is the common hematological abnormality observed in women with PE. The main aim of this study was to systematically review previous studies from around the world to generate evidence about the relationship between platelet count (PC) and PE, as well as mean platelet volume (MPV) and PE, by calculating the pooled weighted mean difference (WMD) of PC and MPV between PE and normotensive (NT) groups.
Methods
Relevant articles which were published in the English language from January 10, 2011, to January 10, 2021, were systematically searched through PubMed, Web of Science, and African journals online. In addition, reference probing of published articles searching was employed through Google Scholar and Google for searching grey literature. The methodological qualities of articles were assessed using Joana Brigg’s institute critical appraisal checklist. A random-effects model was used to estimate pooled WMD of PLT parameters between the two groups with the respective 95% confidence intervals (CI) using Stata version 11.0. The I2 statistics and Egger’s regression test were used to assess heterogeneity and publication bias among included studies, respectively.
Results
A total of 25 articles were included in this systematic review and meta-analysis. Of which, 23 studies were used in each PC and MPV analysis. The overall pooled WMD of PC and MPV between PE and NT groups were -41.45 × 109/L [95% CI; -51.8, -31.0] and 0.98 fl [95% CI; 0.8, 1.1], respectively. The pooled WMD revealed that PC decreased significantly in the PE group compared to the NT group while MPV increased significantly in the PE group.
Conclusions
This systematic review and meta-analysis indicated that there is a significant decrease in PC and a significant increase in MPV during PE development among pregnant women. As a result, a change in these parameters among pregnant women may indicate the development of PE.
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Affiliation(s)
- Muluken Walle
- Medicallaboratory Science Department, College of Medicine and Health Sciences, Jigjiga University, Jigjiga, Ethiopia
| | - Yemataw Gelaw
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fasil Getu
- Medicallaboratory Science Department, College of Medicine and Health Sciences, Jigjiga University, Jigjiga, Ethiopia
| | - Fikir Asrie
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zegeye Getaneh
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Liu H, Pu Y, Ai S, Wang X, He S, Wang K, Dang Y. The Relationship Between Preeclampsia and Arsenic Concentration in the Peripheral Blood. Biol Trace Elem Res 2022; 200:3965-3974. [PMID: 34993909 DOI: 10.1007/s12011-021-02988-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 10/20/2021] [Indexed: 12/26/2022]
Abstract
Preeclampsia (PE) is a pregnancy-specific disorder, which is one of the leading causes of maternal, fetal, and neonatal death, particularly in developing countries. Arsenic (As), which is commonly found in soil and groundwater, has been associated with various complications of pregnancy, such as spontaneous abortion, hypertension, and stillbirth. Hence, the study was used to explore the relationship between PE and blood concentration of As in this study. Blood concentration of As during pregnancy was measured by inductively coupled plasma mass spectrometry (ICP-MS). The results shown that the mean blood concentration of As was gradually increased from the control group to the severe PE group (P < 0.0001). Elevated blood concentration of As was associated with the prevalence of PE (OR = 12.81, 95% CI: 2.43-67.39 and 27.55, 1.75-433.43 for middle and high vs. low). Furthermore, elevated blood concentration of As was associated with the severity of PE. Additionally, we observed that blood concentration of As was associated with the hypoproteinemia (P = 0.001, rs = 0.37). Blood concentration of As was negatively corelated with the mean corpuscular volume (MCV) (P = 0.040, rs = - 0.23) and positively corelated with the mean corpuscular hemoglobin concentration (MCHC) (P = 0.044, rs = 0.23). Overall, our results indicated that the blood concentration of As can significantly predict the occurrence of PE. Additionally, we provided evidence that blood concentration of As may affect the occurrence of hypoproteinemia. These findings may provide some ideas for the prevention of PE and pregnancy complications.
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Affiliation(s)
- Haixia Liu
- Institute of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yudong Pu
- Songshan Lake Central Hospital of Dongguan City, Dongguan, China
| | - Shiwei Ai
- Institute of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Lanzhou, China
| | - Xiaoxue Wang
- Institute of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Lanzhou, China
| | - Shuzhen He
- Songshan Lake Central Hospital of Dongguan City, Dongguan, China
| | - Ke Wang
- Institute of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yuhui Dang
- Institute of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Lanzhou, China.
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7
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Li N, Liu Y, Yun A, Song S. Correlation of Platelet Function with Postpartum Hemorrhage and Venous Thromboembolism in Patients with Gestational Hypertension Complicated with Diabetes. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:2423333. [PMID: 35898483 PMCID: PMC9313953 DOI: 10.1155/2022/2423333] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/31/2022] [Accepted: 06/07/2022] [Indexed: 11/25/2022]
Abstract
Objective This study was aimed at investigating the correlation of platelet function with postpartum hemorrhage and venous thromboembolism (VTE) in gestational hypertension patients with diabetes mellitus. Methods A total of 93 patients with gestational hypertension complicated with diabetes treated from March 2020 to June 2021 were selected as the research group, and 56 healthy pregnant women during the same period were selected as the control group. Platelet function-related indicators (platelet count (PLT), platelet volume distribution width (PDW), and mean platelet volume (MPV)) were compared between the two groups. The patients were divided into a severe group (n = 13), mild group (n = 28), and nonbleeding group (n = 52) according to the severity of postpartum hemorrhage, and the value of combined detection of platelet function-related indicators on the severity of postpartum hemorrhage was evaluated and analyzed. According to the occurrence of VTE, the patients were divided into a VTE group and non-VTE group to analyze the predictive value of combined detection of platelet function-related indicators for VTE occurrence in patients. Results The PLT value of the study group was lower than that of the control group, while the PDW and MPV values were higher than those of the control group (all P < 0.05). The PLT value increased with the aggravation of postpartum hemorrhage, while the PDW and MPV values decreased with the aggravation of postpartum hemorrhage among the three groups with different severities of postpartum hemorrhage (all P < 0.05). The area under the curve (AUC) of PLT, PDW, and MPV combination to evaluate the severity of postpartum hemorrhage in patients with gestational hypertension combined with diabetes was greater than that of PLT alone and PDW alone (both P < 0.05). The PLT value was negatively correlated with the severity of postpartum hemorrhage, while PDW and MPV values were positively correlated with the severity of postpartum hemorrhage (both P < 0.05). According to the occurrence of VTE, patients were divided into the VTE group (n = 10) and non-VTE group (n = 83). The PLT value of the VTE group was higher than that of the non-VTE group, while the PDW and MPV values were lower than those of the non-VTE group (all P < 0.05). The AUC of PLT, PDW, and MPV combination to predict the occurrence of VTE in patients with gestational hypertension combined with diabetes was greater than that of each index alone (all P < 0.05). Conclusion Patients with gestational hypertension complicated with diabetes had abnormal platelet function, and the platelet function was related to postpartum hemorrhage and VTE.
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Affiliation(s)
- Nan Li
- Department of Obstetrics, The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin 300170, China
- Department of Obstetrics, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin 300170, China
- Department of Obstetrics, Artificial Cell Engineering Technology Research Center, Tianjin 300170, China
- Department of Obstetrics, Tianjin Institute of Hepatobiliary Disease, Tianjin 300170, China
| | - Yang Liu
- Department of Obstetrics, The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin 300170, China
- Department of Obstetrics, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin 300170, China
- Department of Obstetrics, Artificial Cell Engineering Technology Research Center, Tianjin 300170, China
- Department of Obstetrics, Tianjin Institute of Hepatobiliary Disease, Tianjin 300170, China
| | - Anqi Yun
- Department of Obstetrics, The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin 300170, China
- Department of Obstetrics, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin 300170, China
- Department of Obstetrics, Artificial Cell Engineering Technology Research Center, Tianjin 300170, China
- Department of Obstetrics, Tianjin Institute of Hepatobiliary Disease, Tianjin 300170, China
| | - Shurong Song
- Department of Obstetrics, The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin 300170, China
- Department of Obstetrics, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin 300170, China
- Department of Obstetrics, Artificial Cell Engineering Technology Research Center, Tianjin 300170, China
- Department of Obstetrics, Tianjin Institute of Hepatobiliary Disease, Tianjin 300170, China
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8
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Li S, Wang Z, Vieira LA, Zheutlin AB, Ru B, Schadt E, Wang P, Copperman AB, Stone JL, Gross SJ, Kao YH, Lau YK, Dolan SM, Schadt EE, Li L. Improving preeclampsia risk prediction by modeling pregnancy trajectories from routinely collected electronic medical record data. NPJ Digit Med 2022; 5:68. [PMID: 35668134 PMCID: PMC9170686 DOI: 10.1038/s41746-022-00612-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 05/19/2022] [Indexed: 11/15/2022] Open
Abstract
Preeclampsia is a heterogeneous and complex disease associated with rising morbidity and mortality in pregnant women and newborns in the US. Early recognition of patients at risk is a pressing clinical need to reduce the risk of adverse outcomes. We assessed whether information routinely collected in electronic medical records (EMR) could enhance the prediction of preeclampsia risk beyond what is achieved in standard of care assessments. We developed a digital phenotyping algorithm to curate 108,557 pregnancies from EMRs across the Mount Sinai Health System, accurately reconstructing pregnancy journeys and normalizing these journeys across different hospital EMR systems. We then applied machine learning approaches to a training dataset (N = 60,879) to construct predictive models of preeclampsia across three major pregnancy time periods (ante-, intra-, and postpartum). The resulting models predicted preeclampsia with high accuracy across the different pregnancy periods, with areas under the receiver operating characteristic curves (AUC) of 0.92, 0.82, and 0.89 at 37 gestational weeks, intrapartum and postpartum, respectively. We observed comparable performance in two independent patient cohorts. While our machine learning approach identified known risk factors of preeclampsia (such as blood pressure, weight, and maternal age), it also identified other potential risk factors, such as complete blood count related characteristics for the antepartum period. Our model not only has utility for earlier identification of patients at risk for preeclampsia, but given the prediction accuracy exceeds what is currently achieved in clinical practice, our model provides a path for promoting personalized precision therapeutic strategies for patients at risk.
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Affiliation(s)
| | | | - Luciana A Vieira
- Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | | | - Pei Wang
- Department of Genetics and Genomic Sciences, The Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alan B Copperman
- Sema4, Stamford, CT, USA.,Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Reproductive Endocrinology and Infertility, Reproductive Medicine associates of New York, New York, NY, USA
| | - Joanne L Stone
- Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Susan J Gross
- Sema4, Stamford, CT, USA.,Department of Genetics and Genomic Sciences, The Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - Siobhan M Dolan
- Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Genetics and Genomic Sciences, The Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Eric E Schadt
- Sema4, Stamford, CT, USA. .,Department of Genetics and Genomic Sciences, The Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Li Li
- Sema4, Stamford, CT, USA. .,Department of Genetics and Genomic Sciences, The Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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9
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Kraemer BF, Hennis I, Karge A, Kraemer AK, Dreyer TF, Kiechle M, Kuschel B, Bronger H. Platelet mitochondrial membrane depolarization reflects disease severity in patients with preeclampsia. Mol Med 2022; 28:51. [PMID: 35508969 PMCID: PMC9066965 DOI: 10.1186/s10020-022-00472-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 04/10/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Thrombocytopenia is a feared complication of preeclampsia (PE) that can additionally complicate the disease course and that carries a poor prognosis. The disease mechanisms of PE on a platelet level are poorly understood and only few platelet-based markers have been investigated. In sepsis, platelet mitochondrial membrane depolarization, a sensitive and early indicator of mitochondrial dysfunction and platelet cell death, correlates with disease severity and outcome as shown in previous studies. The aim of this study was to investigate platelet mitochondrial membrane potential (Mmp-Index) by flow-cytometry in patients with preeclampsia compared to controls and to assess its value in correlation with disease severity of PE and during follow-up after delivery. METHODS In this prospective translational case-control study, platelet Mmp-Index was measured in PE (n = 16) by flow cytometry in living platelets in simultaneous comparison to healthy pregnant (n = 32) and non-pregnant controls (n = 16) and was individually reassessed after delivery to investigate recovery of platelet mitochondrial function. Subgroup analysis of patients with severe and non-severe PE was performed. Six patients with isolated gestational hypertension were also included for comparative analysis. RESULTS Platelet Mmp-Index in patients with symptomatic preeclampsia (Mmp-Index non-severe PE 0.72 ([0.591; 0.861]; p = 0.002) was significantly reduced compared to healthy pregnant controls (Mmp-Index 0.97 [0.795; 1.117]) and even more pronounced in patients with severe PE (n = 6) (Mmp-Index severe PE 0.542 [0.361; 0.623]; p = 0.03). In the severe PE group, complementary measurements of platelet Annexin V- and CD62 (P-Selectin) surface expression showed apoptosis of platelet populations in the majority of patients. Platelet Mmp normalized after delivery within few days. Patients with isolated gestational hypertension showed normal Mmp-Index values. CONCLUSIONS This study shows for the first time that platelet Mmp-Index is a quantifiable, easy-to-measure intracellular marker of platelet mitochondrial function in vital cells that reflects disease severity of preeclampsia. For future investigations, platelet Mmp may serve as a prognostic marker that may aid clinical risk stratification and adds novel information on potential mechanisms for thrombocytopenia in preeclampsia.
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Affiliation(s)
- Bjoern F. Kraemer
- grid.411095.80000 0004 0477 2585Medizinische Klinik Und Poliklinik I, LMU Klinikum, Munich, Germany
| | - Irina Hennis
- grid.6936.a0000000123222966Department of Gynecology and Obstetrics, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Anne Karge
- grid.6936.a0000000123222966Department of Gynecology and Obstetrics, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Anne Katrin Kraemer
- grid.6936.a0000000123222966Department of Gynecology and Obstetrics, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Tobias F. Dreyer
- grid.6936.a0000000123222966Department of Gynecology and Obstetrics, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Marion Kiechle
- grid.6936.a0000000123222966Department of Gynecology and Obstetrics, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Bettina Kuschel
- grid.6936.a0000000123222966Department of Gynecology and Obstetrics, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Holger Bronger
- grid.6936.a0000000123222966Department of Gynecology and Obstetrics, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
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10
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Walle M, Asrie F, Gelaw Y, Getaneh Z. The role of platelet parameters for the diagnosis of preeclampsia among pregnant women attending at the University of Gondar Comprehensive Specialized Hospital antenatal care unit, Gondar, Ethiopia. J Clin Lab Anal 2022; 36:e24305. [PMID: 35202493 PMCID: PMC8993625 DOI: 10.1002/jcla.24305] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 01/22/2022] [Accepted: 02/12/2022] [Indexed: 11/17/2022] Open
Abstract
Background Preeclampsia (PE) is a pregnancy‐related illness characterized by high blood pressure (BP) and proteinuria after the 20th gestational week (GW). Platelet (PLT) parameter changes are the common hematological abnormalities observed in PE patients. The main aim of this study was to assess the role of PLT parameters for PE diagnosis among pregnant women. Methods A comparative cross‐sectional study was conducted at the University of Gondar Specialized Hospital. A total of 126 pregnant women (63 normotensive [NT] and 63 PE) were recruited using a convenient sampling method. Three milliliter blood was collected from each participant, and PLT parameters were determined using Sysmex XS‐500i analyzer. An independent t‐test supplemented with receiver‐operating characteristics (ROC) were used for comparisons and diagnostic value of PLT parameters between the study groups. Results Platelet count (PC) was significantly lower in the PE group compared to that in the NT group, whereas mean platelet volume (MPV), platelet large cell ratio (P‐LCR), and platelet distribution width (PDW) were significantly higher in PE. MPV had the largest area under the curve (AUC) [0.91: 95% CI; 0.85–0.96] followed by PC [0.79: 95% CI; 0.72–0.87]. MPV can differentiate PE patients from NT pregnant women at cut‐off value ≥12.10 fl (84.1% sensitivity and 87.3% specificity) while PC can indicate PE at a cut‐off value ≤176.5 × 109/L (65.1% sensitivity and 87.3% specificity). Conclusion A decreased PC and an increased MPV, P‐LCR, and PDW can be used as a simple, cost‐effective, quick, and reliable method of PE screening. Of them, MPV is the best indicator of PE.
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Affiliation(s)
- Muluken Walle
- Department of Medical laboratory science, College of Medicine and Health Sciences, Jigjiga University, Jigjiga, Ethiopia
| | - Fikir Asrie
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yemataw Gelaw
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zegeye Getaneh
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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11
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Bawore SG, Adissu W, Niguse B, Larebo YM, Ermolo NA, Gedefaw L. A pattern of platelet indices as a potential marker for prediction of pre-eclampsia among pregnant women attending a Tertiary Hospital, Ethiopia: A case-control study. PLoS One 2021; 16:e0259543. [PMID: 34752500 PMCID: PMC8577759 DOI: 10.1371/journal.pone.0259543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/20/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Preeclampsia is the most serious health risk during pregnancy for both the mother and the fetus. Even though platelet parameters are among the proposed biomarkers for the prediction of preeclampsia, the use of its indices in the diagnosis of preeclampsia is not increasing in Ethiopia. There is little information on platelet patterns in preeclampsia and normal pregnancy. The purpose of this study was to determine the pattern of platelet indices in women with preeclampsia in our study setting. METHODS A case-control study was conducted among 180 pregnant women who attended anti-natal follow-ups from January 1 to April 3, 2019. An Ethylene Diamine Tetra Acetic Acid anti-coagulated venous blood was collected and analyzed using a hematology analyzer (MINDRAY®-BC-300Plus, Shenzhen China). The SPSS software version 26 was used to run the Mann Whitney U test, Kruskal-Wallis H test, and Kolmogorov-Smirnov normality test, Post-hock test augmented with Benforeni, receiver operating characteristics curve, and Spear Man rank-order correlation. A P-value of <0.05 was considered statistically significant. RESULTS A total of 180 pregnant women were included in the study. Platelet count and platelet crit levels tend to decrease as pre-eclampsia becomes more severe. In contrast, the mean platelet volume and platelet distribution widths were significantly increased with the severity of preeclampsia (P<0.001). Platelet distribution width (rho = 0.731, p<0.001) and mean platelet volume (rho = 0.674, p<0.001) had statistically significant positive relationships with mean arterial pressure. The best metric for predicting preeclampsia was platelet distribution width (AUC = 0.986; 95%CI; 0.970, 1). CONCLUSIONS Platelet indices, including platelet count, mean platelet volume, platelet distribution width, and Platelet crit, have been identified as promising candidate markers for predicting preeclampsia in pregnant women. In the future, a serial examination of these indicators during several trimesters of pregnancy should be conducted.
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Affiliation(s)
- Solomon Gebre Bawore
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wachemo University, Hosaena, Ethiopia
| | - Wondimagegn Adissu
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Berhanu Niguse
- Wachemo University Nigist Eleni Mohammed Memorial Comprehensive and Specialized Hospital, Hadiya Zone, Southern Nation Nationality People Region, Hosaena, Ethiopia
| | - Yilma Markos Larebo
- Department of Epidemiology, College of Medicine and Health Sciences, Wachemo University, Hosaena, Ethiopia
| | - Nigussie Abebe Ermolo
- Nigussie Abebe Ermolo, Department of Health Service Management, College of Medicine and Health Sciences, Wachemo University, Hosaena, Ethiopia
| | - Lealem Gedefaw
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
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12
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Lin S, Zhang L, Shen S, Wei D, Lu J, Chen X, Chen Q, Xia X, Xiu Q. Platelet Parameters and Risk of Hypertension disorders of Pregnancy: a Propensity Score Adjusted Analysis. Platelets 2021; 33:543-550. [PMID: 34223796 DOI: 10.1080/09537104.2021.1945569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
While the role of platelets in cardiovascular diseases among the general population has been widely reported, evidence is inconsistent regarding the association between platelet indices with hypertension in pregnant women. In this study, we explored the associations between platelet parameters before 20 gestational weeks, an understudied period, with hypertensive disorders of pregnancy (HDP), including preeclampsia/eclampsia (PEEC) and gestational hypertension (GH). Based on the Born in Guangzhou Cohort Study, 12053 singleton pregnant women with platelet parameters, including platelet count (PC), mean platelet volume (MPV), plateletcrit (PCT), and platelet distribution width (PDW) measured at 14-19 gestational weeks were included. Conventional multivariable adjustment and propensity score analysis were used to control for confounders. The restricted cubic spline showed that the risk of PEEC increased linearly for PC, and non-linearly for PCT. For GH, the risk increased linearly for PC, MPV, and PCT, and non-linearly for PDW. When these indices were categorized into quintiles, women with higher PC and PCT were associated with increased risk of both PEEC and GH. Women with MPV exceeding the second quintile (≥ 8.8 fL) had a greater risk for GH, but not for PEEC. When HDP was classified into two groups (early- vs late-onset) based on the occurrence time, significant associations persisted for early-onset PEEC, early-onset GH, and late-onset GH. In conclusion, increased PC and PCT before 20 weeks of gestation were both associated with higher risk of PEEC and GH, while elevated MPV was only linked to GH.
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Affiliation(s)
- Shanshan Lin
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Lifang Zhang
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China.,Department of Women and Child Health Care and Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Songying Shen
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China.,Department of Women and Child Health Care and Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Dongmei Wei
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China.,Department of Women and Child Health Care and Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Jinhua Lu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China.,Department of Women and Child Health Care and Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Xiaojuan Chen
- Department of Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Qiaozhu Chen
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xiaoyan Xia
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China.,Department of Women and Child Health Care and Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Qiu Xiu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China.,Department of Women and Child Health Care and Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China.,Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
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Bulbul M, Uckardes F, Karacor T, Nacar MC, Kaplan S, Kirici P, Surucu A. Can complete blood count parameters that change according to trimester in pregnancy be used to predict severe preeclampsia? J OBSTET GYNAECOL 2021; 41:1192-1198. [PMID: 33645411 DOI: 10.1080/01443615.2020.1854697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We aimed to evaluate the effectiveness of changes over time in complete blood count (CBC) parameters to estimate the diagnosis of preeclampsia. Data on 161 severe preeclampsia patients and 161 healthy pregnant patients who met the study criteria of pregnant women whose CBC had been measured at 10-12, 22-24 and 28-30 weeks of pregnancy were compared. In the preeclampsia group, an increase in the mean platelet volume (MPV) value and a decrease in the number of platelets were statistically significant in the transition from the second to the third trimester. MPV and lymphocyte counts were more significant in the third trimester and neutrophil lymphocyte ratio (NLR) were more significant in the second trimester. We found that evaluation of the changes in lymphocyte, MPV and NLR values in three different trimesters of pregnancy rather than a single trimester was more meaningful to predict severe preeclampsia.Impact StatementWhat is already known on this subject? Studies have shown that MPV and NLR can predict preeclampsia. However, a clear cut off value could not be determined. The reasons for this may be that the gestational week during which the measurement is made is not standard and the patient groups are not homogeneous.What the results of this study add? In this study, CBC parameters at different stages of the preeclampsia process were compared in the severe preeclampsia group. According to our results, lymphocytes, NLR and MPV can be used to predict severe preeclampsia. In addition, NLR measurements in the second trimester and MPV and lymphocyte measurements in the third trimester were found to be more significant in predicting severe preeclampsia.What the implications are of these findings for clinical practice and/or further research? In order to predict severe preeclampsia, instead of a single measurement of CBC parameters, new calculations should be made that add change over time.
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Affiliation(s)
- Mehmet Bulbul
- Department of Obstetrics and Gynecology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey
| | - Fatih Uckardes
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey
| | - Talip Karacor
- Department of Obstetrics and Gynecology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey
| | - Mehmet Can Nacar
- Department of Obstetrics and Gynecology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey
| | - Selcuk Kaplan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey
| | - Pinar Kirici
- Department of Obstetrics and Gynecology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey
| | - Adem Surucu
- Department of Obstetrics and Gynecology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey
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14
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Ye L, Shi MD, Zhang YP, Zhang JS, Zhu CR, Zhou R. Risk factors and pregnancy outcomes associated with retinopathy in patients presenting with severe preeclampsia: A retrospective cohort study. Medicine (Baltimore) 2020; 99:e19349. [PMID: 32176056 PMCID: PMC7220307 DOI: 10.1097/md.0000000000019349] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The visual system was reported to be affected in over half of patients with preeclampsia (PE), though fundus examination was performed only among patients complaining of visual symptoms. Delayed diagnosis and treatment of PE-related retinopathy may lead to permanent visual impairment. Therefore, we hypothesize that some clinical or laboratory parameters could predict severity of retinal damage.The aim of the study was to explore the risk factors for retinopathy in severe preeclampsia (sPE) and investigate pregnancy outcomes with different degrees of retinopathy.This retrospective cohort study included women with sPE who underwent ophthalmoscopy and delivered after admission to West China Second University Hospital, between June 2013 and December 2016. Clinical and laboratory characteristics were retrieved from medical records. Patients confirmed with retinopathy were followed up with telephones. Multiple logistic regression analysis was performed to identify risk factors of PE-related retinopathy.Five hundred thirty-four patients were included, of which 17.6% having stage-1/2 retinopathy, 14.6% having stage-3/4 retinopathy, and 67.8% having normal retina. Compared with patients without retinopathy, patients with stage 3/4 retinopathy were more likely to have preterm-birth and low-birth-weight babies. Significant risk factors for stage 3/4 retinopathy in sPE included severe hypertension (odds ratio [OR] 2.24, 95% confidence interval [CI]: 1.10-4.56), elevated white blood cell (WBC) counts (OR 1.88, 95% CI: 1.05-3.35), decreased platelet counts (OR 2.12, 95% CI: 1.07-4.48), lactate dehydrogenase (LDH) concentration of >800 IU/L (OR 2.31, 95% CI: 1.05-5.06), low hemoglobin (HGB) concentrations of <110 g/L (OR 3.73, 95% CI: 1.21-11.47), 24-hour proteinuria of 2 to 5 g (OR 6.39, 95% CI: 2.84-14.39), and >5 g (OR 8.66, 95% CI: 3.67-20.44).This study confirms the association between retinopathy and preterm-birth and low-birth weight in sPE. The risk factors for severe PE-related retinopathy, including severe hypertension, platelet and WBC count, HGB and LDH concentration, and proteinuria, are associated with the development of retinopathy. Routine and repeated fundus examination is recommended for maternal monitoring in sPE.
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Affiliation(s)
- Lei Ye
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education
| | - Meng-dan Shi
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education
| | - Yan-ping Zhang
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education
| | - Jia-shuo Zhang
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education
| | - Cai-rong Zhu
- West China School of Public Health, Sichuan University, Chengdu, Sichuan, PR China
| | - Rong Zhou
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education
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15
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Tesfay F, Negash M, Alemu J, Yahya M, Teklu G, Yibrah M, Asfaw T, Tsegaye A. Role of platelet parameters in early detection and prediction of severity of preeclampsia: A comparative cross-sectional study at Ayder comprehensive specialized and Mekelle general hospitals, Mekelle, Tigray, Ethiopia. PLoS One 2019; 14:e0225536. [PMID: 31751422 PMCID: PMC6874061 DOI: 10.1371/journal.pone.0225536] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 11/06/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Platelet parameters alterations are one of the most commonly identified hematological changes in preeclampsia (PE). However, their functions as a tool for prediction and prognosis of PE have not been extensively studied in developing countries. The aim of this study was to compare platelet count (PC), and platelet indices (mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (PLCR)) between preeclamptic and normotensive (NT) pregnant women and assess their role in diagnosis and prediction of PE development. METHODS A cross sectional comparative study was conducted at Ayder comprehensive specialized hospital (ACSH) and Mekelle general hospital (MGH) from January to March 2017. Platelet parameters of mild preeclamptic (mPE) (n = 35), severe preeclamptic (sPE) (n = 44) and NT pregnant women (n = 140) were analyzed using SYSMEX-XT 4000i automated hematology analyzer. One-way ANOVA supplemented with post-hoc test, receiver operating characteristics (ROC) curve and pearson correlation test statistical analyses were performed. P < 0.05 was considered significant. RESULT Pregnant women with sPE had lower PC as compared with that of mPE and NT women (p<0.05). All platelet indices showed significant increment with severity of PE. PC was negatively correlated with platelet indices. There was a positive correlation among platelet indices. ROC analysis revealed that MPV had the largest area under the ROC curve (0.85; 95%CI (0.79, 0.89)) with cutoff value >9.45fl, sensitivity of 83.5%, specificity of 86.4%, positive predictive value of 77.6% and negative predictive value of 90.3%. CONCLUSION MPV and PC were identified as good candidates for sPE diagnosis. Because evaluation of platelet parameters is rapid, reliable and economical, they can be utilized as an alternative biomarker for prediction and prognosis of PE.
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Affiliation(s)
- Feven Tesfay
- Department of Medical laboratory Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
- Department of Medical Laboratory Sciences, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mikias Negash
- Department of Medical Laboratory Sciences, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Jemal Alemu
- Department of Medical Laboratory Sciences, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mohammedtahir Yahya
- Department of Gynecology and obstetrics, College of Health Science, Mekelle University, Mekelle, Ethiopia
| | - Gebre Teklu
- Department of Medical laboratory Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Meseret Yibrah
- Department of Medical laboratory Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Tsegay Asfaw
- Department of Medical laboratory Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Aster Tsegaye
- Department of Medical Laboratory Sciences, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
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