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Infectious Diseases

Poster Session 3

(777) Normative values of monocyte distribution width in pregnancy

Wednesday, February 14, 2024
8:30 AM – 10:00 AM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: The volumetric measurement of the monocyte, known as the monocyte distribution width (MDW), has been shown to increase as the infection severity increases in the nonpregnant population. However, there is an absence of data regarding baseline values in pregnancy and whether a normal value of less than 20 units applies to pregnancy. The primary aim of this study was to define monocyte distribution width values in each trimester of pregnancy. The secondary analysis sought to correlate MDW with other infection-associated markers, specifically white blood cell (WBC) and neutrophil counts.

Study Design: In 2023, we performed a retrospective electronic chart review of outpatient antepartum visits over a 2-month interval in an urban safety net hospital. Subjects were included in the data analysis if a complete blood count with MDW was performed. Exclusion criteria were the presence of an active or recent infection (including COVID-19) and antibiotic, immunotherapy, or corticosteroid use in the 14 days before the lab results. Chi-square, Spearman’s rank-order, and Kruskal-Wallis tests were utilized for statistical analyses.

Results: Seven hundred eighty-four charts were reviewed, and 259 were included in the analysis. First-trimester MDW values were significantly lower than the second and third-trimester values (p < 0.001). However, there was no significant difference between second and third-trimester values on post hoc analysis (p=0.85) (Table 1). MDW values greater than 20 U also differed between trimesters, notably increasing in the second and third trimesters (p=0.03) (Table 1). The participants had no correlation between MDW values and WBC or neutrophil counts (r=0.171, 0.124, respectively).

Conclusion: This is the first study that describes normative MDW values in pregnancy and suggests that several normal gravidas without clinical evidence of infection have MDW values above the nonpregnant upper limit of normal (20 U). Further studies are needed to prospectively analyze MDW values in pregnancy to identify values indicative of infection and sepsis.

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