Role of platelet-related parameters in prediction of development and severity of preeclampsia (PE): an observational prospective cohort study

Abstract

Objectives: Preeclampsia (PE) is a major contributor to maternal and foetal morbidity and mortality. Early identification of women at risk is crucial for timely intervention, yet a cost-effective and reliable screening tool remains unavailable. This study aimed to evaluate the role of platelet-related parameters—platelet count (PC), mean platelet volume (MPV), plateletcrit (PCT), platelet distribution width (PDW), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR)—in predicting the development and severity of PE. Methods: This prospective observational cohort study was conducted at AIIMS Patna between January and November 2021. Pregnant women enrolled before 14 weeks of gestation were followed throughout pregnancy. Platelet parameters were measured at three gestational intervals: 10 to 14 weeks, 24 to 28 weeks, and 32 to 36 weeks. Data were analysed using SPSS v22, employing chi-square tests, t-tests, and logistic regression. Results: Among 728 participants, 9.3% developed PE. Risk was significantly higher in primigravida women (p = 0.040), twin pregnancies (p = 0.027), and those with low educational status (p = 0.006). Significant differences were observed in PCT (p = 0.000) and NLR (p = 0.009) at 10 to 14 weeks, PCT (p = 0.034) at mid-trimester, and MPV (p = 0.005) at 32 to 36 weeks. Although MPV showed a consistent association with PE across trimesters, regression models did not achieve overall statistical significance. Conclusion: Platelet indices, particularly PCT and NLR, demonstrated a significant association with PE in early pregnancy, while MPV was significantly elevated in late pregnancy. These findings suggest potential utility in risk stratification, though further studies are required to validate their predictive value before routine use in early screening.