Department of Medical Genetics, Changzhou Maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, 16th Ding Xiang Road, Changzhou, 213023, Jiangsu, China.
BMC Public Health. 2023 Jun 2;23(1):1058. doi: 10.1186/s12889-023-16027-6.
The joint effect of platelet and other modifiers on the risk of pregnancy complications is unknown. This study investigated whether platelet count (PC) and total homocysteine (tHcy) level have a synergistic effect on the incidence of pregnancy complications in a Chinese population.
Total 11,553 consecutive pregnant women who received whole blood cell and biochemical tests at the time of admission for labor in Changzhou Maternal and Child Health Care Hospital were analyzed. The primary outcome was the prevalence of pregnancy complications: gestational diabetes mellitus (GDM), intrahepatic cholestasis of pregnancy (ICP), pre-eclampsia (PE), and pregnancy induced hypertension (PIH).
The prevalence of GDM, ICP, PE, and PIH was 8.4%, 6.2%, 3.4%, and 2.1%, respectively. The highest rate of ICP (28.6%) was observed in women with high tHcy (> 15 μmol/L) and low PC (quartile 1); and the lowest rate of GDM (0.6%) was found in women with high tHcy and high PC (quartiles 2 to 4). In low PC group, the prevalence of ICP in women with high tHcy was significantly higher than that in women with low tHcy (≤ 15 μmol/L) (28.6% vs. 8.4%), representing an absolute risk increment of 20.2% and a relative risk increment of 3.3-fold (OR: 3.34; 95% CI: 1.55, 7.17; P = 0.002), whereas no joint effect was observed among high PC group.
Among Chinese pregnant women, one subgroup (high tHcy and low PC) has the highest risk of ICP and another (high tHcy and high PC) has the lowest risk of GDM; tHcy and platelet could be used as indicators to identify the women with high risk of ICP or low risk of GDM.
血小板和其他修饰物对妊娠并发症风险的联合影响尚不清楚。本研究旨在探讨血小板计数（PC）和总同型半胱氨酸（tHcy）水平在中国人群中对妊娠并发症发生的协同作用。
分析了在常州市妇幼保健院分娩时接受全血细胞和生化检查的 11553 例连续妊娠妇女的资料。主要结局是妊娠并发症的发生率：妊娠期糖尿病（GDM）、妊娠肝内胆汁淤积症（ICP）、子痫前期（PE）和妊娠高血压（PIH）。
GDM、ICP、PE 和 PIH 的发生率分别为 8.4%、6.2%、3.4%和 2.1%。ICP 发生率最高（28.6%）见于 tHcy 升高（>15μmol/L）和 PC 降低（四分位 1）的妇女；GDM 发生率最低（0.6%）见于 tHcy 和 PC 升高（四分位 2 至 4）的妇女。在 PC 降低组中，tHcy 升高的妇女 ICP 发生率明显高于 tHcy 降低的妇女（≤15μmol/L）（28.6%比 8.4%），绝对风险增加 20.2%，相对风险增加 3.3 倍（OR：3.34；95%CI：1.55，7.17；P=0.002），而在 PC 升高组中未观察到联合效应。
在中国孕妇中，一个亚组（高 tHcy 和低 PC）的 ICP 风险最高，另一个亚组（高 tHcy 和高 PC）的 GDM 风险最低；tHcy 和血小板可作为指标，识别 ICP 风险高或 GDM 风险低的妇女。
