Evaluating mean platelet volume and platelet distribution width as predictors of early-onset pre-eclampsia: a prospective cohort study
Abstract Background Platelets are pivotal players in the pathophysiology of pre-eclampsia, with observed lower counts in affected individuals compared to normotensive counterparts. Despite advancements, the elusive cause of pre-eclampsia persists, motivating intense global efforts to identify reliab...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | Maternal Health, Neonatology and Perinatology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40748-024-00174-8 |
| _version_ | 1797273531116945408 |
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| author | Patience Ijeoma Udeh Ayokunle Moses Olumodeji Taiwo Olufunmilayo Kuye-Kuku Oluwaseun Olubowale Orekoya Olufemi Ayanbode Adetokunbo Olusegun Fabamwo |
| author_facet | Patience Ijeoma Udeh Ayokunle Moses Olumodeji Taiwo Olufunmilayo Kuye-Kuku Oluwaseun Olubowale Orekoya Olufemi Ayanbode Adetokunbo Olusegun Fabamwo |
| author_sort | Patience Ijeoma Udeh |
| collection | DOAJ |
| description | Abstract Background Platelets are pivotal players in the pathophysiology of pre-eclampsia, with observed lower counts in affected individuals compared to normotensive counterparts. Despite advancements, the elusive cause of pre-eclampsia persists, motivating intense global efforts to identify reliable predictors. The currently recommended predictors of pre-eclampsia are not readily available in many resource-limited regions like Nigeria. This cohort study explores the potential of mean platelet volume (MPV) and platelet distribution width (PDW) as predictive markers of early-onset pre-eclampsia. Both platelet indices are components of the full blood count, a widely available routine test in pregnancy. Methods In this prospective cohort study, 648 healthy pregnant women attending antenatal care at Lagos State University Teaching Hospital and General Hospital Ifako-Ijaiye, Lagos, were recruited between 14-18weeks gestational age. Platelet count (PC), MPV and PDW were measured from their venous blood at recruitment. Participants were monitored until 34weeks of gestation, focusing on the occurrence of early-onset preeclampsia as the outcome of interest. Individuals with chronic medical conditions were excluded from the study. Data analysis involved t-test, Chi-Square and Mann–Whitney U tests, with statistical significance set at a confidence level of 95% and p < 0.05. Sensitivity, specificity, and predictive values were determined using receiver operating characteristics (ROC) curves. Results The incidence of early-onset pre-eclampsia in the study was 5.9%. Women who later developed pre-eclampsia had higher median MPV and PDW at 14-18weeks (10.8 fl. and 24.8 fl.) compared to normotensive women (8.1 fl. and 13.3 fl.)(p < 0.001). The median PC was lower in pre-eclamptics (190 × 103/µl) compared to normotensives(264 × 103/µl)(p < 0.001). Using Youden’s test, cut-off values identified: PC < 211.5 × 103/µl, MPV > 9.4 fl., and PDW > 21.3 fl., predicted early-onset pre-eclampsia with 96.6% sensitivity and 65.6% specificity for PC; 79.3% sensitivity and 97.7% specificity for PDW; and 82.8% sensitivity and 96.1% specificity for MPV. Cut-offs of PC < 185 × 103/µl, MPV > 10.7 fl., and PDW > 28.3 fl., predicted severe early-onset pre-eclampsia with 100.0% sensitivity and 90.9% specificity for PC, 100.0% sensitivity and 99.4% specificity for MPV, and 100.0% sensitivity and 99.8% specificity for PDW, with corresponding area under the ROC curves of 0.983, 0.996, and 0.998, respectively. Conclusion The evaluation of MPV and PDW between 14 and 18 weeks of gestation appears to be a reliable predictor of severe early-onset pre-eclampsia. |
| first_indexed | 2024-03-07T14:45:42Z |
| format | Article |
| id | doaj.art-6871a25c05304c4883c6714d94dd5bdd |
| institution | Directory Open Access Journal |
| issn | 2054-958X |
| language | English |
| last_indexed | 2024-03-07T14:45:42Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Maternal Health, Neonatology and Perinatology |
| spelling | doaj.art-6871a25c05304c4883c6714d94dd5bdd2024-03-05T20:00:18ZengBMCMaternal Health, Neonatology and Perinatology2054-958X2024-03-011011810.1186/s40748-024-00174-8Evaluating mean platelet volume and platelet distribution width as predictors of early-onset pre-eclampsia: a prospective cohort studyPatience Ijeoma Udeh0Ayokunle Moses Olumodeji1Taiwo Olufunmilayo Kuye-Kuku2Oluwaseun Olubowale Orekoya3Olufemi Ayanbode4Adetokunbo Olusegun Fabamwo5Department of Obstetrics and Gynaecology, Lagos State University Teaching HospitalDepartment of Obstetrics and Gynaecology, Lagos State University Teaching HospitalDepartment of Obstetrics and Gynaecology, Lagos State University Teaching HospitalDepartment of Obstetrics and Gynaecology, Lagos State University Teaching HospitalDepartment of Obstetrics and Gynaecology, Lagos State University Teaching HospitalDepartment of Obstetrics and Gynaecology, Lagos State University Teaching HospitalAbstract Background Platelets are pivotal players in the pathophysiology of pre-eclampsia, with observed lower counts in affected individuals compared to normotensive counterparts. Despite advancements, the elusive cause of pre-eclampsia persists, motivating intense global efforts to identify reliable predictors. The currently recommended predictors of pre-eclampsia are not readily available in many resource-limited regions like Nigeria. This cohort study explores the potential of mean platelet volume (MPV) and platelet distribution width (PDW) as predictive markers of early-onset pre-eclampsia. Both platelet indices are components of the full blood count, a widely available routine test in pregnancy. Methods In this prospective cohort study, 648 healthy pregnant women attending antenatal care at Lagos State University Teaching Hospital and General Hospital Ifako-Ijaiye, Lagos, were recruited between 14-18weeks gestational age. Platelet count (PC), MPV and PDW were measured from their venous blood at recruitment. Participants were monitored until 34weeks of gestation, focusing on the occurrence of early-onset preeclampsia as the outcome of interest. Individuals with chronic medical conditions were excluded from the study. Data analysis involved t-test, Chi-Square and Mann–Whitney U tests, with statistical significance set at a confidence level of 95% and p < 0.05. Sensitivity, specificity, and predictive values were determined using receiver operating characteristics (ROC) curves. Results The incidence of early-onset pre-eclampsia in the study was 5.9%. Women who later developed pre-eclampsia had higher median MPV and PDW at 14-18weeks (10.8 fl. and 24.8 fl.) compared to normotensive women (8.1 fl. and 13.3 fl.)(p < 0.001). The median PC was lower in pre-eclamptics (190 × 103/µl) compared to normotensives(264 × 103/µl)(p < 0.001). Using Youden’s test, cut-off values identified: PC < 211.5 × 103/µl, MPV > 9.4 fl., and PDW > 21.3 fl., predicted early-onset pre-eclampsia with 96.6% sensitivity and 65.6% specificity for PC; 79.3% sensitivity and 97.7% specificity for PDW; and 82.8% sensitivity and 96.1% specificity for MPV. Cut-offs of PC < 185 × 103/µl, MPV > 10.7 fl., and PDW > 28.3 fl., predicted severe early-onset pre-eclampsia with 100.0% sensitivity and 90.9% specificity for PC, 100.0% sensitivity and 99.4% specificity for MPV, and 100.0% sensitivity and 99.8% specificity for PDW, with corresponding area under the ROC curves of 0.983, 0.996, and 0.998, respectively. Conclusion The evaluation of MPV and PDW between 14 and 18 weeks of gestation appears to be a reliable predictor of severe early-onset pre-eclampsia.https://doi.org/10.1186/s40748-024-00174-8Early-onset pre-eclampsiaPlateletsPlatelet indicesPregnancy |
| spellingShingle | Patience Ijeoma Udeh Ayokunle Moses Olumodeji Taiwo Olufunmilayo Kuye-Kuku Oluwaseun Olubowale Orekoya Olufemi Ayanbode Adetokunbo Olusegun Fabamwo Evaluating mean platelet volume and platelet distribution width as predictors of early-onset pre-eclampsia: a prospective cohort study Maternal Health, Neonatology and Perinatology Early-onset pre-eclampsia Platelets Platelet indices Pregnancy |
| title | Evaluating mean platelet volume and platelet distribution width as predictors of early-onset pre-eclampsia: a prospective cohort study |
| title_full | Evaluating mean platelet volume and platelet distribution width as predictors of early-onset pre-eclampsia: a prospective cohort study |
| title_fullStr | Evaluating mean platelet volume and platelet distribution width as predictors of early-onset pre-eclampsia: a prospective cohort study |
| title_full_unstemmed | Evaluating mean platelet volume and platelet distribution width as predictors of early-onset pre-eclampsia: a prospective cohort study |
| title_short | Evaluating mean platelet volume and platelet distribution width as predictors of early-onset pre-eclampsia: a prospective cohort study |
| title_sort | evaluating mean platelet volume and platelet distribution width as predictors of early onset pre eclampsia a prospective cohort study |
| topic | Early-onset pre-eclampsia Platelets Platelet indices Pregnancy |
| url | https://doi.org/10.1186/s40748-024-00174-8 |
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