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Prematurity

Poster Session 1

(364) Aspartate Aminotransferase to Platelet Ratio: Predictor of Early Preterm Delivery in Women with Preeclampsia Toxemia

Tuesday, February 13, 2024
10:30 AM – 12:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

    Primary & Presenting Author(s)

  • Lior Yahav, MD, MPH

    Soroka Medical Center
    Beer-Sheva, HaDarom, Israel

    • Coauthor(s)

  • Noa Leybovitz-Haleluya, MD (she/her/hers)

    OB/Gyn resident
    Soroka University Medical Center
    Meitar, HaDarom, Israel

  • Alla Saban, MD, MPH

    Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
    Beer Sheva, HaDarom, Israel, Israel

  • AW

    Adi Y. Weintraub, MD

    Soroka Medical Center
    Beer-Sheva, HaDarom, Israel

  • RH

    Reli Hershkovitz, MD

    Head of the Obstretics and Gynecology Division
    Soroka Medical Center
    Omer, HaDarom, Israel

  • Tamar Eshkoli, MD

    Senior
    Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
    Beer Sheva, HaDarom, Israel, Israel

Objective: Preeclampsia toxemia (PET) is one of the leading causes of maternal morbidity and mortality worldwide. Inflammatory processes have been suggested as underlying mechanisms that eventually lead to ischemia and vasoconstriction in the affected end organs. Aspartate aminotransferase-to-platelet ratio index (APRI) can be easily calculated from routine blood tests, and is associated with early inflammatory processes. However, the association between APRI, PET and its complications is not well studied. Therefore, our study aims to explore the correlation between the APRI parameter and the risk of early preterm delivery (< 34 weeks of gestation) in women with PET.

Study Design: We conducted a population-based cohort study at a tertiary medical center, including all women with singleton gestations who delivered between 2020 and 2022 and were diagnosed with PET. The exclusion criteria included women with an incomplete medical record, multiple gestations, and fetal malformations. The median APRI index of the cohort served as the cut-off point to compare the risk of preterm delivery between the low APRI index group and the high APRI index group. A multivariable logistic regression analysis was used to adjust for confounders, including parity and maternal age

Results: The study population included 513 women with PET who met the inclusion criteria. The median APRI index value of the cohort served as the cutoff point, with 255 women having an APRI index < 0.26 and 258 with an APRI index >0.26. A higher APRI index was significantly associated with an increased risk of early preterm delivery (Table 1, 15.1% vs. 9.0%; p= 0.040).  Using a multivariable logistic regression analysis, after adjusting for maternal age and parity, the association between early preterm delivery and an APRI index of >0.26 remained significant (adjusted OR 1.89, 95% CI 1.09-3.29; p=0.024, Table 2).

Conclusion:

An APRI index > 0.26 is independently associated with early preterm delivery before 34 weeks of gestation among women with PET.