# Can aspartate aminotransferase and platelet distribution width-to-platelet ratio in the first trimester predict fetal macrosomia?: a retrospective case-control study

## TL;DR

This study explores whether early pregnancy blood markers can predict large baby size at birth.

## Contribution

It identifies aspartate aminotransferase and platelet distribution width-to-platelet ratio as potential early predictors of fetal macrosomia.

## Key findings

- Higher aspartate aminotransferase and platelet distribution width-to-platelet ratio levels were found in mothers of larger babies.
- Cutoff values for these markers showed potential for use in screening tests.
- The study suggests these markers may reflect an unbalanced inflammatory process linked to fetal macrosomia.

## Abstract

The aim of this study was to investigate the performance of aspartate aminotransferase level and platelet distribution width-to-platelet ratio as predictive factors for fetal macrosomia in the first trimester.

This retrospective case-control study was conducted between August 2017 and August 2020. The data of the study group as Group I (n=426) and the control group as Group II (n=426) were collected and compared by scanning the records. For each patient who was eligible for Group I, the first patient from the file review who met the criteria listed in the inclusion/exclusion section was selected for Group II. Aspartate aminotransferase levels and serum platelet distribution width-to-platelet ratio levels were determined in the first trimester using the participants’ medical records. The study parameters of the two groups were statistically compared.

The median aspartate aminotransferase, platelet, platelet distribution width, and platelet distribution width-to-platelet ratio values of the laboratory test results in the first trimester were significantly different. The aspartate aminotransferase and platelet distribution width-to-platelet ratio values were higher in Group I.

Higher aspartate aminotransferase and platelet distribution width-to-platelet ratio levels in the maternal blood sample in the first trimester indicate an unbalanced inflammatory process causing fetal macrosomia. The cutoff values for aspartate aminotransferase (>21 U/L) at 94% specificity and for platelet distribution width-to-platelet ratio (>0.19) at 51% specificity can be used as markers for a screening test. However, randomized controlled trials combining body mass index and the parameters in the present study are needed in future studies.