{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T16:07:17Z","timestamp":1779811637293,"version":"3.53.1"},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Hypertension"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    This study investigated the risk factors and adverse perinatal outcomes of severe preeclampsia complicated with HELLP (Hemolysis, Elevated Liver Enzymes, and Low Platelet Count syndrome). A total of 170 patients with severe preeclampsia and 30 healthy pregnant women admitted to Wuxi Maternal and Child Health Hospital from January 2020 to October 2023 were enrolled. Of the 170 patients, 30 were complicated by HELLP syndrome and 140 were not; 30 healthy women served as controls. Clinical data, laboratory results, and pregnancy outcomes were compared. Risk factors were analyzed by logistic regression, and predictive efficacy was evaluated by ROC curves. Maternal and neonatal outcomes were assessed, and correlations with risk factors were analyzed. Patients with severe preeclampsia had higher age, BMI, and blood pressure but lower gestational weeks than controls (\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.05). In the HELLP group, D\u2010dimer, bilirubin, liver enzymes, and lactate dehydrogenase (LDH) were significantly elevated, while platelets, albumin, and globulin were reduced compared with the non\u2010HELLP group (\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.05). Multivariate analysis identified D\u2010dimer and LDH as independent risk factors. ROC analysis showed AUCs of 0.929 for D\u2010dimer, 0.937 for LDH, and 0.956 for their combination, with cutoffs of 3.26\u00a0mg\/L and 261.60\u00a0U\/L, yielding 94.4% sensitivity and 92.6% specificity. Adverse outcomes, including stillbirth, preterm labor, neonatal asphyxia, and MICU transfer, were more frequent in HELLP patients (\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.05). Elevated D\u2010dimer and LDH correlated with fetal growth restriction and neonatal asphyxia. In conclusion, D\u2010dimer and LDH are independent predictors of HELLP syndrome and adverse perinatal outcomes.\n                  <\/jats:p>","DOI":"10.1111\/jch.70289","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T09:09:28Z","timestamp":1779354568000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk Factors and Adverse Perinatal Outcomes in Severe Preeclampsia Complicated by HELLP Syndrome"],"prefix":"10.1111","volume":"28","author":[{"given":"Chengfang","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Toxicology, School of Public Health, Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical University, China Wuxi Maternity and Child Health Care Hospital, Affiliated Women's Hospital of Jiangnan University  Wuxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaying","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Women Health Care Wuxi School of Medicine Wuxi Maternal and Child Health Hospital Jiangnan University  Wuxi Jiangsu Province PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Women Health Care Wuxi School of Medicine Wuxi Maternal and Child Health Hospital Jiangnan University  Wuxi Jiangsu Province PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Wuxi School of Medicine Wuxi Maternal and Child Health Hospital Jiangnan University  Wuxi Jiangsu Province PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minhui","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Women Health Care Wuxi School of Medicine Wuxi Maternal and Child Health Hospital Jiangnan University  Wuxi Jiangsu Province PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongqin","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Women Health Care Wuxi School of Medicine Wuxi Maternal and Child Health Hospital Jiangnan University  Wuxi Jiangsu Province PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Sang","sequence":"additional","affiliation":[{"name":"Department of Women Health Care Wuxi School of Medicine Wuxi Maternal and Child Health Hospital Jiangnan University  Wuxi Jiangsu Province PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hualong","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Toxicology, School of Public Health, Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical University, China Key Laboratory of Population Health Across Life Cycle (Anhui Medical University) Ministry of Education of The People's Republic of China  Hefei Anhui China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaling","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Toxicology, School of Public Health, Anhui Medical University, China; Wuxi Maternity and Child Health Care Hospital Affiliated Women's Hospital of Jiangnan University  Wuxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cnc.2022.04.009"},{"key":"e_1_2_12_3_1","first-page":"17","article-title":"Management of Pregnancy Complicated With HELLP Syndrome","volume":"1","author":"Yang Z.","year":"2012","journal-title":"Chinese Journal of Obstetric Emergency (Electronic Edition)"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16225"},{"issue":"6","key":"e_1_2_12_5_1","first-page":"1007","article-title":"Difficulties and Dilemmas in the Management of Hypertensive Disorders in Pregnancy: Interpretation of the Guidelines for the Diagnosis and Treatment of Hypertensive Disorders in Pregnancy (2020)","volume":"53","author":"Lin J. H.","year":"2022","journal-title":"Journal of Sichuan University (Medical Science Edition)"},{"key":"e_1_2_12_6_1","first-page":"899","article-title":"Management of HELLP Syndrome","volume":"38","author":"Yuan L.","year":"2022","journal-title":"Journal of Practical Obstetrics and Gynecology"},{"key":"e_1_2_12_7_1","first-page":"15","article-title":"Early Warning and Management of Severe Complications in Severe Preeclampsia","volume":"13","author":"Zhang Y. P.","year":"2021","journal-title":"Chinese Journal of Family Planning and Obstetrics and Gynecology"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina58020326"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/17511437211025410"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.859180"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000126245.35811.2a"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2017.08.010"},{"key":"e_1_2_12_13_1","first-page":"48","article-title":"Expression Differences of Plasma D\u2010dimer in Normal Pregnancy and in Pregnant Women With Hypertensive Disorders","volume":"24","author":"Guo B. J.","year":"2020","journal-title":"Chinese Journal of Experimental Diagnosis"},{"issue":"2","key":"e_1_2_12_14_1","first-page":"1150","article-title":"Predictive Value of Coagulation Function and D\u2010Dimer for Pregnancy Outcome in Pregnancy\u2010Induced Hypertension","volume":"15","author":"Zhang Y.","year":"2023","journal-title":"American Journal of Translational Research"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2012.09.026"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.4103\/1735-1995.193170"},{"key":"e_1_2_12_17_1","first-page":"264","article-title":"Diagnosis and Treatment of Preeclampsia Complicated With HELLP Syndrome and Microvascular Lesions","volume":"28","author":"Xiao M.","year":"2012","journal-title":"Chinese Journal of Practical Gynecology and Obstetrics"},{"key":"e_1_2_12_18_1","first-page":"881","article-title":"Physiological Changes of the Liver During Pregnancy and Interpretation of Biochemical Indicators","volume":"38","author":"Zhang Q. J.","year":"2022","journal-title":"Journal of Practical Obstetrics and Gynecology"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.118.11211"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2017.1359528"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijabmr.ijabmr_626_22"},{"key":"e_1_2_12_22_1","first-page":"388","article-title":"Clinical Analysis of 66 Cases of Pregnancy Complicated With HELLP Syndrome","volume":"28","author":"He F.","year":"2012","journal-title":"Chinese Journal of Practical Gynecology and Obstetrics"},{"key":"e_1_2_12_23_1","first-page":"1217","article-title":"Predictive Value of Prenatal Plasma D\u2010dimer Levels for Adverse Pregnancy Outcomes","volume":"14","author":"Wei H. T.","year":"2021","journal-title":"Chinese Journal of Clinical New Medicine"},{"issue":"1","key":"e_1_2_12_24_1","first-page":"S83","article-title":"Sensitivity, Specificity, Receiver\u2010operating Characteristic (ROC) Curves and Likelihood Ratios: Communicating the Performance of Diagnostic Tests","volume":"29","author":"Florkowski C. M.","year":"2008","journal-title":"Clinical Biochemist"},{"key":"e_1_2_12_25_1","article-title":"Prediction of Complications in Early\u2010Onset Preeclampsia: A Systematic Review","volume":"342","author":"Thangaratinam S.","year":"2011","journal-title":"BMJ"},{"key":"e_1_2_12_26_1","first-page":"1","article-title":"Hypertension in Pregnancy: Diagnosis And Management [J]","volume":"133","author":"National Institute for Health and Care Excellence (NICE)","year":"2019","journal-title":"NICE Guideline"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003891"},{"issue":"19","key":"e_1_2_12_28_1","first-page":"3015","article-title":"Limitations of the Odds Ratio in Gauging the Performance of a Diagnostic, Prognostic, or Screening Marker","volume":"23","author":"Pepe M. S.","year":"2004","journal-title":"Statistics in Medicine"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.120.15146"}],"container-title":["The Journal of Clinical Hypertension"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jch.70289","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jch.70289","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jch.70289","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T15:59:27Z","timestamp":1779811167000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jch.70289"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":28,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1111\/jch.70289"],"URL":"https:\/\/doi.org\/10.1111\/jch.70289","archive":["Portico"],"relation":{},"ISSN":["1524-6175","1751-7176"],"issn-type":[{"value":"1524-6175","type":"print"},{"value":"1751-7176","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"2025-09-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70289"}}