The association between aspartate aminotransferase (AST) to platelets (PLT) ratio (APRI) and the development of intrahepatic cholestasis in pregnancy and other related complications

Razan Saadi; Alla Saban; Adi Y Weintraub; David Yardeni; Tamar Eshkoli

doi:10.1007/s00404-024-07383-8

The association between aspartate aminotransferase (AST) to platelets (PLT) ratio (APRI) and the development of intrahepatic cholestasis in pregnancy and other related complications

Arch Gynecol Obstet. 2024 Feb 15. doi: 10.1007/s00404-024-07383-8. Online ahead of print.

Authors

Razan Saadi¹, Alla Saban², Adi Y Weintraub², David Yardeni³, Tamar Eshkoli²

Affiliations

¹ Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. razans@post.bgu.ac.il.
² Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
³ Department of Gastroenterology and Liver Diseases, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

PMID: 38355761
DOI: 10.1007/s00404-024-07383-8

Abstract

Objective: To assess the association between aspartate aminotransferase (AST) to platelet count ratio index (APRI score), during the first and third trimesters of pregnancy and the development of intrahepatic cholestasis in pregnancy (ICP).

Methods: Case-control study was conducted. The study included patients diagnosed with ICP by elevated bile acids (n = 118) and a control group of women with symptoms such as elevated liver enzymes or pruritus with normal level of bile acids (n = 127) who attended a large tertiary teaching medical center between the years 2014 and 2021. The groups were compared in terms of obstetrical characteristics, perinatal outcomes, first- and third-trimester laboratory tests, and APRI scores during the first and third trimester. A receiver operating characteristic (ROC) analysis was performed to determine the APRI score cutoff value that could predict ICP.

Results: The third-trimester APRI scores of patients with ICP were significantly higher than those of the control group (P < 0.001). The ROC analysis revealed that the cutoff value for the APRI score was 0.42 with 65.3% sensitivity and 73.2% specificity.

Conclusion: Our results suggest that the third-trimester APRI score is positively associated with ICP.

Keywords: APRI; ICP; Intrahepatic cholestasis of pregnancy.