Platelet and coagulation-fibrinolysis marker changes and their relationship with pregnancy outcomes in preeclampsia patients

Liu Jin; Ming Lumin; Lan Bo; Zhou Tingting; Yang Min; Ding Zhaoning; Lan Ruilun; Liang Hao

doi:10.11986/j.issn.1673-873X.2025.10.20

Abstract：Objective To investigate changes in platelet and coagulation-fibrinolysis markers in patients with preeclampsia(PE)and their relationships with pregnancy outcomes,aiming to provide a reference for clinical decision-making.Methods From April 2021 to July 2024,127 PE patients treated at a hospital in Chongqing were enrolled and classified by disease severity into a mild group(n=58)and a severe group(n=69).Fifty normal pregnant women admitted in the same period were included as a control group.PE patients were followed until delivery and grouped by pregnancy outcome into a favorable-outcome group(n=94)and an adverse-outcome group(n=33).Platelet and coagulation-fibrinolysis markers were compared among groups.Logistic regression analysis was used to analyze risk factors for adverse pregnancy outcomes in PE patients,and the predictive value of platelet and coagulation-fibrinolysis markers for adverse outcomes was evaluated.Results Across the control,mild,and severe PE groups,platelet count(PLT),prothrombin time(PT),and activated partial thromboplastin time(APTT)pro-gressively decreased,while fibrinogen(FIB)and D-dimer(D-D)progressively increased;these differences were statistically significant(P<0.05).Compared with the favorable-outcome group,the adverse-outcome group had significantly lower PLT,PT,and APTT and higher FIB and D-D(P<0.05);patients in the adverse-outcome group aged 35 or adove accounted for a higher proportion and their 24-h urinary protein levels were higher than those in the favorable-outcome group,with differences being statistically significant(P<0.05).Logistic regression analysis identified elevated D-D and increased 24-h urinary protein as independent risk factors for adverse pregnancy outcomes in PE patients(P<0.05).The area under the curve(AUC)for D-D and 24-h urinary protein in predicting adverse outcomes were 0.738(95%CI:0.642-0.833)and 0.775(95%CI:0.666-0.883),respectively;the combined predictor yielded an AUC of 0.889(95%CI:0.813-0.965),which was significantly higher than either single marker alone(Z=3.022,2.234,P<0.05).Conclusion Patients with PE frequently show abnor-malities in platelet and coagulation-fibrinolysis markers.Combined assessment of D-dimer and 24-h urinary protein has high predictive value for adverse pregnancy outcomes in PE.