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Meta-Analysis
. 2022 Sep 14;17(9):e0274398.
doi: 10.1371/journal.pone.0274398. eCollection 2022.

Preeclampsia has an association with both platelet count and mean platelet volume: A systematic review and meta-analysis

Muluken Walle  1 , Yemataw Gelaw  2 , Fasil Getu  1 , Fikir Asrie  2 , Zegeye Getaneh  2
Affiliations
Meta-Analysis

Preeclampsia has an association with both platelet count and mean platelet volume: A systematic review and meta-analysis

Muluken Walle et al. PLoS One. .

Abstract

Background: Preeclampsia (PE) is a pregnancy-specific disorder characterized by endothelial dysfunction, and activation of the coagulation system. Alteration of PLT parameters is the common hematological abnormality observed in women with PE. The main aim of this study was to systematically review previous studies from around the world to generate evidence about the relationship between platelet count (PC) and PE, as well as mean platelet volume (MPV) and PE, by calculating the pooled weighted mean difference (WMD) of PC and MPV between PE and normotensive (NT) groups.

Methods: Relevant articles which were published in the English language from January 10, 2011, to January 10, 2021, were systematically searched through PubMed, Web of Science, and African journals online. In addition, reference probing of published articles searching was employed through Google Scholar and Google for searching grey literature. The methodological qualities of articles were assessed using Joana Brigg's institute critical appraisal checklist. A random-effects model was used to estimate pooled WMD of PLT parameters between the two groups with the respective 95% confidence intervals (CI) using Stata version 11.0. The I2 statistics and Egger's regression test were used to assess heterogeneity and publication bias among included studies, respectively.

Results: A total of 25 articles were included in this systematic review and meta-analysis. Of which, 23 studies were used in each PC and MPV analysis. The overall pooled WMD of PC and MPV between PE and NT groups were -41.45 × 109/L [95% CI; -51.8, -31.0] and 0.98 fl [95% CI; 0.8, 1.1], respectively. The pooled WMD revealed that PC decreased significantly in the PE group compared to the NT group while MPV increased significantly in the PE group.

Conclusions: This systematic review and meta-analysis indicated that there is a significant decrease in PC and a significant increase in MPV during PE development among pregnant women. As a result, a change in these parameters among pregnant women may indicate the development of PE.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart to describe the selection of studies for the systematic review and meta-analysis on the association between PC and MPV with PE.
Fig 2
Fig 2. Forest plot of included studies for the pooled WMD estimate of PC between PE and NT groups.
Fig 3
Fig 3. Forest plot of included studies for the pooled WMD estimate of MPV between PE and NT groups using a random effect model.
Fig 4
Fig 4. Funnel plot for the pooled WMD estimate of PC between PE and NT groups.
Fig 5
Fig 5. Funnel plot for the pooled WMD estimate of MPV between PE and NT groups.
Fig 6
Fig 6. Forest plot of subgroup analysis for the pooled WMD estimate of PC by PE severity.
Fig 7
Fig 7. Forest plot of subgroup analysis for the pooled WMD estimate of PC by continent using random effect model.
Fig 8
Fig 8. Forest plot of subgroup analysis for the pooled WMD estimate of PC by study design using random effect model.
Fig 9
Fig 9. Forest plot of subgroup analysis for the pooled WMD estimate of MPV by PE severity using random effect model.
Fig 10
Fig 10. Forest plot of subgroup analysis for the pooled WMD estimate of MPV by continent using random effect model.
Fig 11
Fig 11. Forest plot of subgroup analysis for the pooled WMD estimate of MPV by study design using random effect model.
Fig 12
Fig 12. Sensitivity statistics of WMD analysis of PC between PE and NT groups.
Fig 13
Fig 13. Sensitivity statistics of included studies for WMD analysis of MPV.
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