Wu Jinjuan, Zhang Jing, Yang Jinying, Zheng Thomas Qintian, Chen Yu-Ming
Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou, China.
Department of Obstetrics and Gynecology, Valleywise Health/District Medical Group, 2601 E. Roosevelt Road, Phoenix, AZ, USA.
J Obstet Gynaecol. 2022 Oct;42(7):2764-2770. doi: 10.1080/01443615.2022.2109136. Epub 2022 Aug 12.
We aimed to examine the association between the platelet indices and the risk of preeclampsia (PE) at different gestational weeks (GW) to explore the feasibility of early prediction of PE with these indices. About 7314 normotensive pregnant women and 396 PE patients were included and platelet indices, including platelet count (PC), plateletcrit (PCT), platelet distribution width (PDW), mean platelet volume (MPV) at different gestational weeks (1-12, 13-28, 29-32, 33-36 and 37-41 GW) were compared in two statistical methods. Patients with PE tended to have higher means of PC, PCT, PDW and MPV than normal pregnant women at early stage of pregnancy. The odds of PE were significantly increased with the increase of PC, PCT, PDW and MPV both at 13-28 GW and 29-32 GW, which indicated that increased values of PC, PCT, PDW and MPV at 13-32 GW were associated with greater subsequent risk of preeclampsia. Increased PC, PCT, PDW and MPV may have potential to predict preeclampsia before the disease onset.Impact Statement Previous studies indicated that preeclampsia patients may have decreased platelet count (PC), plateletcrit (PCT) and increased platelet distribution width (PDW) and mean platelet volume (MPV). Increased PDW and MPV or decreased PC/MPV may have predictive values for PE. The discrepancy with previous studies lay in the increased values of PC and PCT in PE patients at early stage of pregnancy. The study indicated that increased PC, PCT, PDW and MPV may have potential to predict preeclampsia far ahead of the disease onset. The results may reflect the abnormal turnover of platelets in PE patients. These findings may help to guide early interventions before progress to overt preeclampsia by predicting onset of preeclampsia via easily available platelet indices in early weeks of gestation, which is especially valuable in areas lacking medical resources. The inconsistency with previous studies can facilitate researchers to further explore the coagulation mechanism beneath preeclampsia and pay more attention to the dynamic changes of platelet indices and other coagulation indices during pregnancy.
我们旨在研究不同孕周（GW）时血小板指标与子痫前期（PE）风险之间的关联，以探讨利用这些指标早期预测PE的可行性。纳入了约7314名血压正常的孕妇和396名PE患者，并采用两种统计方法比较了不同孕周（1 - 12、13 - 28、29 - 32、33 - 36和37 - 41 GW）时的血小板指标，包括血小板计数（PC）、血小板压积（PCT）、血小板分布宽度（PDW）、平均血小板体积（MPV）。在妊娠早期，PE患者的PC、PCT、PDW和MPV均值往往高于正常孕妇。在13 - 28 GW和29 - 32 GW时，PE的发生几率均随PC、PCT、PDW和MPV的升高而显著增加，这表明在13 - 32 GW时PC、PCT、PDW和MPV值升高与随后发生子痫前期的风险增加有关。PC、PCT、PDW和MPV升高可能具有在疾病发作前预测子痫前期的潜力。影响声明 先前的研究表明，子痫前期患者可能血小板计数（PC）、血小板压积（PCT）降低，血小板分布宽度（PDW）和平均血小板体积（MPV）升高。PDW和MPV升高或PC/MPV降低可能对PE具有预测价值。与先前研究的差异在于妊娠早期PE患者的PC和PCT值升高。该研究表明，PC、PCT、PDW和MPV升高可能具有在疾病发作前很久就预测子痫前期的潜力。结果可能反映了PE患者血小板的异常周转。这些发现可能有助于通过在妊娠早期利用易于获得的血小板指标预测子痫前期的发作，从而在进展为显性子痫前期之前指导早期干预，这在缺乏医疗资源的地区尤其有价值。与先前研究的不一致性可以促使研究人员进一步探索子痫前期背后的凝血机制，并更多地关注妊娠期间血小板指标和其他凝血指标的动态变化。
