Efficacy of blood parameters in predicting the severity of gestational hypertension and preeclampsia

Abstract

The aim of this retrospective study was to demonstrate the effectiveness of APRI, DNI, NLR, PLR, and PDW in predicting the severity of gestational hypertension (GHT) and PE and to determine whether these factors can be used as screening tools. Normotensive pregnant women (n = 792) served as the control group. 1,213 single pregnant women who met the following criteria for a GHT diagnosis were included in the study group. We found a significantly higher mean PLR and NLR value. The mean PDW value was significantly lower in the control group than in the other groups. The SPE group had a significantly higher mean APRI score. The groups did not differ by their DNI. We determined PDW and APRI as independent parameters that predicted SPE by multiple logistic regression analysis. In retrospective analysis of blood samples taken from these participants below week 20, we found that the APRI value differed significantly between the control and SPE groups. NLR, PLR, DNI, and PDW had no clinical significance. We further suggested that APRI may provide a clinical indication of progression from hypertensive pregnancy disorders to SPE, which seems to be a promising implication that should be verified by further studies.

IMPACT STATEMENT

• What is already known on this subject? Hypertensive disorders in pregnancy are a major cause of maternal and perinatal morbidity and mortality. Screening pregnant women for risk factors for developing hypertensive disorders and identifying women at high risk in early pregnancy and initiating prophylactic treatment are important for pregnancy monitoring and planning in experienced centres. Because only 30% of women who will develop preeclampsia can be predicted by risk factors, the combined use of laboratory tests and imaging with risk factors to calculate a woman’s risk of developing preeclampsia is currently being investigated. However, no proven marker has yet been found.

• What do the results of this study add? In our study, we found that NLR, PLR, DNI, and PDW have no clinical significance in assessing the risk of developing gestational hypertension and preeclampsia and in predicting the severity of preeclampsia. However, in our study, we found that APRI can provide a clinical indication of the progression of hypertensive pregnancy to SPE.

• What are the implications of these findings for clinical practice and/or further research? This study represents an important contribution to the literature because it is the first study to examine the association between APRI and HT in pregnancy.

Keywords:

• Delta neutrophil index (DNI)
• neutrophil-to-lymphocyte ratio (NLR)
• platelet-to-lymphocyte ratio (PLR)
• platelet distribution width (PDW)
• aspartate aminotransferase platelet ratio index (APRI)

Author contributions

All of the authors have contributed to project development, data collection, data analysis, and writing of the manuscript.

Contributions: Conception and design of the study, acquisition of data, analysis and/or interpretation of data, drafting the manuscript.

Mujde Can Ibanoglu Contributions: Analysis and/or interpretation of data, drafting the manuscript.

Kevser Adar Contributions: Analysis and/or interpretation of data, drafting the manuscript.

Merve Ozkan Contributions: Analysis and/or interpretation of data, drafting the manuscript.

Omer Lutfi Tapisiz Contributions: Conception and design of the study, acquisition of data.

Yaprak Engin-Ustun Contributions: Conception and design of the study, analysis and/or interpretation of data, drafting the manuscript.

Additional author: Can Tekin Iskender.

Ethics statement

Approval was obtained by the institutional review board from Ankara Etlik Zubeyde Hanım Women’s Health Training and Research Hospital on 17.06.2020 # 2020/77.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data are openly available in a public repository that issues datasets with DOIs.