Pre & Postpartum Leukocyte Difference: A Predictor of postpartum maternal infectious morbidity and neonatal outcome
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 1, Pages 5282-5288
Abstract
Clinically, an increase in the White Blood Cells (WBC) count is regarded as an active sign of an infection. However, the WBC count also increases throughout pregnancy and declines only during the late postpartum period.Aim and objectives:To determine the association between the change in the maternal leukocyte count (between admission and post-partum) and the incidence of Postpartum Infectious Maternal morbidity (PPIM) among afebrile women with term pregnancy.
Material and Methods: This was a single centre, hospital-based, prospective observational study involving 185 pregnant women coming for delivery. We collected data on obstetric details, total WBC count (at admission and within 24 hours after delivery), and maternal and neonatal outcomes.
Results: Overall, among the 185 study participants, only 12 women were diagnosed with PPIM (6.5%). The mean WBC count before (10,200) and after (15,200) delivery among women who developed PPIM was statistically highly significant (p<0.0001). The difference in the mean delta counts for women having puerperal fever was highly significant (p<0.0001). However, the delta WBC count was not significant for women having abnormal lochia (p=0.067). Among neonatal outcomes, the delta WBC count was statistically significant for low APGAR score @ five minutes and developing neonatal sepsis. The delta WBC count was statistically insignificant for admission to NICU (p=0.072).
Conclusion: A higher delta leukocyte count between admission for labour and the postpartum period was a significant risk predictor of PPIM.
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