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Research article
Prediction of Subclinical Chorioamnionitis After Cervical Cerclage
MIAN PAN
FUJIAN PROVINCIAL MATERNITY AND CHILDREN'S HOSPITAL
Corresponding Author
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This work is licensed under a CC BY 4.0 License. Read Full License
Objective: To explore non-invasive indices for predicting subclinical chorioamnionitis following cervical cerclage.
Methods: We performed a retrospective analysis of 80 singleton pregnant women who underwent cervical cerclage surgery in our hospital. Eighty patients were divided into either a histological chorioamnionitis group (n=57) and non-histological chorioamnionitis group (n=23). Gestational age before cervical cerclage, cervical dilation size, vaginal microbiota, cervical microbial colonization, and inflammatory indicators related to peripheral blood cells (white blood cell count, neutrophil count, lymphocyte count, platelet count, CRP, neutrophil/lymphocyte ratio, platelet/white blood cell ratio, etc.) at pre-surgery time and onset of labor post-surgery were compared, and an independent sample t-test and multivariate logistic regression analysis were performed to study the risk factors associated with histological chorioamnionitis. Histological chorioamnionitis was used as the outcome variable, and receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off value and evaluate the predictive value of these indicators for chorioamnionitis.
Results: 1) Single-factor logistics analysis showed that the preoperative number of platelets, indicators related to peripheral blood cells during onset of labor post-surgery（the total number of leukocytes，neutrophils，platelets， platelet/white blood cell ratio） , the area under the curve of each indice was all statistically significant. Their cut-off values were 229.5×109/L; 10.245×109/L; 9.86×109/L; 240.5×109/L; 1.022 respectively. 2) Additional multivariate logistic regression analysis was performed. Preoperative number of platelets, the number of white blood cells and platelet/white blood cell ratio during onset of labor were identified as significant variables. 3) The statistically significant variables (preoperative platelets, white blood cells and platelet/white blood cell during onset of labor) obtained from multi-factor analysis were grouped according to the cut-off value. A joint screening system was established that specified that two or more indicators are positive as joint screening, with a screening sensitivity of 87.5%, and specificity of 45.5%.
Conclusions: After cervical cerclage, the number of white blood cells and the ratio of platelet/white blood cell during onset of labor combined with preoperative number of platelets have predictive value for potential histological chorioamnionitis in pregnant women with cervical cerclage.
Keywords
cervical cerclage, histological chorioamnionitis, platelet/white blood cell ratio, cervical insufficiency
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This is a preprint. It has not completed peer review.
Research article
Prediction of Subclinical Chorioamnionitis After Cervical Cerclage
MIAN PAN
FUJIAN PROVINCIAL MATERNITY AND CHILDREN'S HOSPITAL
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 12 Aug, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Maternal & Fetal Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Objective: To explore non-invasive indices for predicting subclinical chorioamnionitis following cervical cerclage.
Methods: We performed a retrospective analysis of 80 singleton pregnant women who underwent cervical cerclage surgery in our hospital. Eighty patients were divided into either a histological chorioamnionitis group (n=57) and non-histological chorioamnionitis group (n=23). Gestational age before cervical cerclage, cervical dilation size, vaginal microbiota, cervical microbial colonization, and inflammatory indicators related to peripheral blood cells (white blood cell count, neutrophil count, lymphocyte count, platelet count, CRP, neutrophil/lymphocyte ratio, platelet/white blood cell ratio, etc.) at pre-surgery time and onset of labor post-surgery were compared, and an independent sample t-test and multivariate logistic regression analysis were performed to study the risk factors associated with histological chorioamnionitis. Histological chorioamnionitis was used as the outcome variable, and receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off value and evaluate the predictive value of these indicators for chorioamnionitis.
Results: 1) Single-factor logistics analysis showed that the preoperative number of platelets, indicators related to peripheral blood cells during onset of labor post-surgery（the total number of leukocytes，neutrophils，platelets， platelet/white blood cell ratio） , the area under the curve of each indice was all statistically significant. Their cut-off values were 229.5×109/L; 10.245×109/L; 9.86×109/L; 240.5×109/L; 1.022 respectively. 2) Additional multivariate logistic regression analysis was performed. Preoperative number of platelets, the number of white blood cells and platelet/white blood cell ratio during onset of labor were identified as significant variables. 3) The statistically significant variables (preoperative platelets, white blood cells and platelet/white blood cell during onset of labor) obtained from multi-factor analysis were grouped according to the cut-off value. A joint screening system was established that specified that two or more indicators are positive as joint screening, with a screening sensitivity of 87.5%, and specificity of 45.5%.
Conclusions: After cervical cerclage, the number of white blood cells and the ratio of platelet/white blood cell during onset of labor combined with preoperative number of platelets have predictive value for potential histological chorioamnionitis in pregnant women with cervical cerclage.
Figure 1