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Second-Third Trimester Aspartate Aminotransferase to Platelet Ratio Index in Predicting in Intrahepatic Cholestasis of Pregnancy and its Relationship with Neoanatal Intensive Care Unit Requirement: A Case Control Study From a Tertiary Hospital

Year 2023, Volume: 20 Issue: 3, 1863 - 1866, 01.10.2023
https://doi.org/10.38136/jgon.1231865

Abstract

Aim: To evaluate the aspartate aminotransferase platelet ratio index (APRI) score in the prediction of intrahepatic cholestasis (ICP) in the second-third trimester of pregnancy.
Material and Methods: The patient group (n=40) and control group (n=70) diagnosed with ICP who applied to the hospital Perinatology clinic between 2021-2022 were included in this study. Laboratory tests of both groups were analyzed retrospectively. Age, gravida, parity, body mass index, third trimester laboratory tests and first trimester aspartate aminotransferase (AST)/platelet count ratio [AST - platelet ratio index (APRI) score] APRI scores were compared between the two groups. The relationship between APRI score index and neonatal outcomes was evaluated in the study group.In the study, the cut-off value of the APRI score was determined for predicting ICP in second-third trimester in pregnant women.
Results: Patients with ICP had significantly higher APRI scores compared with controls (p <0.001). In the ROC analysis, the cut-off value for APRI score to predicting ICP in second-third trimester was 0.092 with 78 % sensitivity and 79 % specificity. Spearman’s correlation indicated that there was a significant positive association between APRI score and neonatal intensive care unit (NICU) requirement in the study group (p=0.022). The demographic characteristics of patients did not differ, except for aspartateamino transferase and alanine transferase values.
Conclusions: APRI score may be used in the prediction of ICP development and NICU requirement with satisfactory sensitivity and specifity. As ICP is associated with poor perinatal outcomes, this novel index may help physicians in their clinical practice to obtain more favorable outcomes.

References

  • 1. Allen AM, Kim WR, Larson JJ, Rosedahl JK, Yawn BP, McKeon K, et al. The Epidemiology of Liver Diseases Unique to Pregnancy in a US Community: A Population-Based Study. Clin Gastroenterol Hepatol. 2016;14(2):287-94.e1-2. 2. Lee R, Goodwin T, Greenspoon J, Incerpi M. The prevalence of intrahepatic cholestasis of pregnancy in a pri- marily Latina Los Angeles population. Journal of perinatology. 2006;26(9):527-32. 3. Madazli R, Yuksel M, Oncul M, Tuten A, Guralp O, Ay- din B. Pregnancy outcomes and prognostic factors in patients with intrahepatic cholestasis of pregnancy. Journal of Obstetri- cs and Gynaecology. 2015;35(4):358-61.

İkinci-Üçüncü Trimesterde Aspartat Aminotransferaz Trombosit Oranı İndeksinin Gebeliğin İntrahepatik Kolestazı Öngörmesi ve İndeksin Yenidoğan Yoğun Bakım Gereksinimi ile İlişkisi: Üçüncü Basamak Bir Hastaneden Vaka Kontrol Çalışması

Year 2023, Volume: 20 Issue: 3, 1863 - 1866, 01.10.2023
https://doi.org/10.38136/jgon.1231865

Abstract

Amaç: Gebeliğin ikinci-üçüncü trimesterinde intrahepatik kolestaz (ICP) öngörüsünde aspartat aminotransferaz trombosit oranı indeksi (APRI) skorunu değerlendirmek.
Gereçler ve Yöntem: Bu çalışmaya 2021-2022 yılları arasında hastanemiz Perinatoloji kliniğinde değerlendirilen İCP tanılı hasta grubu (n=40) ve kontrol grubu (n=70) dahil edildi. Her iki grubun laboratuvar testleri retrospektif olarak incelendi. İki grup arasında yaş, gravida, parite, vücut kitle indeksi, üçüncü trimester laboratuvar testleri ve birinci trimester aspartat aminotransferaz (AST)/trombosit sayısı [AST - trombosit oran indeksi (APRI) skoru] skorları karşılaştırıldı. Çalışma grubunda APRI skor indeksi ile neonatal sonuçlar arasındaki ilişki değerlendirildi. Çalışmada gebelerde ikinci-üçüncü trimesterde ICP'yi öngörmede APRI skorunun cut-off değeri belirlendi.
Bulgular: ICP'li hastalarda kontrol grubu ile karşılaştırıldığında anlamlı olarak daha yüksek APRI skorları vardı (p <0.001). ROC analizinde, APRI skorunun ikinci-üçüncü trimesterde ICP'yi öngörme kesme değeri, %78 duyarlılık ve %79 özgüllük ile 0,092 idi. Spearman korelasyonu, çalışma grubunda APRI skoru ile yenidoğan yoğun bakım ünitesi (YYBÜ) gereksinimi arasında anlamlı pozitif bir ilişki olduğunu gösterdi (p=0.022). Hastaların demografik özellikleri benzerdi.
Sonuç: APRİ skoru,gebeliğin intrahepatik kolestazında ve YYBÜ gereksiniminin tahmininde tatmin edici duyarlılık ve özgüllük ile kullanılabilir.Gebeliğin intrahepatik kolestazı olumsuz perinatal sonuçlarla ilişkili olduğundan, bu indeks klinik uygulamalarda daha olumlu sonuçlar elde etmeleri için hekimlere yardımcı olabilir.

References

  • 1. Allen AM, Kim WR, Larson JJ, Rosedahl JK, Yawn BP, McKeon K, et al. The Epidemiology of Liver Diseases Unique to Pregnancy in a US Community: A Population-Based Study. Clin Gastroenterol Hepatol. 2016;14(2):287-94.e1-2. 2. Lee R, Goodwin T, Greenspoon J, Incerpi M. The prevalence of intrahepatic cholestasis of pregnancy in a pri- marily Latina Los Angeles population. Journal of perinatology. 2006;26(9):527-32. 3. Madazli R, Yuksel M, Oncul M, Tuten A, Guralp O, Ay- din B. Pregnancy outcomes and prognostic factors in patients with intrahepatic cholestasis of pregnancy. Journal of Obstetri- cs and Gynaecology. 2015;35(4):358-61.
There are 1 citations in total.

Details

Primary Language English
Subjects Obstetrics and Gynaecology
Journal Section Research Articles
Authors

Bedri Sakcak 0000-0003-0277-5072

Ramazan Denizli 0000-0003-1128-7169

Nihat Farisoğulları 0000-0002-7767-0657

Göksun İpek 0000-0001-8663-8053

Özgür Kara 0000-0002-4204-0014

Atakan Tanacan 0000-0001-8209-8248

Dilek Sahin 0000-0001-8567-9048

Publication Date October 1, 2023
Submission Date January 13, 2023
Acceptance Date July 23, 2023
Published in Issue Year 2023 Volume: 20 Issue: 3

Cite

Vancouver Sakcak B, Denizli R, Farisoğulları N, İpek G, Kara Ö, Tanacan A, Sahin D. Second-Third Trimester Aspartate Aminotransferase to Platelet Ratio Index in Predicting in Intrahepatic Cholestasis of Pregnancy and its Relationship with Neoanatal Intensive Care Unit Requirement: A Case Control Study From a Tertiary Hospital. JGON. 2023;20(3):1863-6.