Prognostic laboratory parameters in placental abruption: A retrospective case-control study

Abstract

To evaluate routine laboratory parameters in women with and without placental abruption (PA) and in controls, 417 women were included in this retrospective cohort study in a tertiary-care center. 118 women with PA (Group A: 54 without vaginal bleeding and Group B: 64 with bleeding), 130 women without either PA or vaginal bleeding throughout their pregnancy (Group C), 123 women with vaginal bleeding but without PA (Group D), and 46 healthy pregnant women who had undergone a control laboratory evaluation in the second/third trimester for history of previous cytomegalovirus (additional control group) were included. Hemoglobin, leukocytes, thrombocytes, C-reactive protein (CRP), and fibrinogen were obtained within 48 hours before C-section and/or at the time of bleeding onset. Cases (Groups A and B) revealed higher CRP levels than controls (Groups C and D) after multivariate analysis in the sub-analyses of bleeding (0.56 mg/dL, interquartile range (IQR) 0.28-1.24 vs. 0.51 mg/dL, IQR 0.28-0.84; odds ratio (OR) 1.108, p = 0.006) and non-bleeding women (0.64 mg/dL, IQR 0.48-1.08 vs. 0.32 mg/dL, IQR 0.18-0.61; OR 7.454, p < 0.001). The non-bleeding cases (Group A) revealed significantly higher leukocyte (12.01 g/L, IQR 9.41-14.10 vs. 9.21 g/L, IQR 7.95-10.49; OR 1.378, 95% confidence interval (CI): 1.095⁻1.735; p = 0.006) and CRP levels (0.64 mg/dL, IQR 0.48-1.08 vs. 0.33 mg/dL, IQR 0.20-0.50; OR 7.942, 95% CI: 1.435-43.958; p = 0.018) than the additional control group. In cases, none of the laboratory parameters differed between women with and without bleeding. The significantly increased CRP levels found for women with PA and the lack of a difference in CRP between bleeding and non-bleeding cases point toward a chronic process underlying placental abruption. However, this laboratory parameter does not seem clinically relevant for distinguishing between women with and without placental abruption at this point in time.