Immature platelet fraction in hypertensive pregnancy

Abstract

Background: Imbalance in hemostatic mechanisms can occur during pregnancy with a tendency for hypercoagulability and increased thrombosis risk. Pregnant women with hypertensive disorder, especially preeclampsia, show alterations in platelet indexes. Immature platelet fraction (IPF) has been suggested as a sensitive index for monitoring changes in platelet production and destruction. Objectives: To evaluate the IPF in patients diagnosed with a gestational hypertensive disorder (GHD). Patients and methods: A cross-sectional study was conducted at an University Hospital to estimate maternal blood IPF index in 99 pregnant women, divided into three groups: normotensive pregnancy (NP), preeclampsia syndrome (PES), and non-proteinuric hypertensive pregnancy (nPHP). Following ethical approval and written informed consent, samples were collected from 33 NP, 34 PES, and 32 nPHP women. Platelet indexes were measured by fluorescent flow cytometry. Results: IPF and mean platelet volume (MPV) counts in GHD were significantly higher than in NP (IPF: 3.8, 2.4–5.1%; 8.6, 5.8–10.6%; 7.3, 4.2–10.2%; p < 0.001 and MPV: 10.6 ± 0.9 fL; 12.1 ± 1.0 fL; 11.6 ± 1.0 fL; p < 0.001 for NP, PES, and nPHP, respectively). No difference was detected between PES and nPHP groups. The distribution of patients with an IPF above 6.1%for NP, PES, and nPHP was 9%, 65%, and 43.8%, respectively (p < 0.001). IPF as a test to differentiate GHD from the controls achieved an area under the curve of 0.83 on a receiver operating characteristics curve. Conclusion: A distinct profile in platelet indexes was detected in hypertensive pregnancies. It suggests that these markers could be used in daily routine as an additional tool in the management of pregnant women.

Keywords:

• Blood platelets
• mean platelet volume
• preeclampsia
• pregnancy induced hypertension

Acknowledgments

We thank Professor Mario Wagner for the statistical analysis, and to Roche Diagnóstica Brasil Ltda, São Paulo (Brazil), for providing reagents to the measurements.

Poli-de-Figueiredo is a CNPq researcher.

Declaration of interest

Reagents for IPF assays were provided by Roche Diagnóstica Brasil Ltda, São Paulo, Brazil.

Funding

Grant support was received from the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq; National Council for Scientific and Technological Development), Fundação de Amparo à Pesquisa do Rio Grande do Sul (FAPERGS; Foundation for the Support of Research in the State of Rio Grande do Sul), and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES; Coordination for the Improvement of Higher Education Personnel Foundation).

Additional information

Funding

Grant support was received from the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq; National Council for Scientific and Technological Development), Fundação de Amparo à Pesquisa do Rio Grande do Sul (FAPERGS; Foundation for the Support of Research in the State of Rio Grande do Sul), and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES; Coordination for the Improvement of Higher Education Personnel Foundation).