Abstract
Background
Threatened miscarriage is one of the most common complications of early pregnancy and remains a major clinical challenge because currently available clinical, ultrasonographic, and laboratory markers have limited ability to predict subsequent pregnancy loss. The immature platelet fraction (IPF), a readily available indicator of thrombopoietic activity, has recently emerged as a potential dynamic biomarker in several inflammatory and vascular disorders. However, its longitudinal behavior during early pregnancy has not been adequately investigated.
Objective
To evaluate whether serial changes in IPF during the first week after presentation are associated with spontaneous abortion in women presenting with threatened miscarriage.
Methods
This prospective cohort study included 150 women with singleton viable intrauterine pregnancies between 6 and 12 weeks of gestation who presented with vaginal bleeding and a closed cervix. Venous blood samples were obtained at presentation (T0), 48 h (T1), and one week (T2). Participants were followed until 20 weeks of gestation, and pregnancy outcomes were recorded as continuation or spontaneous abortion. Longitudinal changes in IPF were evaluated using repeated‐measures statistical methods. Receiver operating characteristic (ROC) analysis was performed to assess the predictive performance of serial IPF measurements.
Results
Thirty women (20%) experienced spontaneous abortion before 20 weeks of gestation. Baseline IPF values were comparable between the spontaneous abortion and pregnancy continuation groups (median 2.40% vs. 2.35%;
p
= 0.785). In contrast, serial measurements demonstrated significantly different temporal patterns between the groups (time‐by‐group interaction,
p
Conclusions
Longitudinal assessment of IPF provides substantially greater prognostic information than a single baseline measurement in women presenting with threatened miscarriage. Serial IPF monitoring may represent a simple, inexpensive, and promising adjunctive biomarker for early risk stratification. External validation in larger multicenter cohorts is warranted before routine clinical implementation.