The clinical value of complete blood count parameters in the prediction of postpartum hemorrhage severity

To assess the prognostic value of complete blood count parameters in two periods (antepartum and intrapartum) for the severity of postpartum hemorrhage, and to identify earlier, simple, and cost-benefit prognostic markers for timely severity stratification and improvement of unfavorable maternal outcomes related to severe postpartum hemorrhage. This retrospective study included 290 women who delivered vaginally at or beyond 37 weeks of gestation with a diagnosis of postpartum hemorrhage between February 2021 and December 2022. Complete blood count parameters were measured at antepartum, intrapartum, and postpartum stages. Postpartum hemorrhage severity was confirmed based on the decrease in pre- to post-delivery hemoglobin values (Δhemoglobin). The antepartum and intrapartum complete blood count parameters were compared according to different categories of Δhemoglobin. A total of 290 women were divided into four groups based on a 10 g/L increase in Δhemoglobin value. Both antepartum hematocrit and intrapartum platelet distribution width were independently associated with Δhemoglobin value, and generalized linear model analyses showed the association was positive (P < 0.05); Based on each 5 g/L increase in Δhemoglobin value, the highest area under curve of antepartum hematocrit and intrapartum platelet distribution width for predicting postpartum hemorrhage severity were 0.712 and 0.559, respectively. The area under the curve of intrapartum platelet distribution width could be improved to 0.719 when combined with antepartum hematocrit. Antepartum hematocrit and intrapartum platelet distribution width are economical, easily available and useful parameters for severity stratification of postpartum hemorrhage.