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Background <p>Hypertensive disorders of pregnancy (HDP) are major contributors to maternal and perinatal morbidity worldwide. Platelet indices and the neutrophil-to-lymphocyte ratio (NLR) have emerged as potential hematological markers of systemic inflammation and endothelial dysfunction, yet their diagnostic and prognostic roles remain underexplored.</p> Objectives <p>To assess variations in platelet indices—mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), platelet-large cell ratio (P-LCR)—and NLR in women with HDP versus normotensive controls, and to evaluate their diagnostic performance and association with disease severity.</p> Methods <p>In this hospital-based case–control study, 223 pregnant women ≥ 20&#xa0;weeks’ gestation (111 HDP, 112 controls) were enrolled. Blood pressure, proteinuria, and edema were recorded. Complete blood counts were analyzed on a standardized platform, and platelet indices/NLR were compared between groups. Diagnostic accuracy was tested using ROC curves.</p> Results <p>MPV, PDW, and P-LCR were significantly higher in HDP (all <i>p</i> &lt; 0.001). MPV showed the best diagnostic accuracy (AUC = 0.705; cutoff 11.05 fL; sensitivity 72%, specificity 65%). NLR did not differ overall (<i>p</i> = 0.228) but was significantly associated with proteinuria (<i>p</i> = 0.001) and edema (<i>p</i> = 0.003). Indices rose progressively across disease spectrum, from gestational hypertension to severe preeclampsia/eclampsia.</p> Conclusion <p>Platelet indices, particularly MPV and PDW, provide gestational age-independent, low-cost adjuncts for the detection and severity assessment of HDP. NLR may serve as a marker of organ involvement rather than a screening tool. Larger multi-center studies with longitudinal follow-up incorporating maternal and neonatal outcomes are needed.</p>

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Gestational Age-Independent Platelet Indices and Neutrophil-to-Lymphocyte Ratio in Hypertensive Disorders of Pregnancy: A Case–Control Study

  • 期刊论文

  • 发表日期：

    2025年11月1日

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  • Manodeep Barai,
  • Yashita Gupta,
  • Aishwarya John,
  • Amit Kumar Chowhan,
  • Vinita Singh

摘要

Background

Hypertensive disorders of pregnancy (HDP) are major contributors to maternal and perinatal morbidity worldwide. Platelet indices and the neutrophil-to-lymphocyte ratio (NLR) have emerged as potential hematological markers of systemic inflammation and endothelial dysfunction, yet their diagnostic and prognostic roles remain underexplored.

Objectives

To assess variations in platelet indices—mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), platelet-large cell ratio (P-LCR)—and NLR in women with HDP versus normotensive controls, and to evaluate their diagnostic performance and association with disease severity.

Methods

In this hospital-based case–control study, 223 pregnant women ≥ 20 weeks’ gestation (111 HDP, 112 controls) were enrolled. Blood pressure, proteinuria, and edema were recorded. Complete blood counts were analyzed on a standardized platform, and platelet indices/NLR were compared between groups. Diagnostic accuracy was tested using ROC curves.

Results

MPV, PDW, and P-LCR were significantly higher in HDP (all p < 0.001). MPV showed the best diagnostic accuracy (AUC = 0.705; cutoff 11.05 fL; sensitivity 72%, specificity 65%). NLR did not differ overall (p = 0.228) but was significantly associated with proteinuria (p = 0.001) and edema (p = 0.003). Indices rose progressively across disease spectrum, from gestational hypertension to severe preeclampsia/eclampsia.

Conclusion

Platelet indices, particularly MPV and PDW, provide gestational age-independent, low-cost adjuncts for the detection and severity assessment of HDP. NLR may serve as a marker of organ involvement rather than a screening tool. Larger multi-center studies with longitudinal follow-up incorporating maternal and neonatal outcomes are needed.