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

Objectives: To investigate the role of coagulation indices in assessing the severity of hypertensive disorders in pregnancy (HDP) and their predictive value for delivery outcomes.

Methods: 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.

Results: 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).

Conclusions: 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.