Postpartum hemorrhage risk is driven by changes in blood composition through pregnancy

Abstract The extent to which women differ in the course of blood cell counts throughout pregnancy, and the importance of these changes to pregnancy outcomes has not been well defined. Here, we develop a series of statistical analyses of repeated measures data to reveal the degree to which women diff...

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Autores principales:	Matthew R. Robinson, Marion Patxot, Miloš Stojanov, Sabine Blum, David Baud
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/4018dafa449942b7b906c3b69050d2b5
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spelling	oai:doaj.org-article:4018dafa449942b7b906c3b69050d2b52021-12-02T19:17:05ZPostpartum hemorrhage risk is driven by changes in blood composition through pregnancy10.1038/s41598-021-98411-z2045-2322https://doaj.org/article/4018dafa449942b7b906c3b69050d2b52021-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-98411-zhttps://doaj.org/toc/2045-2322Abstract The extent to which women differ in the course of blood cell counts throughout pregnancy, and the importance of these changes to pregnancy outcomes has not been well defined. Here, we develop a series of statistical analyses of repeated measures data to reveal the degree to which women differ in the course of pregnancy, predict the changes that occur, and determine the importance of these changes for post-partum hemorrhage (PPH) which is one of the leading causes of maternal mortality. We present a prospective cohort of 4082 births recorded at the University Hospital, Lausanne, Switzerland between 2009 and 2014 where full labour records could be obtained, along with complete blood count data taken at hospital admission. We find significant differences, at a $$p<0.001$$ p < 0.001 level, among women in how blood count values change through pregnancy for mean corpuscular hemoglobin, mean corpuscular volume, mean platelet volume, platelet count and red cell distribution width. We find evidence that almost all complete blood count values show trimester-specific associations with PPH. For example, high platelet count (OR 1.20, 95% CI 1.01–1.53), high mean platelet volume (OR 1.58, 95% CI 1.04–2.08), and high erythrocyte levels (OR 1.36, 95% CI 1.01–1.57) in trimester 1 increased PPH, but high values in trimester 3 decreased PPH risk (OR 0.85, 0.79, 0.67 respectively). We show that differences among women in the course of blood cell counts throughout pregnancy have an important role in shaping pregnancy outcome and tracking blood count value changes through pregnancy improves identification of women at increased risk of postpartum hemorrhage. This study provides greater understanding of the complex changes in blood count values that occur through pregnancy and provides indicators to guide the stratification of patients into risk groups.Matthew R. RobinsonMarion PatxotMiloš StojanovSabine BlumDavid BaudNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Matthew R. Robinson Marion Patxot Miloš Stojanov Sabine Blum David Baud Postpartum hemorrhage risk is driven by changes in blood composition through pregnancy
description	Abstract The extent to which women differ in the course of blood cell counts throughout pregnancy, and the importance of these changes to pregnancy outcomes has not been well defined. Here, we develop a series of statistical analyses of repeated measures data to reveal the degree to which women differ in the course of pregnancy, predict the changes that occur, and determine the importance of these changes for post-partum hemorrhage (PPH) which is one of the leading causes of maternal mortality. We present a prospective cohort of 4082 births recorded at the University Hospital, Lausanne, Switzerland between 2009 and 2014 where full labour records could be obtained, along with complete blood count data taken at hospital admission. We find significant differences, at a $$p<0.001$$ p < 0.001 level, among women in how blood count values change through pregnancy for mean corpuscular hemoglobin, mean corpuscular volume, mean platelet volume, platelet count and red cell distribution width. We find evidence that almost all complete blood count values show trimester-specific associations with PPH. For example, high platelet count (OR 1.20, 95% CI 1.01–1.53), high mean platelet volume (OR 1.58, 95% CI 1.04–2.08), and high erythrocyte levels (OR 1.36, 95% CI 1.01–1.57) in trimester 1 increased PPH, but high values in trimester 3 decreased PPH risk (OR 0.85, 0.79, 0.67 respectively). We show that differences among women in the course of blood cell counts throughout pregnancy have an important role in shaping pregnancy outcome and tracking blood count value changes through pregnancy improves identification of women at increased risk of postpartum hemorrhage. This study provides greater understanding of the complex changes in blood count values that occur through pregnancy and provides indicators to guide the stratification of patients into risk groups.
format	article
author	Matthew R. Robinson Marion Patxot Miloš Stojanov Sabine Blum David Baud
author_facet	Matthew R. Robinson Marion Patxot Miloš Stojanov Sabine Blum David Baud
author_sort	Matthew R. Robinson
title	Postpartum hemorrhage risk is driven by changes in blood composition through pregnancy
title_short	Postpartum hemorrhage risk is driven by changes in blood composition through pregnancy
title_full	Postpartum hemorrhage risk is driven by changes in blood composition through pregnancy
title_fullStr	Postpartum hemorrhage risk is driven by changes in blood composition through pregnancy
title_full_unstemmed	Postpartum hemorrhage risk is driven by changes in blood composition through pregnancy
title_sort	postpartum hemorrhage risk is driven by changes in blood composition through pregnancy
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/4018dafa449942b7b906c3b69050d2b5
work_keys_str_mv	AT matthewrrobinson postpartumhemorrhageriskisdrivenbychangesinbloodcompositionthroughpregnancy AT marionpatxot postpartumhemorrhageriskisdrivenbychangesinbloodcompositionthroughpregnancy AT milosstojanov postpartumhemorrhageriskisdrivenbychangesinbloodcompositionthroughpregnancy AT sabineblum postpartumhemorrhageriskisdrivenbychangesinbloodcompositionthroughpregnancy AT davidbaud postpartumhemorrhageriskisdrivenbychangesinbloodcompositionthroughpregnancy
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Postpartum hemorrhage risk is driven by changes in blood composition through pregnancy

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