Comparative study of platelet profile in GDM and non-diabetic pregnancy in a tertiary care centre
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20263979Keywords:
Gestational diabetes mellitus, Insulin resistance, MPV, PDW, Platelet indices, P-LCR, ROC analysisAbstract
Background: Gestational diabetes mellitus (GDM) is a common metabolic complication of pregnancy associated with significant maternal and neonatal morbidity. Increasing evidence suggests that platelet activation and altered platelet indices reflect underlying inflammation and insulin resistance in GDM. Objectives were to compare platelet profile parameters between gestational diabetes mellitus and non-diabetic pregnancies and to evaluate their predictive value for GDM.
Methods: This hospital-based comparative cross-sectional study was conducted at a tertiary care centre in Puducherry among 60 pregnant women, including 30 women with GDM and 30 age-matched non-diabetic controls. Platelet parameters were analyzed using an automated hematology analyzer. Statistical analysis included independent sample t-test and ROC curve analysis.
Results: The mean platelet count was significantly lower in the GDM group (2.41±0.46×105/µl) compared to controls (2.78±0.52×105/µl; p=0.006). MPV (11.2±1.1 versus 9.6±0.9 fl; p<0.001), PDW (15.8±2.1 versus 13.6±1.7%; p<0.001), PCT (0.21±0.05 versus 0.24±0.04%; p=0.014), and P-LCR (32.4±5.6 versus 26.8±4.9%; p<0.001) were significantly higher in the GDM group. ROC curve analysis showed that MPV had the highest diagnostic accuracy (AUC 0.82; sensitivity 76.7%; specificity 80.0% at ≥10.5 fl).
Conclusions: Platelet indices are significantly altered in gestational diabetes mellitus and demonstrate good predictive value. These inexpensive hematological markers may aid in early identification and risk stratification of GDM in routine antenatal care.
References
Cunningham FG, Leveno KJ, Bloom SL, Dashe JS, Hoffman BL, Casey BM, et al. Williams Obstetrics. 25th ed. New York: McGraw-Hill; 2018.
Metzger BE, Buchanan TA, Coustan DR, de Leiva A, Dunger DB, Hadden DR, et al. Summary and recommendations of the Fifth International Workshop-Conference on Gestational Diabetes Mellitus. Diabetes Care. 2007;30(Suppl 2):S251-60.
Conrad KP, Davison JM. The renal circulation in normal pregnancy and preeclampsia. Is it altered? Am J Physiol Renal Physiol. 2014;306(10):F1121-35.
Lurie S. Changes in leukocyte count during pregnancy and labor. Isr Med Assoc J. 2000;2(4):243-6.
Bath PM, Butterworth RJ. Platelet size and vascular disease. Blood Coagul Fibrinolysis. 1996;7(2):157-61.
Leader A, Pereg D, Lishner M. Are platelet volume indices of clinical use? Ann Med. 2012;44(8):805-16.
Davi G, Falco A, Patrono C. Platelet activation in diabetes mellitus. Thromb Haemost. 2005;93(4):707-16.
Sak ME, Soydinç HE, Özler A, Evsen MS, Turgut A, Sak S, Gül T. Platelet profile in patients with gestational diabetes: a retrospective study. J Turk Ger Gynecol Assoc. 2012;13(4):259-63.
Zhou Z, Chen H, Sun M, Ju H. Mean platelet volume and gestational diabetes mellitus: a systematic review and meta‐analysis. J Diabetes Res. 2018;2018(1):1985026.
Seshiah V, Balaji V, Balaji MS, Sanjeevi CB, Green A. Gestational diabetes mellitus in India. J Assoc Phys India. 2004;52:707-11.
Metzger BE, Gabbe SG, Persson B, Buchanan TA, Catalano PA, Damm P, et al. IADPSG recommendations. Diabetes Care. 2010;33(3):676-82.
Yogev Y, Langer O. Pregnancy outcome in gestational diabetes. Obstet Gynecol Clin North Am. 2004;31(4):639-50.
Brownlee M. The pathobiology of diabetic complications: a unifying mechanism. Diabetes. 2005;54(6):1615-25.
Kodiatte TA, Manikyam UK, Rao SB, Jagadish TM, Reddy M, Lingaiah HK. Mean platelet volume in type 2 diabetes mellitus. J Lab Phys. 2012;4(1):5-9.
Naylor CD, Sermer M, Chen E, Sykora K. Selective screening for GDM. N Engl J Med. 1997;337(22):1591-6.
Santilli F, Simeone P, Liani R, Davì G. Platelets and diabetes mellitus. Prostaglandins Other Lipid Mediat. 2015;120:28-39.
Brownlee M. The pathobiology of diabetic complications: a unifying mechanism. Diabetes. 2005;54(6):1615-25.
Ferreira IA, Mocking AI, Feijge MA, Gorter G, van Haeften TW, Heemskerk JW. Platelet inhibition by insulin is absent in type 2 diabetes mellitus. Arterioscler Thromb Vasc Biol. 2006;26(2):417-22.
Catalano PM, Tyzbir ED, Roman NM, Amini SB, Sims EA. Longitudinal changes in insulin release. Am J Obstet Gynecol. 1991;165(6 Pt 1):1667-72.
Kim C, Newton KM, Knopp RH. Gestational diabetes and future diabetes. Diabetes Care. 2002;25(10):1862-8.
Buchanan TA, Xiang AH. Gestational diabetes mellitus. J Clin Invest. 2005;115:485-91.
Catalano PM, Shankar K. Obesity and pregnancy. BMJ. 2017;356:j1.
Damm P. Gestational diabetes mellitus and later development of type 2 diabetes. Diabetes Care. 1998;212):B25-9.
Kwak SH, Kim HS, Choi SH, Lim S, Cho YM, Park KS, et al. Genetic variants and risk of GDM. Diabetes. 2012;61(6):1434-40.
Kirwan JP, Hauguel-De Mouzon S, Lepercq J, Challier JC, Huston-Presley L, Friedman JE, et al. TNF-alpha and insulin resistance in pregnancy. Diabetes. 2002;51(7):2207-13.
Plows JF, Stanley JL, Baker PN, Reynolds CM, Vickers MH. Placental dysfunction and GDM. J Physiol. 2018;596(8):1515-30.
Fasshauer M, Blüher M, Stumvoll M. Adipokines in pregnancy. Exp Clin Endocrinol Diabetes. 2014;122(7):362-8.
Coughlan MT, Vervaart PP, Permezel M, Georgiou HM, Rice GE. Placental oxidative stress in GDM. Placenta. 2004;25(1):78-84.
HAPO Study Cooperative Research Group. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008;358(19):1991-2002.
Yogev Y, Langer O. Pregnancy outcome in gestational diabetes. Obstet Gynecol Clin North Am. 2004;31(4):639-50.
Casey BM, Lucas MJ, McIntire DD, Leveno KJ. Pregnancy outcomes in women with GDM. Am J Obstet Gynecol. 1997;176(4):790-7.
Boehlen F, Hohlfeld P, Extermann P, Perneger TV, de Moerloose P. Platelet count at term pregnancy. Obstet Gynecol. 2000;95(1):29-33.
Bremme KA. Hemostatic changes in pregnancy. Best Pract Res Clin Hematol. 2003;16(2):153-68.
Burrows RF, Kelton JG. Thrombocytopenia at delivery. Am J Obstet Gynecol. 1990;162(3):731-4.
Hellgren M. Hemostasis during normal pregnancy and puerperium. Semin Thromb Hemost. 2003;29(2):125–30.
Redman CW, Sargent IL. Inflammation in pregnancy. Am J Reprod Immunol. 2003;49(3):155-62.
Pritchard JA, Cunningham FG, Mason RA. Coagulation changes in preeclampsia. Am J Obstet Gynecol. 1976;126(7):851-7.
Leader A, Pereg D, Lishner M. Are platelet volume indices of clinical use? Ann Med. 2012;44(8):805-16.
Davi G, Falco A, Patrono C. Platelet activation in diabetes mellitus. Thromb Haemost.2005;93(4):707-16.
Vagdatli E, Gounari E, Lazaridou E, Katsibourlia E, Tsikopoulou F, Labrianou I. Platelet distribution width. Hippokratia. 2010;14(1):28-32.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Sandhiya Kirubanandan, Hiremath P. B., Balaji S.

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.