A Comparative Study of Immature Platelet Fraction, Mean Platelet Volume and Aspartate Aminotransferase to Platelet Ratio Index Score in Pre-eclampsia and Normotensive Pregnant Women

Abstract Background: Hypertensive disorders during pregnancy, particularly preeclampsia, remain a leading cause of maternal and fetal morbidity and mortality worldwide. Despite advances in diagnostic modalities, simple and cost-effective markers for early detection and severity assessment are needed. This study aimed to evaluate the clinical utility of Immature Platelet Fraction (IPF), Mean Platelet Volume (MPV), and Aspartate Aminotransferase to Platelet Ratio Index (APRI) as potential biomarkers in preeclampsia. Methods: A prospective, observational comparative study was conducted on 320 pregnant women (160 preeclamptic and 160 normotensive controls) at SMS Medical College, Jaipur. Hematological parameters including IPF, MPV, and APRI were assessed at two time points: at recruitment and prior to delivery. Data were analyzed using SPSS v29.0, with a p-value <0.05 considered statistically significant. Results: IPF, MPV, and APRI levels were significantly higher in the preeclampsia group compared to normotensive controls at both assessment points (p<0.05). While intragroup differences over time were not statistically significant, these parameters consistently remained elevated in preeclamptic women. Further, severe preeclampsia cases demonstrated significantly higher IPF (12.59 ± 2.91 vs. 11.02 ± 2.42; p=0.02), MPV (8.09 ± 0.167 vs. 7.83 ± 0.11; p=0.01), and APRI (2.9 ± 1.81 vs. 2.13 ± 1.77; p=0.04) compared to mild cases. In patients with HELLP syndrome, MPV was notably elevated, with a non-significant rising trend in IPF. Conclusion: IPF, MPV, and APRI are significantly associated with the presence and severity of preeclampsia and may serve as reliable, cost-effective supplementary markers for its early detection and risk stratification. Their inclusion in routine antenatal evaluations could enhance clinical decision-making and improve maternal-fetal outcomes.