Platelet count in preeclampsia: a systematic review and meta-analysis

Gashaw Garedew Woldeamanuel; Kenean Getaneh Tlaye; Ling Wu; Liona C Poon; Chi Chiu Wang

doi:10.1016/j.ajogmf.2023.100979

Platelet count in preeclampsia: a systematic review and meta-analysis

Am J Obstet Gynecol MFM. 2023 Jul;5(7):100979. doi: 10.1016/j.ajogmf.2023.100979. Epub 2023 Apr 24.

Authors

Gashaw Garedew Woldeamanuel¹, Kenean Getaneh Tlaye¹, Ling Wu¹, Liona C Poon¹, Chi Chiu Wang²

Affiliations

¹ Department of Obstetrics and Gynaecology, Li Ka Shing Institute of Health Sciences, School of Biomedical Sciences, Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong SAR.
² Department of Obstetrics and Gynaecology, Li Ka Shing Institute of Health Sciences, School of Biomedical Sciences, Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong SAR. Electronic address: ccwang@cuhk.edu.hk.

PMID: 37098392
DOI: 10.1016/j.ajogmf.2023.100979

Abstract

Objective: Many studies have reported the association between platelets and preeclampsia. However, sample sizes were small, and their findings were inconsistent. We conducted a systematic review and meta-analysis to evaluate the association in pooled samples and in detail.

Data sources: A systematic literature search was performed using Medline, Embase, ScienceDirect, Web of Science, Cochrane Library, NICHD-DASH, LILACS, and Scopus from inception to April 22, 2022.

Study eligibility criteria: Observational studies comparing platelet count between women with preeclampsia and normotensive pregnant women were included.

Methods: The mean differences with 95% confidence interval in platelet count were calculated. Heterogeneity was assessed using I² statistics. Sensitivity and subgroup analyses were conducted. Statistical analysis was performed using RevMan 5.3 and ProMeta 3 software.

Results: A total of 56 studies comprising 4892 preeclamptic and 9947 normotensive pregnant women were included. Meta-analysis showed that platelet count was significantly lower in women with preeclampsia than in normotensive controls (overall: mean difference, -32.83; 95% confidence interval, -40.13 to -25.52; P<.00001; I²=92%; mild preeclampsia: mean difference, -18.65; 95% confidence interval, -27.17 to -10.14; P<.00001; I²=84%; severe preeclampsia: mean difference, -42.61; 95% confidence interval, -57.53 to -27.68; P<.00001; I²=94%). Significantly lower platelet count was also observed in the second trimester (mean difference, -28.84; 95% confidence interval, -44.59 to -13.08; P=.0003; I²=93%), third trimester (mean difference, -40.67; 95% confidence interval, -52.14 to -29.20; P<.00001; I²=92%), and before the diagnosis of preeclampsia (mean difference, -18.81; 95% confidence interval, -29.98 to -7.64; P=.009; I²=87%), but not in the first trimester (mean difference, -15.14; 95% confidence interval, -37.71 to 7.43; P=.19; I²=71%). Overall, the pooled sensitivity and specificity of platelet count were 0.71 and 0.77, respectively. The area under the curve was 0.80.

Conclusion: This meta-analysis confirmed that platelet count was significantly lower in preeclamptic women, irrespective of severity and presence or absence of associated complications, even before the onset of preeclampsia and in the second trimester of pregnancy. Our findings suggest that platelet count may be a potential marker to identify and predict preeclampsia.

Keywords: hypertensive disorders of pregnancy; platelet count; platelets; preeclampsia; pregnancy; thrombocyte.

Publication types

Meta-Analysis
Systematic Review
Review
Research Support, Non-U.S. Gov't

MeSH terms

Blood Pressure
Female
Humans
Platelet Count
Pre-Eclampsia* / diagnosis
Pre-Eclampsia* / epidemiology
Pregnancy
Pregnancy Trimester, First
Pregnancy Trimester, Third