Antepartum and Postpartum Monocyte Distribution Width Values in Patients With Histopathologic Chorioamnionitis [ID: 1376799

Abstract

INTRODUCTION: In nonpregnant adults presenting to the emergency department, monocyte distribution width (MDW) progressively increases with infection severity. While studies have shown that chorioamnionitis alters monocyte response, MDW has not been well studied in pregnancy. The primary aim of the study was to examine MDW values antepartum and postpartum in patients with histopathologic chorioamnionitis. METHODS: A retrospective electronic chart review was performed from an urban safety net hospital. Patients with an MDW value on admission and postpartum day number 1 (PPD1), in addition to postpartum placental histopathologic examination, were included in the study. Institutional review board approval was obtained (UMKC #2093657). The Mann-Whitney U test was utilized for statistical analyses. RESULTS: Of the 419 obstetric patient encounters reviewed, 89 encounters met inclusion criteria, of which 32% were diagnosed with histopathologic chorioamnionitis. There was no difference (P>.05) in median MDW at the time of admission between those with and without chorioamnionitis on histopathology (18.78 U versus 18.53 U, P=.602). However, the median MDW was significantly higher on PPD1 in patients diagnosed with chorioamnionitis compared to those without chorioamnionitis on postpartum histopathology (21.48 U versus 19.56 U, P=.001). CONCLUSION: In the setting of histopathologic chorioamnionitis, a significant elevation in postpartum MDW values compared to admission values suggests intrapartum MDW values increase as the infection develops. Additional longitudinal and prospective analysis of intrapartum MDW values may help characterize this rise and establish its potential role as a predictor of adverse pregnancy outcomes.