Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, University of Health Sciences, Ankara, Turkey.
Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, University of Health Sciences, Ankara, Turkey.
Pregnancy Hypertens. 2024 Sep;37:101132. doi: 10.1016/j.preghy.2024.101132. Epub 2024 Jun 5.
To evaluate the role of aspartate aminotransferase to platelet ratio index (APRI) in the prediction of superimposed preeclampsia in chronic hypertensive pregnancy group in the first trimester.
The present retrospective case-control study was conducted on 258 pregnant women, including 75 patients in the isolated chronic hypertension group, 92 in the superimposed preeclampsia group, and 91 low-risk pregnant women in the control group. APRI1 was calculated from routine blood test results in the first antenatal visit, and APRI2 was calculated from prelabor routine blood test results. APRI indices and other blood count parameters were evaluated and compared between groups and with the literature.
APRI1 was lower in the superimposed preeclampsia group than in the control and chronic hypertension groups, with p-values < 0.001. In the first trimester, platelet counts were higher in the superimposed preeclampsia group than in the hypertension and control groups. APRI2 was increased in the superimposed preeclampsia group compared to the control and chronic hypertension groups, with p-values 0.001 and 0.002, respectively. The optimal cut-off value for APRI1 was 0.036 (sensitivity 65.2 %, specificity 83.7 %), and for APRI2, it was found to be 0.057 (sensitivity 67.4 %, specificity 52.0 %) to predict superimposed preeclampsia.
To the best of our knowledge, this was the first study evaluating APRI in predicting superimposed preeclampsia in the first trimester. Increased platelet counts and lower APRI were found to be valuable indices for predicting superimposed preeclampsia. Further studies are needed to determine the utility of APRI in clinical practice.
评估天门冬氨酸氨基转移酶与血小板比值指数（APRI）在预测初诊慢性高血压孕妇子痫前期中的作用。
本回顾性病例对照研究纳入了 258 名孕妇，其中 75 例为单纯慢性高血压组，92 例为子痫前期组，91 例为低危孕妇对照组。在首次产前检查时计算 APRI1，在产前常规血液检查时计算 APRI2。评估和比较各组之间及与文献的 APRI 指数和其他血液计数参数。
子痫前期组的 APRI1 低于对照组和慢性高血压组，p 值均<0.001。在孕早期，子痫前期组的血小板计数高于高血压组和对照组。与对照组和慢性高血压组相比，子痫前期组的 APRI2 增加，p 值分别为 0.001 和 0.002。APRI1 的最佳截断值为 0.036（灵敏度 65.2%，特异性 83.7%），APRI2 的截断值为 0.057（灵敏度 67.4%，特异性 52.0%），可预测子痫前期。
据我们所知，这是第一项评估 APRI 在预测孕早期子痫前期的研究。血小板计数升高和 APRI 降低是预测子痫前期的有价值指标。需要进一步研究确定 APRI 在临床实践中的应用价值。
