Evaluation of the APRI score and blood-count-derived inflammatory markers in patients with preeclampsia

This study aimed to evaluate the clinical significance of the Aspartate Aminotransferase to Platelet Ratio Index (APRI) score and blood-count-derived inflammatory markers in patients with preeclampsia. This retrospective study included pregnant women diagnosed with preeclampsia, gestational hypertension, and healthy controls. Demographic, perinatal, hematological, and biochemical parameters were analyzed. Inflammatory markers, including Neutrophil-to-Lymphocyte Ratio (NLR), Monocyte-to-Lymphocyte Ratio (MLR), Platelet-to-Lymphocyte Ratio (PLR), Systemic Immune-Inflammation Index (SII), and APRI score, were compared among the study groups. ROC analysis was performed to assess the diagnostic discriminatory performance of these markers in diagnosing preeclampsia. The APRI score was significantly higher in the preeclampsia group compared to the control and gestational hypertension groups (p = 0.004), suggesting potential hepatic involvement in preeclampsia. In contrast, no statistically significant differences were found among the groups for NLR (p = 0.106), MLR (p = 0.593), PLR (p = 0.319), and SII (p = 0.247). Hematological and biochemical analysis revealed that AST, BUN, and creatinine levels were significantly elevated in the preeclampsia group (p < 0.001), consistent with hepatic and renal involvement. However, platelet counts and hemoglobin levels did not show significant differences among the groups. ROC analysis demonstrated that the APRI score had poor diagnostic discriminatory performance (AUC = 0.437, p = 0.128), and similarly, other inflammatory markers, including NLR (AUC = 0.539), MLR (AUC = 0.554), PLR (AUC = 0.552), and SII (AUC = 0.507), also failed to exhibit significant diagnostic accuracy. Although the APRI score was elevated in preeclamptic patients, ROC analysis indicated poor discriminatory performance, suggesting that APRI does not provide meaningful diagnostic accuracy when used alone. Further prospective studies with larger populations are needed to explore its potential role in clinical practice.