Gestational Age at Delivery Is an Independent Predictor of Neonatal Outcome for Maternal HELLP Syndrome
Abstract Hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome is a severe complication of preeclampsia (PE), with a higher incidence rate in people living at high altitudes, such as Tibet area. Maternal HELLP syndrome is associated with an elevated neonatal mortality rate. The purp...
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Wiley
2025-01-01
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| Series: | The Journal of Clinical Hypertension |
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| Online Access: | https://doi.org/10.1111/jch.70007 |
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| author | Yan Shi Xiaoli Yang Chengqin Wang Luosong Zhuoga Dongmei Xu |
| author_facet | Yan Shi Xiaoli Yang Chengqin Wang Luosong Zhuoga Dongmei Xu |
| author_sort | Yan Shi |
| collection | DOAJ |
| description | Abstract Hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome is a severe complication of preeclampsia (PE), with a higher incidence rate in people living at high altitudes, such as Tibet area. Maternal HELLP syndrome is associated with an elevated neonatal mortality rate. The purpose of this study was to investigate the predicting factors for neonatal outcomes with maternal HELLP syndrome. We collected 49 PE with HELLP cases and stratified them into the Survival Group (n = 28) and Death Group (n = 21) based on the neonatal outcomes. We compared the basic characteristics and laboratory indicators using the Student's t‐test or the Mann–Whitney U test, followed by univariate and multivariate logistic regression analysis to detect the independent predicting factors for neonatal outcomes. Subsequently, we performed the receiver operating characteristics (ROC) analysis to predict the prognostic power of the variables with a cutoff value. The results indicated that levels of neutrophil‐to‐lymphocyte ratio (NLR), serum creatinine (Scr), lactic dehydrogenase (LDH), and brain natriuretic peptide (BNP) were significantly elevated, while gestational age (GA) at delivery and alkaline phosphatase (AP) level was significantly decreased in the Death Group. The multivariate regression analysis indicated that only GA at delivery was able to predict the neonatal outcome. The cutoff value was 32.6 weeks on the ROC curve, with both 85.7% sensitivity and 85.7% specificity (AUC: 0.927, 95% CI: 0.856–0.998, p < 0.001). Thus, it was concluded that GA at delivery less than 32.6 weeks was an independent predictor of neonatal death for maternal HELLP syndrome. |
| format | Article |
| id | doaj-art-fa7b698b0787451594872c4d6844576d |
| institution | Kabale University |
| issn | 1524-6175 1751-7176 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
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| series | The Journal of Clinical Hypertension |
| spelling | doaj-art-fa7b698b0787451594872c4d6844576d2025-01-31T05:38:37ZengWileyThe Journal of Clinical Hypertension1524-61751751-71762025-01-01271n/an/a10.1111/jch.70007Gestational Age at Delivery Is an Independent Predictor of Neonatal Outcome for Maternal HELLP SyndromeYan Shi0Xiaoli Yang1Chengqin Wang2Luosong Zhuoga3Dongmei Xu4Department of Obstetrics and Gynecology Women and Children's Hospital of Chongqing Medical University Chongqing ChinaDepartment of Obstetrics and Gynecology People's Hospital of Qamdo City Tibet ChinaDepartment of Obstetrics and Gynecology People's Hospital of Qamdo City Tibet ChinaDepartment of Obstetrics and Gynecology People's Hospital of Qamdo City Tibet ChinaDepartment of Obstetrics and Gynecology Women and Children's Hospital of Chongqing Medical University Chongqing ChinaAbstract Hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome is a severe complication of preeclampsia (PE), with a higher incidence rate in people living at high altitudes, such as Tibet area. Maternal HELLP syndrome is associated with an elevated neonatal mortality rate. The purpose of this study was to investigate the predicting factors for neonatal outcomes with maternal HELLP syndrome. We collected 49 PE with HELLP cases and stratified them into the Survival Group (n = 28) and Death Group (n = 21) based on the neonatal outcomes. We compared the basic characteristics and laboratory indicators using the Student's t‐test or the Mann–Whitney U test, followed by univariate and multivariate logistic regression analysis to detect the independent predicting factors for neonatal outcomes. Subsequently, we performed the receiver operating characteristics (ROC) analysis to predict the prognostic power of the variables with a cutoff value. The results indicated that levels of neutrophil‐to‐lymphocyte ratio (NLR), serum creatinine (Scr), lactic dehydrogenase (LDH), and brain natriuretic peptide (BNP) were significantly elevated, while gestational age (GA) at delivery and alkaline phosphatase (AP) level was significantly decreased in the Death Group. The multivariate regression analysis indicated that only GA at delivery was able to predict the neonatal outcome. The cutoff value was 32.6 weeks on the ROC curve, with both 85.7% sensitivity and 85.7% specificity (AUC: 0.927, 95% CI: 0.856–0.998, p < 0.001). Thus, it was concluded that GA at delivery less than 32.6 weeks was an independent predictor of neonatal death for maternal HELLP syndrome.https://doi.org/10.1111/jch.70007gestational age at deliveryHELLP syndromepredicting factorspreeclampsia |
| spellingShingle | Yan Shi Xiaoli Yang Chengqin Wang Luosong Zhuoga Dongmei Xu Gestational Age at Delivery Is an Independent Predictor of Neonatal Outcome for Maternal HELLP Syndrome The Journal of Clinical Hypertension gestational age at delivery HELLP syndrome predicting factors preeclampsia |
| title | Gestational Age at Delivery Is an Independent Predictor of Neonatal Outcome for Maternal HELLP Syndrome |
| title_full | Gestational Age at Delivery Is an Independent Predictor of Neonatal Outcome for Maternal HELLP Syndrome |
| title_fullStr | Gestational Age at Delivery Is an Independent Predictor of Neonatal Outcome for Maternal HELLP Syndrome |
| title_full_unstemmed | Gestational Age at Delivery Is an Independent Predictor of Neonatal Outcome for Maternal HELLP Syndrome |
| title_short | Gestational Age at Delivery Is an Independent Predictor of Neonatal Outcome for Maternal HELLP Syndrome |
| title_sort | gestational age at delivery is an independent predictor of neonatal outcome for maternal hellp syndrome |
| topic | gestational age at delivery HELLP syndrome predicting factors preeclampsia |
| url | https://doi.org/10.1111/jch.70007 |
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