Platelet Count in First Trimester of Pregnancy as a Predictor of Perinatal Outcome

Authors

  • Santiago Garcia-Tizon Larroca Department of Obstetrics and Gynecology Hospital General Universitario Gregorio Marañon de Madrid, Madrid
  • Juan Arevalo-Serrano Department of Obstetrics and Gynecology, Hospital General, Universitario Gregorio Marañon de Madrid, Madrid
  • Virginia Ortega Abad Department of Internal Medicine, Hospital Universitario, Principe de Asturias de Alcalá de Henares, Madrid
  • Pilar Pintado Recarte Department of Obstetrics and Gynecology, Hospital General, Universitario Gregorio Marañon de Madrid, Madrid
  • Alejandro Garcia Carreras Department of Obstetrics and Gynecology, Hospital General, Universitario Gregorio Marañon de Madrid, Madrid
  • Gonzalo Nozaleda Pastor Department of Obstetrics and Gynecology, Hospital General, Universitario Gregorio Marañon de Madrid, Madrid
  • Cesar Rodriguez Hernandez Department of Obstetrics and Gynecology, Hospital General, Universitario Gregorio Marañon de Madrid, Madrid
  • Ricardo Perez Fernandez Pacheco Department of Obstetrics and Gynecology, Hospital General, Universitario Gregorio Marañon de Madrid, Madrid
  • Juan De Leon Luis Department of Obstetrics and Gynecology, Hospital General, Universitario Gregorio Marañon de Madrid, Madrid

DOI:

https://doi.org/10.3889/oamjms.2017.013

Keywords:

Platelet Count, Pregnancy Trimester First, Pregnancy Outcome

Abstract

AIM: To rule out maternal and pregnancy factors that may contribute to platelet count (PLT) changes in the first trimester of gestation and examine if there is any association between its levels and adverse perinatal outcome.

METHODS: The study population included all patients from the first-trimester visit between 2013-2015 with pregnancy results. Linear multiple regression was constructed to rule out variables that may have a significant contribution to PLT. For each adverse outcome at birth, multiple logistic regression analysis was implemented to estimate the PLT effect.

RESULTS: PLT was measured in 6092 patients. There was the significant contribution on PLT in the first trimester from maternal weight, the presence of rheumatologic disease, BHCG levels and MPV. There was a significant association between PLT and abnormal cardiotocography at delivery (OR 1.004; IC95% 1.001 to 1.007) and C-Section due to abnormal CTG (OR 1.005; IC95% 1.002 to 1.008). When adjusted for factors that interact with PLT there was also a significant association with pH at birth < 7.10 and gestational diabetes.

CONCLUSIONS: Maternal and pregnancy factors can poorly predict relevant changes in PLT at the first trimester of gestation. PLT at first trimester of pregnancy might predict adverse perinatal outcome in combination with other markers.

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References

Wright D. Syngelaki A. Akolekar R. et al. Competing risks model in screening for preeclampsia by maternal characteristics and medical history. Am J Obstet Gynecol. 2015;213:62.e1-62.e10. https://doi.org/10.1016/j.ajog.2015.02.018 PMid:25724400

Poon LC. Nicolaides KH. Early prediction of preeclampsia. Obstet Gynecol Int. 2014;2014:297397.

Fay RA. Hughes AO. Farron NT. Platelets in pregnancy: Hyperdestruction in pregnancy. Obstet Gynecol. 1983; 61: 238–40. https://doi.org/10.1097/00132582-198312000-00003

Ahmed Y. van Iddekinge B. Paul C. et al. Retrospective analysis of platelet numbers and volumes in normal pregnancy and pre-eclampsia. Br J Obstet Gynaecol. 1993; 100:216–20. https://doi.org/10.1111/j.1471-0528.1993.tb15233.x PMid:8476825

Norris LA. Sheppard BL. Bonnar J. Increased whole blood platelet aggregation in normal pregnancy can be prevented in vitro by aspirin and dazmegrel (UK38485). Br J Obstet Gynaecol. 1992; 99:253–7. https://doi.org/10.1111/j.1471-0528.1992.tb14508.x PMid:1606123

Zarbock A. Polanowska-Grabowska RK. Ley K. Platelet–neutrophil interactions: linking hemostasis and infl ammation. Blood Rev. 2007; 21(2):99–111. https://doi.org/10.1016/j.blre.2006.06.001 PMid:16987572

Sato Y. Fujiwara H. Zeng BX. et al. Platelet-derived soluble factors induce human extravillous trophoblast migration and differentiation: platelets are a possible regulator of trophoblast infiltration into maternal spiral arteries. Blood. 2005;106(2):428–435. https://doi.org/10.1182/blood-2005-02-0491 PMid:15797992

Rouse DJ. Owen J. Goldenberg RL. Routine maternal platelet count: an assessment of a technologically driven screening practice. Am J Obstet Gynecol. 1998; 179:573-6. https://doi.org/10.1016/S0002-9378(98)70046-8

George JN. Woolf SH. Raskob GE. et al. Idiopathic thrombocytopenic purpura: a practice guideline developed by explicit methods for the American Society of Hematology. Blood. 1996;30:38-44.

Hutt R. Ogunniyi SO. Sullivan LHF. et al. Increased platelet volume and aggregation precede the onset of pre-eclampsia. Obstet Gynecol. 1994; 83: 146–9. PMid:8272297

Ozgur Dundar. Pinar Yoruk. Levent Tutuncu. et al. Longitudinal study of platelet size changes in gestation and predictive power of elevated MPV in development of pre-eclampsia. Prenat Diagn. 2008; 28: 1052–1056. https://doi.org/10.1002/pd.2126 PMid:18973157

Kanat-Pektas M. Yesildager U. Tuncer N. et al. Could mean platelet volume in late first trimester of pregnancy predict intrauterine growth restriction and pre-eclampsia? J Obstet Gynaecol Res. 2014;40(7):1840-5. https://doi.org/10.1111/jog.12433 PMid:25056460

Hutt R. Ogunniyi SO. Sullivan MH. et al. Increased platelet volume and aggregation precede the onset of preeclampsia. Obstet Gynecol. 1994; 83:146–149. https://doi.org/10.1016/0020-7292(94)90489-8

Tzur T. Sheiner E. Is there an association between platelet count during the first trimester and preeclampsia or other obstetric complications later in pregnancy? Hypertens Pregnancy. 2013;32(1):74-82. https://doi.org/10.3109/10641955.2012.704109 PMid:23394118

Khong TY. De Wolf F. Robertson WB. et al. Inadequate maternal vascular response to placentation in pregnancies complicated by pre-eclampsia and by small-for-gestational age infants. Br J Obstet Gynaecol. 1986;93:1049-1059. https://doi.org/10.1111/j.1471-0528.1986.tb07830.x PMid:3790464

Pijnenborg R. Anthony J. Davey DA. et al. Placental bed spiral arteries in the hypertensive disorders of pregnancy. Br J Obstet Gynaecol. 1991;98:648-655. https://doi.org/10.1111/j.1471-0528.1991.tb13450.x PMid:1883787

Onisâi M. Vlădăreanu AM. Delcea C. et al. Perinatal outcome for pregnancies complicated with thrombocytopenia. J Matern-Fetal Neonatal Med. 2012;25(9):1622-6. https://doi.org/10.3109/14767058.2011.648245 PMid:22220678

Dundar O. Yoruk P. Tutuncu L. et al. Longitudinal study of platelet size changes in gestation and predictive power of elevated MPV in development of pre-eclampsia. Prenat Diagn. 2008; 28(11):1052–1056. https://doi.org/10.1002/pd.2126 PMid:18973157

Akolekar R. Syngelaki A. Poon L.et al: Competing risks model in early screening for preeclampsia by biophysical and biochemical markers. Fetal Diagn Ther. 2013;33:8-15. https://doi.org/10.1159/000341264 PMid:22906914

Poon LC. Kametas NA. Maiz N. et al: First-trimester prediction of hypertensive disorders in pregnancy. Hypertension. 2009;53:812-818. https://doi.org/10.1161/HYPERTENSIONAHA.108.127977 PMid:19273739

Bujold E. Roberge S. Lacasse Y. et al. Prevention of preeclampsia and intrauterine growth restriction with aspirin started in early pregnancy: a meta-analysis. Obstet Gynecol. 2010;116:402-414. https://doi.org/10.1097/AOG.0b013e3181e9322a PMid:20664402

Sibai BM. Ramadan MK. Chari RS. et al. Pregnancies complicated by HELLP syndrome (hemolysis. elevated liver enzymes. and low platelets): subsequent pregnancy outcome and long-term prognosis. Am J Obstet Gynecol. 1995; 172:125-9. https://doi.org/10.1016/0002-9378(95)90099-3

Lescale KB. Eddleman KA. Cines DB. et al. Antiplatelet antibody testing in thrombocytopenic pregnant women. Am J Obstet Gynecol. 1996; 174:1014-8. https://doi.org/10.1016/S0002-9378(96)70342-3

Bath PM. Butterworth RJ. Platelet size: measurement. physiology and vascular disease. Blood Coagul Fibrinolysis. 1996; 7: 157–161. https://doi.org/10.1097/00001721-199603000-00011

Additional Files

Published

2017-02-01

How to Cite

1.
Garcia-Tizon Larroca S, Arevalo-Serrano J, Ortega Abad V, Pintado Recarte P, Garcia Carreras A, Nozaleda Pastor G, Rodriguez Hernandez C, Perez Fernandez Pacheco R, De Leon Luis J. Platelet Count in First Trimester of Pregnancy as a Predictor of Perinatal Outcome. Open Access Maced J Med Sci [Internet]. 2017 Feb. 1 [cited 2022 Oct. 6];5(1):27-32. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2017.013

Issue

Section

B - Clinical Sciences