The Use of the Aspartate Aminotransferase-to-Platelet Ratio Index as a Predictor of Obstetrical and Neonatal Adverse Outcomes in Patients with Preeclampsia Toxemia.

BACKGROUND

Hypertensive disorders during pregnancy can lead to significant adverse outcomes. Currently, no established and effective tests have a high predictive value for preeclampsia toxemia (PET) severity and its associated adverse outcomes.

OBJECTIVES

To investigate the correlation between the aspartate aminotransferase-to-platelet ratio index (APRI) and the risk of obstetrical and neonatal adverse outcomes in women with PET.

METHODS

We conducted a population-based cohort study at a tertiary medical center, which included all women who delivered between the years 2020 and 2022 and were diagnosed with PET. Women with incomplete records, multiple gestations, and fetal malformations were excluded. The median APRI of the cohort was the cut-off point to compare the risk of obstetrical and neonatal complications between low and high APRI scores. A multivariable logistic regression was used to adjust for confounders.

RESULTS

The study included 513 women with PET who met the inclusion criteria. The median APRI score was used as a cut-off value, resulting in 255 women with an APRI score < 0.26 and 258 with a score > 0.26. A higher APRI score was significantly correlated with a small for gestational age (SGA) newborn and preterm delivery before 34 weeks after controlling for parity, previous cesarean delivery (CD), and maternal age (adjusted odds ratio 1.60, 95% confidence interval 1.01-2.55; P = 0.047, adjusted hazard ration 1.75, 95% confidence interval 1.12-3.09, P = 0.047).

CONCLUSIONS

In patients with PET, an APRI score > 0.26 was associated with an increased risk for SGA and preterm deliveries.