Aspartate aminotransferase to platelet ratio index (APRI) score: is it useful in patients with intrahepatic cholestasis of pregnancy?

Abstract

Objective It is aimed to evaluate the efficacy of using aspartate aminotransferase (AST)/platelet count ratio [AST to platelet ratio index (APRI) score] in ICP patients. Methods This study was carried out including 101 patients diagnosed with ICP (72 patients with mild ICP and 29 patients with severe ICP). Laboratory tests and neonatal outcomes of both groups were analyzed retrospectively. APRI scores were compared between the two groups. Receiver operating characteristic (ROC) analysis was used to evaluate the performance of the APRI score in determining the severity of ICP and the prediction of adverse neonatal outcomes. p < .05 was considered to be a statistically significant result. Results Patients with severe ICP had higher APRI scores than patients with mild ICP (p < .001). The cutoff value for the APRI score was 1.06, with 82% sensitivity and 72% specificity. There was also a significant positive association between APRI score and fasting bile acid level (r = 0.445, p < .001). In addition, elevated APRI scores were associated with meconium-stained amniotic fluid, neonatal intensive care unit admission and preterm delivery. Conclusion The APRI score may not be the perfect differentiating method for the severity of ICP but it may help the clinician working with limited resources.