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Infectious Diseases

Poster Session 4

(1097) Prediction of placental chorioamnionitis in active labor utilizing platelets and complete blood count indices

Wednesday, February 14, 2024
1:00 PM – 2:30 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: The complete blood count (CBC) has been utilized for decades in pregnancy, but only recently have indices and their ratios been studied for their association with intraamniotic infection and adverse pregnancy outcomes. Platelets actively engage in the immune response to acute infections and are anticipated to increase. This study aimed to describe the utility of platelet to white blood cell (PW), platelet to neutrophil (PN), and platelet to lymphocyte (PL) ratios in predicting chorioamnionitis identified on placental pathology. White blood cell (WBC), neutrophil, lymphocyte, and platelet counts were analyzed secondarily.

Study Design: A retrospective electronic chart review was performed at an urban safety net hospital for 6 months from 2022-2023. Subjects in active labor beyond 20 weeks of gestation were included in the study if a CBC was performed at admission with placental pathology available. Exclusion criteria were extrauterine infection or platelet count of less than 100,000. Preterm labor (PTL) was defined as less than 37 weeks of gestation. Descriptive and Mann-Whitney U statistical tests were utilized for analyses.

Results: One thousand seventy-nine subject charts were reviewed, with only 35.1% of those with placental pathology available. Of those, 37 subjects admitted with PTL and 81 subjects with term labor were included in the final analysis. There was a significantly higher PL ratio as well as neutrophil count in subjects admitted with PTL who had chorioamnionitis on placental pathology (Table 1). The PL ratio and neutrophil count were moderate predictors of chorioamnionitis in the PTL group, with an area under the curve of 0.724 (95% CI [0.559, 0.888]) and 0.720 (95% CI [0.528, 0.913]), respectively.

Conclusion: Platelet to lymphocyte count ratio and neutrophil count may serve as more effective indicators of histopathologic chorioamnionitis in preterm labor patients less than 37 weeks of gestation compared to the traditional use of the WBC count. Larger studies that include neonatal outcomes are warranted to examine if targeted treatment can improve maternal and neonatal outcomes.

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