Mild thrombocytopenia indicating maternal organ damage in pre-eclampsia: a cross-sectional study
Abstract BackgroundCurrently, there is a disagreement between guidelines regarding platelet count cut-off values as a sign of maternal organ damage in pre-eclampsia; the American College of Obstetricians and Gynecologists guidelines state a cut-off value of <100× 109/L; however, the International Society for the Study of Hypertension in Pregnancy guidelines specify a cut-off of <150 × 109/L. We evaluated the effect of mild thrombocytopenia: platelet count <150 × 109/L and ≥100 × 109/L on clinical features of pre-eclampsia to examine whether mild thrombocytopenia reflects maternal organ damage in pre-eclampsia. MethodsA total of 264 women were enrolled in this study. Participants were divided into three groups based on platelet count levels at delivery: normal, ≥150 × 109/L; mild thrombocytopenia, <150 × 109/L and ≥100 × 109/L; and severe thrombocytopenia, <100 × 109/L. Risk of severe hypertension, utero-placental dysfunction, maternal organ damage, preterm delivery, and neonatal intensive care unit admission were analyzed based on platelet count levels. Adjusted relative risk were calculated with a Poisson regression analysis with a robust error. ResultsPlatelet counts indicated normal levels in 189 patients, mild thrombocytopenia in 51 patients, and severe thrombocytopenia in 24 patients. The adjusted risk ratios of severe thrombocytopenia were 2.11 [95% confidence interval, 1.61–2.77] for maternal organ damage except thrombocytopenia, 1.24 [1.01–1.53] for preterm delivery <34 gestational weeks, and 1.16 [1.02–1.32] for neonatal intensive care unit admission. On the other hand, the adjusted risk ratios of mild thrombocytopenia were 1.06 [0.86–1.30] for severe hypertension, 1.17 [0.74–1.83] for utero-placental dysfunction, 0.96 [0.41–2.24] for maternal organ damage except thrombocytopenia, 0.89 [0.60–1.31] for preterm delivery <34 gestational weeks, and 0.96 [0.75–1.23] for neonatal intensive care unit admission. ConclusionsMild thrombocytopenia was not related with severe features of pre-eclampsia and would not be suitable as a sign of maternal organ damage.