PB0805 - Platelet indices as a predictive marker in neonatal sepsis and respiratory distress in preterm prelabor rupture of membranes

Background: Preterm Prelabor rupture of membranes(PPROM) accompanies 2-3% of pregnancies and 1/3rd of preterm deliveries leading to infections/sepsis, perinatal morbidity/mortality worldwide. Early management can prevent complications of PPROM and improve mother and child health. Platelet indices (platelet count/MPV/Plateletcrit/IPF) could be a useful predictive parameters in PPROM.

Aims: To measure platelet indices in PPROM patients and to correlate with sepsis and respiratory distress in neonates.

Methods: Prospective case control study with 50 cases (28-36 wk gestation with PPROM) and 50 controls (with 28-36 wks gestation with intact membranes) with strict exclusion/inclusion criteria. Platelet indices were measured and compared with neonatal outcome. All statistical analysis was done by SPSS16.0 VERSION.

Results: MPV levels showed significant increase in cases as compared to controls (10.47±1.92 fl Vs 8.84±1.30 fl; P < 0.004). Plateletcrit levels were also significantly increased in cases with respect to controls (0.22±0.10% Vs 0.18±0.05%; P = 0.004). Immature platelet fraction is significantly increased in cases than in control subjects (8.73±6.67% Vs 4.43±1.75%; P < 0.001). Also, Mean Platelet volume levels were found to be significantly higher in subjects whose neonate had developed sepsis (11.39±1.69 fl Vs 8.91±1.31 fl; P < 0.001) and respiratory distress (10.62±2.09 fl Vs 9.26 ± 1.56 fl; P = 0.003). Similarly, Plateletcrit was significantly higher in groups with positive neonatal sepsis (0.32 ± 0.74% Vs 0.19 ± 0.65%; P = 0.010) and with respiratory distress (0.24 ± 0.78% Vs 0.18 ± 0.59%; P < 0.001). Levels of IPF were also increased in positive neonatal sepsis group (10.11 ± 6.27% Vs 5.06 ± 4.07%; P < 0.001) and respiratory distress group (9.11 ± 6.38% Vs 5.54 ± 4.43%; P = 0.009).

Conclusion(s): Maternal platelet parameters can be utilized as early predictors of neonatal sepsis and respiratory distress and as predictive markers for adverse neonatal outcome