Table 1. The criteria of maternal organ damage and utero-placental dysfunction
Liver involvement without underlying disease
AST or ALT >40 IU/L with or without right upper quadrant or epigastric abdominal pain
|
Acute kidney injury
Serum creatine level ≥90 umol/L; 1.0 mg/dL
|
Neurological complications
Eclampsia, altered mental status, blindness, stroke, clonus, severe headache, or persistent visual scotoma
|
Blood coagulation disorders
Thrombocytopenia: platelet count <150 × 109/L, disseminated intravascular coagulation, or hemolysis
|
Utero-placental dysfunction
Fetal growth restrictiona, abnormal umbilical artery doppler waveformb, or stillbirthc
|
a Estimated fetal weight < −1.5 standard deviation without chromosomal abnormality and multiple congenital anomaly syndrome
b Absent or reversal of end diastolic flow, or extremely high pulsatility index or resistance index
c The cases of stillbirth with chromosomal abnormality or multiple congenital anomaly syndrome are excluded
AST, aspartate transaminase; ALT, alanine transaminase
Table 2. Clinical characteristics based on the overall reduction of PC from the first trimester in women with preeclampsia
|
Overall
(n = 240)
|
Decrease
(<30.0%)
(n = 145)
|
Decrease (≥30.0%)
(n = 95)
|
p value
|
Maternal agea
|
34.1 ± 5.1
|
33.8 ± 5.2
|
34.5 ± 5.0
|
0.312
|
Primipara†
|
153 (63.8)
|
96 (66.2)
|
57 (60.0)
|
0.328
|
Previous history of preeclampsiab
|
18 (7.5)
|
11 (7.6)
|
7 (7.4)
|
0.950
|
Low-dose aspirin for preventionb
|
4 (1.7)
|
2 (1.4)
|
2 (2.1)
|
0.667
|
Severe hypertensionb
|
166 (69.2)
|
94 (64.8)
|
72 (75.8)
|
0.072
|
Uteroplacental dysfunctionb
|
67 (27.9)
|
47 (32.4)
|
20 (21.1)
|
0.055
|
Maternal organ damage except for thrombocytopeniab
|
39 (16.3)
|
18 (12.4)
|
21 (22.1)
|
0.047
|
Preterm delivery <34 GW†
|
90 (39.5)
|
44 (30.3)
|
46 (48.4)
|
0.005
|
PC at first trimestera (× 109/L)
|
251 ± 56
|
249 ± 53
|
254 ± 59
|
0.442
|
PC at deliverya (× 109/L)
|
187 ± 64
|
219 ± 52
|
138 ± 47
|
<0.001
|
PC levels at deliveryb
|
|
|
|
|
Normal
|
174 (72.5)
|
133 (91.7)
|
41 (43.2)
|
<0.001
|
Mild thrombocytopenia
|
44 (18.3)
|
11 (7.6)
|
33 (34.7)
|
Severe thrombocytopenia
|
22 (9.2)
|
1 (0.7)
|
21 (22.1)
|
a Mean ± standard deviation, statistical significance was calculated with independent t-test
b n (%), statistical significance was calculated with chi-square test
PC, platelet count; GW, gestational weeks
PC levels, Normal, >150 × 109/L; mild thrombocytopenia, < 150 × 109/L and ≥100 × 109/L; severe thrombocytopenia, < 100 × 109/L
Table 3. Relative risk of ≥30.0% of overall PC reduction for adverse outcomes of preeclampsia in adjusting maternal age
|
RR
|
95% CI
|
p value
|
Severe hypertension
|
1.16
|
0.99–1.37
|
0.073
|
Uteroplacental dysfunction
|
0.64
|
0.41–1.02
|
0.059
|
Maternal organ damage except thrombocytopenia
|
1.77
|
0.99–3.15
|
0.052
|
Preterm delivery <34 GW
|
1.58
|
1.14–2.18
|
0.015
|
PC, platelet count; GW, gestational week; RR, relative risk; CI, confidence interval
Table 4. Clinical characteristics based on the overall reduction of PC in preeclamptic women without thrombocytopenia
|
Overall
(n = 174)
|
Decrease (<30.0%)
(n = 133)
|
Decrease (≥30.0%)
(n = 41)
|
p value
|
Maternal agea
|
34.0 ± 5.2
|
34.0 ± 5.1
|
34.0 ± 5.5
|
0.538
|
Primiparab
|
110 (63.2)
|
88 (66.2)
|
22 (53.7)
|
0.147
|
Previous history of preeclampsiab
|
14 (8.1)
|
9 (6.8)
|
5 (12.2)
|
0.264
|
Low-dose aspirin for preventionb
|
1 (0.6)
|
1 (0.8)
|
0
|
0.578
|
Severe hypertensionb
|
123 (70.7)
|
88 (66.2)
|
35 (85.4)
|
0.018
|
Uteroplacental dysfunctionb
|
49 (28.2)
|
44 (33.1)
|
5 (12.2)
|
0.009
|
Maternal organ damage except for thrombocytopeniab
|
22 (12.6)
|
16 (12.0)
|
6 (14.6)
|
0.661
|
Preterm delivery <34 GWb
|
62 (35.6)
|
41 (30.8)
|
21 (51.2)
|
0.017
|
PC at first trimestera (× 109/L)
|
265 ± 53
|
256 ± 50
|
297 ± 49
|
<0.001
|
PC at deliverya (× 109/L)
|
215 ± 47
|
226 ± 47
|
179 ± 25
|
<0.001
|
a Mean ± standard deviation, statistical significance was calculated with independent t-test
b n (%), statistical significance was calculated with chi-square test
PC, platelet count; GW, gestational weeks
Table 5. Relative risk of ≥30.0% of overall PC reduction for adverse outcomes of preeclamptic women without thrombocytopenia in adjusting maternal age
|
RR
|
95% CI
|
p value
|
Severe hypertension
|
1.29
|
1.08–1.54
|
0.005
|
Uteroplacental dysfunction
|
0.37
|
0.16–0.87
|
0.023
|
Maternal organ damage except thrombocytopenia
|
1.21
|
0.50–2.92
|
0.666
|
Preterm delivery <34 GW
|
1.66
|
1.12–2.46
|
0.012
|
PC, platelet count; GW, gestational week; RR, relative risk; CI, confidence interval