Significance of platelet parameters in pre-eclampsia: A prospective cross-sectional study from a tertiary care center in North India

Abstract

Background: Pre-eclampsia is a life-threatening disorder that develops after 20 weeks of gestation and is a major cause of maternal morbidity and mortality worldwide. Platelet activation plays a crucial role in its pathogenesis, contributing to end-organ damage. Platelet parameters such as platelet count, mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) are indirect markers of platelet activation and can be evaluated during routine hematological analysis.

Aims and Objectives: This study aimed to evaluate and compare platelet parameters (platelet count, MPV, PDW, and PCT) in women with pre-eclampsia and normotensive pregnant women, establishing their role in diagnosing and predicting pre-eclampsia. Variations in these parameters in patients with and without severe features were also analyzed.

Materials and Methods: A prospective cross-sectional study was conducted between August 2022 and February 2024, involving 120 pre-eclamptic and 120 normotensive pregnant women. Platelet parameters were analyzed, and statistical tests such as Mann-Whitney, Independent t-test, Chi-square, and Fisher’s exact test were applied. The receiver operating characteristic (ROC) curve analysis evaluated the predictive value of platelet parameters in pre-eclampsia.

Results: Pre-eclamptic women showed significantly higher MPV (12.73±2.19 fL vs. 11.98±1.78 fL, P=0.004) and PDW (20.35±2.98% vs. 16.02±0.87%, P<0.0001) compared to normotensive women. Platelet count (141.3±42.47×103/μL vs. 174.32±27.24×103/μL, P<0.0001) and PCT (0.17±0.04% vs. 0.22±0.04%, P<0.0001) were significantly reduced. Among 19 pre-eclamptic women with severe features, platelet count and PCT were further decreased, whereas MPV and PDW increased. ROC curve analysis revealed significant discriminatory power for all platelet parameters. PDW had the highest predictive accuracy (area under the curve [AUC] 0.965; 95% confidence interval [CI]: 0.946–0.984) with a sensitivity of 83.33% and specificity of 97.50% at a cut-off value >17.4%. PCT (AUC 0.838; 95% CI: 0.783–0.893) and platelet count (AUC 0.779; 95% CI: 0.719–0.839) also showed notable predictive ability.

Conclusion: Platelet parameters are significantly altered in pre-eclampsia and serve as reliable, cost-effective biomarkers for diagnosis, monitoring, and assessing severity, particularly in resource-limited settings.