Association of Liver and Renal Function Parameters, Platelet Count and Lactate Dehydrogenase with Severity of Hypertensive Disorders of Pregnancy: A Prospective Observational Study

Abstract

Background: Hypertensive disorders of pregnancy are multisystem conditions in which hepatic injury, renal dysfunction, thrombocytopenia and tissue injury may accompany increasing clinical severity. Simple laboratory parameters may therefore provide useful information during maternal assessment.

Objectives: To evaluate the association of liver function parameters, renal function parameters, platelet count and lactate dehydrogenase (LDH) with severity of hypertensive disorders of pregnancy.

Methods: This prospective observational study included 50 pregnant women with hypertensive disorders of pregnancy. Women were classified as having mild (n=28) or severe disease (n=22) according to the severity category recorded clinically. Demographic, blood pressure and laboratory variables were analysed. Because several variables were non-normally distributed, between-group comparisons used the Mann-Whitney U test. Spearman rank correlation was used to examine the association between laboratory parameters and an ordinal severity code.

Results: Severe disease was associated with markedly higher median AST, ALT, ALP, total bilirubin, urea, creatinine, uric acid and LDH, together with lower albumin and platelet count (all p<0.001). Median LDH increased from 213.0 (185.0-236.2) in mild disease to 764.0 (712.8-1072.5) in severe disease, while platelet count decreased from 205.0 (194.2-225.0) to 76.5 (65.8-84.8). Creatinine increased from 0.6 (0.6-0.7) to 1.6 (1.4-2.0). Each laboratory parameter showed a strong rank association with the recorded severity category, with absolute Spearman rho values ranging from 0.860 to 0.880 (all p<0.001).

Conclusion: In this cohort, severe hypertensive disease was accompanied by a consistent biochemical pattern of hepatic injury, renal impairment, thrombocytopenia and elevated LDH. These routinely available parameters may support clinical assessment of disease severity, although larger studies with multivariable adjustment are required before defining independent prognostic thresholds.