Mild thrombocytopenia indicating maternal organ damage in pre‐eclampsia: a cross‐sectional study
Abstract Background Currently, 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 Internatio...
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doaj-0ac944503b0042f8879c0cff5cb9a9122021-01-31T16:06:36ZengBMCBMC Pregnancy and Childbirth1471-23932021-01-012111610.1186/s12884-021-03564-4Mild thrombocytopenia indicating maternal organ damage in pre‐eclampsia: a cross‐sectional studyMichinori Mayama0Mamoru Morikawa1Takashi Yamada2Takeshi Umazume3Kiwamu Noshiro4Kinuko Nakagawa5Yoshihiro Saito6Kentaro Chiba7Satoshi Kawaguchi8Hidemichi Watari9Department of Obstetrics and Gynecology, Hokkaido University Graduate School of MedicineDepartment of Obstetrics and Gynecology, Hokkaido University Graduate School of MedicineDepartment of Obstetrics and Gynecology, Japan Community Health Care Organization Hokkaido HospitalDepartment of Obstetrics and Gynecology, Hokkaido University Graduate School of MedicineDepartment of Obstetrics and Gynecology, Hokkaido University Graduate School of MedicineDepartment of Obstetrics and Gynecology, Hokkaido University Graduate School of MedicineDepartment of Obstetrics and Gynecology, Hokkaido University Graduate School of MedicineDepartment of Obstetrics and Gynecology, Hokkaido University Graduate School of MedicineDepartment of Obstetrics and Gynecology, Hokkaido University Graduate School of MedicineDepartment of Obstetrics and Gynecology, Hokkaido University Graduate School of MedicineAbstract Background Currently, 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. Methods A 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. Estimated relative risk was calculated with a Poisson regression analysis with a robust error. Results Platelet counts indicated normal levels in 189 patients, mild thrombocytopenia in 51 patients, and severe thrombocytopenia in 24 patients. The estimated relative risks of severe thrombocytopenia were 4.46 [95 % confidence interval, 2.59–7.68] for maternal organ damage except for thrombocytopenia, 1.61 [1.06–2.45] for preterm delivery < 34 gestational weeks, and 1.35 [1.06–1.73] for neonatal intensive care unit admission. On the other hand, the estimated relative risks of mild thrombocytopenia were 0.97 [0.41–2.26] for maternal organ damage except for thrombocytopenia, 0.91 [0.62–1.35] for preterm delivery < 34 gestational weeks, and 0.97 [0.76–1.24] for neonatal intensive care unit admission. Conclusions Mild thrombocytopenia was not associated with severe features of pre-eclampsia and would not be suitable as a sign of maternal organ damage.https://doi.org/10.1186/s12884-021-03564-4Cut-off valueMaternal organ damagePre-eclampsiaPreterm deliveryThrombocytopenia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Michinori Mayama Mamoru Morikawa Takashi Yamada Takeshi Umazume Kiwamu Noshiro Kinuko Nakagawa Yoshihiro Saito Kentaro Chiba Satoshi Kawaguchi Hidemichi Watari |
spellingShingle |
Michinori Mayama Mamoru Morikawa Takashi Yamada Takeshi Umazume Kiwamu Noshiro Kinuko Nakagawa Yoshihiro Saito Kentaro Chiba Satoshi Kawaguchi Hidemichi Watari Mild thrombocytopenia indicating maternal organ damage in pre‐eclampsia: a cross‐sectional study BMC Pregnancy and Childbirth Cut-off value Maternal organ damage Pre-eclampsia Preterm delivery Thrombocytopenia |
author_facet |
Michinori Mayama Mamoru Morikawa Takashi Yamada Takeshi Umazume Kiwamu Noshiro Kinuko Nakagawa Yoshihiro Saito Kentaro Chiba Satoshi Kawaguchi Hidemichi Watari |
author_sort |
Michinori Mayama |
title |
Mild thrombocytopenia indicating maternal organ damage in pre‐eclampsia: a cross‐sectional study |
title_short |
Mild thrombocytopenia indicating maternal organ damage in pre‐eclampsia: a cross‐sectional study |
title_full |
Mild thrombocytopenia indicating maternal organ damage in pre‐eclampsia: a cross‐sectional study |
title_fullStr |
Mild thrombocytopenia indicating maternal organ damage in pre‐eclampsia: a cross‐sectional study |
title_full_unstemmed |
Mild thrombocytopenia indicating maternal organ damage in pre‐eclampsia: a cross‐sectional study |
title_sort |
mild thrombocytopenia indicating maternal organ damage in pre‐eclampsia: a cross‐sectional study |
publisher |
BMC |
series |
BMC Pregnancy and Childbirth |
issn |
1471-2393 |
publishDate |
2021-01-01 |
description |
Abstract Background Currently, 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. Methods A 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. Estimated relative risk was calculated with a Poisson regression analysis with a robust error. Results Platelet counts indicated normal levels in 189 patients, mild thrombocytopenia in 51 patients, and severe thrombocytopenia in 24 patients. The estimated relative risks of severe thrombocytopenia were 4.46 [95 % confidence interval, 2.59–7.68] for maternal organ damage except for thrombocytopenia, 1.61 [1.06–2.45] for preterm delivery < 34 gestational weeks, and 1.35 [1.06–1.73] for neonatal intensive care unit admission. On the other hand, the estimated relative risks of mild thrombocytopenia were 0.97 [0.41–2.26] for maternal organ damage except for thrombocytopenia, 0.91 [0.62–1.35] for preterm delivery < 34 gestational weeks, and 0.97 [0.76–1.24] for neonatal intensive care unit admission. Conclusions Mild thrombocytopenia was not associated with severe features of pre-eclampsia and would not be suitable as a sign of maternal organ damage. |
topic |
Cut-off value Maternal organ damage Pre-eclampsia Preterm delivery Thrombocytopenia |
url |
https://doi.org/10.1186/s12884-021-03564-4 |
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