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Hypertension

Poster Session 4

(1010) The relationship between platelets indices and hypertensive disorders of pregnancy

Wednesday, February 14, 2024
1:00 PM – 2:30 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective:

The underlying mechanism of hypertensive disorders of pregnancy (HDP) is unclear. Aspirin, a well-known platelet function inhibitor, is indicated in high-risk pregnancies for the prevention of preeclampsia. We sought to investigate the relationship between platelet indices (count, size, and production/immaturity) and HDP.


Study Design:

This was a prospective cohort of pregnant participants followed from the 1st trimester between 2/2022 to 6/2022. Routine platelet indices obtained prospectively during prenatal care and delivery were compared between those who developed HDP and those who did not. We assessed platelet count (by trimester), mean platelet volume (MPV, an assessment of platelet size), and immature platelet function (IPF, an assessment of platelet production/immaturity) measured as percent (%) and absolute count. Platelet indices are presented as median (25th,75th %ile) and compared between groups via Mann-Whitney U test. Data are presented as adjusted odds ratio (95% CI) following multivariable logistic regression.


Results:

Overall, 78 of 459 (17.0%) developed HDP. While age and race/ethnicity did not differ, obesity (29.5% v. 13.6%, p< 0.01) and chronic hypertension (12.8% v. 5.8%, p< 0.05) were more frequent in those who developed HDP. There was no significant difference in platelet count in the 1st trimester, 2nd trimester, or at delivery in those with or without HDP. In contrast, people who developed HDP had higher MPV (11.7 fL [10.8,12.4] v. 11.1 fL [10.5,12.0], P<sub>adj=0.005), IPF% (7.3% [4.9,10.7] v. 5.9% [4.2,9.2], P<sub>adj=0.025), and absolute IPF (16.4 x109 [11.2,20.4] v. 13.3 x109 [9.3,17.4], P<sub>adj=0.022) than those without. When stratified by the median, the prevalence and adjusted odds of HDP increased with increasing MPV, IPF (%), and absolute IPF. (Figure)


Conclusion:

Platelet indices of size and production/immaturity were significantly increased in those with HDP, suggesting that platelets play an important role in HDP development. These data support further investigation into platelet activity and the role of targeting platelets with aspirin to prevent HDP.