The potential biomarker role of platelet parameters for the prediction of preeclampsia development among pregnant women attending at the University of Gondar Comprehensive Specialized Hospital antenatal care unit, Gondar, Northwest Ethiopia

Abstract

ABSTRACT Background: Preeclampsia is a pregnancy-related medical disorder marked by elevated blood pressure and proteinuria after the 20th week of gestation. Platelet parameters changes are the common hematological abnormalities usually observed in women with preeclampsia. However, their roles as potential biomarkers for the prediction of preeclampsia have not been extensively studied in developing countries. Therefore, the main aim of this study was to assess the potential biomarker role of platelet parameters for the prediction of preeclampsia among pregnant women. Methods: A comparative cross-sectional study was conducted at the University of Gondar Comprehensive Specialized Hospital. A total of 126 pregnant women were recruited by using a consecutive sampling method. Socio-demographic data were collected by face-to-face interviews while clinical data were extracted from the patient’s chart. Three milliliters of blood were collected from each participant and platelet parameters were determined using Sysmex XS-500i. The collected data were entered into Epi-data and then exported to SPSS 20 for analysis. Data distribution was checked by the Shapiro-Wilk test. Independent t-test was used to compare platelet parameters between groups, whereas the Mann-Whitney U test was employed for comparison of clinical data. Receiver operating characteristics was utilized to determine the diagnostic values of platelet parameters. Spearman’s correlation test was used for correlation analysis of platelet parameters with mean arterial pressure. Results: Platelet count was significantly lower in preeclampsia group compared to normotensive group [mean difference: -64.97×109/L; 95% CI; -84.2, -45.7], whereas mean platelet volume, platelet large cell ratio, and platelet distribution width were significantly higher in preeclampsia group [mean difference: 2.20fl; 95% CI; 1.78-2.62, 6.10%; 95% CI; 2.99-9.21 and 1.74fl; 95% CI; 0.86-2.62, respectively]. Mean platelet volume had the largest area under the curve [0.91: 95% CI; 0.85-0.96] followed by platelet count [0.79: 95% CI; 0.72-0.87]. Mean platelet volume can differentiate preeclamptic patients from normotensive pregnant women at cut-off value ? 12.10fl (84.1% sensitivity and 87.3% specificity) while Platelet count can indicate preeclampsia at a cut-off value of ? 176.5× 109/L (sensitivity 65.1% and specificity 87.3%). Conclusion: A decreased platelet count and an increased mean platelet volume, platelet large cell ratio, and platelet distribution width were identified as potentially useful markers for preeclampsia diagnosis. Of them, mean platelet volume was the best indicator of preeclampsia. Keywords: Platelet parameter, pregnancy, preeclampsia, biomarkers