TITLE:
Changes in Platelet Indices during Pregnancy as Potential Markers for Prediction of Preeclampsia Development
AUTHORS:
Ahmed Mohamed Nooh, Hussein Mohammed Abdeldayem
KEYWORDS:
Platelet Indices, Platelet Count, Mean Platelet Volume, Platelet Distribution Width, Preeclampsia
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.5 No.12,
October
16,
2015
ABSTRACT: Objective: To assess whether changes in platelet indices, detectable by
simple complete blood count
(CBC), during pregnancy could be
used as markers for prediction of development of preeclampsia (PE). Methods: A total of
2813 pregnant women who received regular antenatal care until delivery were included. Participants were divided into 3
groups: normotensive pregnant women (n = 2621), women with PE without severe features (n = 169), and women with PE with severe features (n = 23). Blood samples were collected
during antenatal visits and/or during the period of in-patient hospital stay,
and changes in platelet indices were compared among the three groups. Results: Platelet
count (PC) was decreasing while mean platelet volume (MPV) and platelet
distribution width (PDW) were increasing as PE progressed. Receiver operating
characteristics (ROC) curve analysis showed that PDW had the largest area under
curve (AUC) [0.980 (95% CI: 0.964 - 1.000)], making it the best marker for
predicting development of PE. Also, PDW showed the most statistically
significant correlation with mean arterial pressure (MAP)
(r = 0.902, p = 0.000), making it the best marker for predicting severity of
hypertension. Conclusion: This study provides evidence that PC decreases while
MPV and PDW increase as pregnancy advances, and these changes are more
pronounced in PE than normotensive pregnancy. These changes predate development
of PE by 2 - 8 weeks and are proportional to the progress of this disorder. The
selected platelet indices, especially PDW, have the potential to be utilized as
markers for not only prediction of PE development but also severity of
hypertension.