Assessing the transaminase complex-platelet ratio (TACPR) and the platelet-albumin ratio (PAR) as composite biomarkers in severe preeclampsia

Aim: To evaluate the clinical significance of the transaminase complex-platelet ratio (TACPR) and the platelet-albumin ratio (PAR) in predicting obstetric and perinatal outcomes among women with severe preeclampsia (PE). Material and Methods: A retrospective study was conducted at Ankara Bilkent City Hospital, including 60 pregnant women diagnosed with severe PE and 120 gestational age-matched healthy controls. TACPR was calculated as (AST×ALT)/PLT count, and PAR as PLT/Albumin. Clinical, laboratory, and perinatal outcomes were compared between groups. ROC curve analysis was used to assess the predictive performance of TACPR for preterm birth. Subgroup analysis was performed based on proteinuria severity (spot urine 0.05). TACPR was significantly elevated in severe PE cases (p < 0.05), while PAR did not differ significantly (p > 0.05). Severe PE was associated with significantly higher rates of preterm birth, low birth weight (LBW), and NICU admission (p < 0.001). ROC analysis identified a TACPR cut-off of 0.86 for predicting preterm birth (AUC = 0.701, sensitivity 63.6%, specificity 63.2%). Among severe PE patients, those with ≥+2 proteinuria exhibited higher blood pressures, creatinine, and albumin levels, along with increased rates of preterm birth and LBW. However, TACPR and PAR did not significantly differ across proteinuria levels. Conclusion: TACPR is a novel and accessible composite biomarker that correlates with adverse perinatal outcomes in severe PE. Its integration into clinical assessment could enhance risk stratification. PAR showed limited utility near delivery. Further multicenter prospective studies are warranted.