Analysis of changes in platelet parameters and inflammatory markers in intrahepatic cholestasis of pregnancy before disease development.

Abstract

Background: Intrahepatic cholestasis of pregnancy (ICP) is the most common liver condition during pregnancy, associated with adverse outcomes for both mother and fetus. While inflammatory markers are important predictors in oncology and cardiovascular disease, their role in ICP remains unclear. This study investigates changes in platelet parameters and blood-derived inflammatory markers around the onset of ICP and evaluates their potential as independent risk factors.

Methods: This retrospective study analyzed inflammatory markers, including the Neutrophil-to-Lymphocyte Ratio (NLR), Derived NLR (dNLR), Monocyte-to-Lymphocyte Ratio (MLR), Neutrophil-Monocyte-to-Lymphocyte Ratio (NMLR), Systemic Inflammation Response Index (SIRI), and Systemic Immune-Inflammation Index (SII) along with variations in platelet parameters in 49 ICP patients and 250 healthy controls during late pregnancy, specifically at disease onset. Additionally, changes in these parameters were assessed among the same 49 ICP patients compared to 1439 healthy controls during early pregnancy.

Results: During an episode of ICP, individuals exhibited increased platelet parameters, including PCT, P-LCR, PDW and MPV, compared to those with uncomplicated pregnancies. The levels of WBC, NEUT, NLR, dNLR, NMLR, SIRI, and SII were also elevated in the ICP group relative to the control group. Prior to disease onset, platelet parameters such as PCT and PDW, along with inflammatory markers including NEUT, NLR, NMLR, SIRI, and SII, were significantly higher in ICP patients. Additionally, a notable increase in HGB, HCT, MCV, MCH, and RDW-CV was observed in the ICP group, while MCHC was decreased. Logistic regression analysis identified MCV, PDW and SII as risk factors for developing ICP.

Conclusions: PCT, PDW, NEUT, NLR, NMLR, SIRI, and SII levels were significantly elevated both before and during the progression of ICP. Notably, MCV, PDW, and SII were identified as independent risk factors, representing new predictive indicators for the development of ICP.