Role of coagulation indices in assessinghypertensive disorders in pregnancy and predicting delivery outcomes.

Abstract

To investigate the role of coagulation indices in assessing the severity of hypertensive disorders in pregnancy (HDP) and their predictive value for delivery outcomes. A retrospective analysis was conducted on clinical data from 54 pregnant women with HDP who delivered at Zhoushan Hospital between June 2013 and June 2023. A control group of 42 healthy pregnant women from the same period was also included. In the HDP group, activated partial thromboplastin time (APTT) and prothrombin time (PT) were significantly lower, while D-Dimer (D-D) levels were significantly higher compared to the control group (all P < 0.01). Receiver operating characteristic (ROC) curve analysis showed that the areas under the curve (AUC) for APTT, D-D, PT, and the combined assay were 0.886, 0.813, 0.830, and 0.960, respectively (all P < 0.001). The combined assay demonstrated higher predictive efficacy for HDP than that of any single assay (all P < 0.05). Furthermore, APTT, D-D, and PT showed strong correlations with systolic blood pressure and 24-hour urinary protein levels in HDP patients (all P < 0.001), indicating the corresponding HDP severity. For prediction of adverse birth outcomes (ABO), APTT, D-D, PT, and the combined test all had high predictive value (all P < 0.01). The incidence of ABO, especially neonatal ABO, increased significantly when these coagulation indices (except APTT) were at their optimal cut-off points (P < 0.05). The combined testing of APTT, D-D, and PT provides high predictive efficacy for both HDP and ABO and is closely associated with the severity of HDP.