Changes Of Platelet And Leukocyte Parameters In Pregnant Women With Spontaneous Preterm Birth During Pregnancy

ObjectiveThe levels of platelet and leukocyte parameters in pregnancy of spontaneous preterm pregnant women were analyzed retrospectively,and the relationship between platelet and leukocyte parameters and spontaneous preterm birth and their predictive value were discussed.Methods1050 cases of singleton pregnant women who were scheduled and delivered in Fujian Provincial Maternity and Children's Hospital from September 2016 to August 2018 were selected as the research subjects and divided into three groups.350 cases of pregnant women with 28 weeks to less than 37 weeks of gestation were preterm birth group,and 350 cases of pregnant women who had been admitted to hospital during pregnancy with the warning of preterm birth,the final ? 37 weeks of childbirth were the threatened preterm group,and 350 cases of pregnant women in ? 37 weeks were the term birth group.The clinical data of three groups of pregnant women were collected,and the differences of platelet parameters,white blood cell parameters,maternal complications and perinatal outcomes among the three groups were retrospectively compared.The correlation between platelet,leukocyte parameters and spontaneous premature labor was studied.The BP artificial neural network model was used to evaluate the predictive value of platelet and leukocyte parameters in spontaneous preterm labor.Results1.Among the platelet parameters,the PLT and MPV in the preterm birth group were higher than in the term birth group and the threatened preterm birth group,and PDW decreased compared with the term birth group,MPV and PDW in the the threatened preterm birth group were lower in the term birth group,and the difference was statistically significant(P<0.05).2.The platelet count showed a decreasing trend throughout pregnancy among all group,with the lowest in delivery period.The platelet count in term birth group was greater than term birth and threatened preterm birth group during late pregnancy and delivery,the difference was statistically significant(P<0.05).3.Among the white blood cell parameters,the NLR and CRP were higher in the preterm birth group than in the term birth group and the threatened preterm birth group,and the PLR was higher than that of the term group,NLR and PLR in the the threatened preterm birth group were higher in the term birth group,the difference was statistically significant(P<0.05).4.During pregnancy NLR gradually increased,the term birth group reached a peak during childbirth,the threatened preterm birth group and preterm birth group NLR reached a peak in the late pregnancy,to the delivery period showed a decrease.The NLR of early pregnancy,late pregnancy and delivery in preterm birth group was higher than that in the term birth group and the threatened preterm labor group,the difference was statistically significant(P<0.05).5.A total of 248 pregnant women in the premature delivery group underwent placental pathological examination.Among them,HCA(histologic chorioamnionitis)was confirmed by pathology in 106 cases(42.74%),non-HCA group was confirmed by pathology in 142 cases,NLR,PLR,CPR in HCA group was higher than that in non-HCA group,the difference was statistically significant(P<0.05).6.Among preterm birth group and threatened preterm labor group maternal complications,the incidence of placental abruption in preterm women was higher than that in the threatened preterm labor group,but there was no significant difference in the incidence of postpartum hemorrhage,uterine infection,fetal distress and oligohydramnios.7.In perinatal outcomes,the proportion of male infants in preterm birth group was higher than that of female infants,and the difference was statistically significant(P<0.05).There was a negative correlation between NLR and neonatal body quality and birth pregnancy week.The incidence of neonatal respiratory distress syndrome in HCA group was lower than that in non-HCA group,while neonatal pneumonia,sepsis were higher than that in non-HCA group,and the difference was statistically significant(P<0.05).8.The BP artificial neural network model was constructed by using the meaningful PLT,MPV,NLR and PLR as input values in single factor analysis,and the AUC with ROC curve evaluation model to predict preterm birth risk was 0.819,and the sensitivity was 69.2% when the diagnostic boundary value was 0.491,and the specificity was 86.7%,the consistency rate was 80.9%.ConclusionThe increase of PLT,MPV,NLR and PLR in pregnant women is related to spontaneous preterm birth,BP artificial neural network model has certain predictive value for spontaneous preterm birth,clinical can use platelet parameters and white blood cell parameters to achieve early detection,early diagnosis of spontaneous preterm birth,in order to improve perinatal maternal outcome.