Faculty of Environmental Science & Engineering, Kunming University of Science & Technology, Kunming City, China.
Department of Obstetrics, The First People's Hospital of Yunnan Province, Kunming City, China.
J Clin Hypertens (Greenwich). 2024 Oct;26(10):1181-1187. doi: 10.1111/jch.14893. Epub 2024 Aug 26.
Preeclampsia (PE) is a severe pregnancy complication characterized by significant alterations in coagulation function. This study aims to analyze the correlation between coagulation function, platelet parameters, and pregnancy outcomes in PE patients. Clinical data, along with blood and urine samples, were collected from 168 PE patients and 128 healthy pregnant women. General demographic and laboratory testing data were recorded, and maternal and fetal outcomes were followed up. Data were analyzed using Kaplan-Meier and logistic regression analyses. In mild PE patients, thrombin time (p = .000), platelet distribution width (PDW) (p = .000), and clot formation time (p = .000) were increased, while prothrombin time (p = .000) and fibrinogen (p = .045) were reduced. With increasing PE severity, prothrombin time (p = .000), platelet count (PLT) (p = .000), mean platelet volume (MPV) (p = .000), plateletcrit (p = .000), maximum amplitude (MA) (p = .000), and coagulation index (p = .001) decreased, whereas activated partial thromboplastin time (APTT) (p = .000), thrombin time (p = .002), D-dimer (p = .026), and PDW (p = .000) increased. Lower prothrombin time (p = .048), PLT (p = .004), and coagulation index (p = .026) or higher APTT (p = .032), thrombin time (p = .044), D-dimer (p = .023), and PDW (p = .016) were associated with a higher risk of poor pregnancy outcomes. Thrombin time was identified as an independent risk factor (p = .025, OR = 2.918, 95% CI: 1.145-7.436), whereas gestational age was an independent protective factor (p = .000, OR = 0.244, 95% CI: 0.151-0.395). This study demonstrates that specific coagulation and platelet parameters are significantly associated with PE severity and adverse pregnancy outcomes. These findings highlight the importance of monitoring coagulation function in PE patients to improve clinical management and outcomes.
子痫前期(PE)是一种严重的妊娠并发症,其特征是凝血功能发生显著改变。本研究旨在分析凝血功能、血小板参数与 PE 患者妊娠结局的相关性。收集了 168 例 PE 患者和 128 例健康孕妇的临床资料、血和尿样本。记录了一般人口统计学和实验室检测数据,并对母婴结局进行了随访。采用 Kaplan-Meier 和逻辑回归分析进行数据分析。在轻度 PE 患者中,凝血酶时间(p =.000)、血小板分布宽度(PDW)(p =.000)和凝血形成时间(p =.000)增加,而凝血酶原时间(p =.000)和纤维蛋白原(p =.045)降低。随着 PE 严重程度的增加,凝血酶原时间(p =.000)、血小板计数(PLT)(p =.000)、平均血小板体积(MPV)(p =.000)、血小板比容(p =.000)、最大振幅(MA)(p =.000)和凝血指数(p =.001)降低,而活化部分凝血活酶时间(APTT)(p =.000)、凝血酶时间(p =.002)、D-二聚体(p =.026)和 PDW(p =.000)增加。较低的凝血酶原时间(p =.048)、血小板计数(p =.004)和凝血指数(p =.026)或较高的 APTT(p =.032)、凝血酶时间(p =.044)、D-二聚体(p =.023)和 PDW(p =.016)与不良妊娠结局风险增加相关。凝血酶时间被确定为独立危险因素(p =.025,OR = 2.918,95%CI:1.145-7.436),而胎龄为独立保护因素(p =.000,OR = 0.244,95%CI:0.151-0.395)。本研究表明,特定的凝血和血小板参数与 PE 严重程度和不良妊娠结局显著相关。这些发现强调了监测 PE 患者凝血功能的重要性,以改善临床管理和结局。