Platelet distribution width (PDW): a putative marker for threatened preterm labour

Objective: To determine the alterations of mean platelet volume (MPV), platelet distribution width (PDW), platelet level and hemoglobin level in pregnancies with threatened preterm labor (TPL).

Methods: The retrospective analysis of 201 pregnant women with threatened preterm labour admitted to our clinic between 2009 and 2013 and 192 healthy pregnancies was conducted. The data regarding the maternal age, hemoglobin level, platelet count, mean platelet volume (MPV), platelet distribution width (PDW) was evaluated.

Results: The mean MPV and hemoglobin levels were significantly lower in TPL group (p=0.001 and p=0.01, respectively). PDW levels were significantly higher in TPL group (p=0.05). (p=0.01). Regarding the platelet count, there was no statistically significant difference between the TPL and control groups. ROC curve analysis for PDW revealed an area under curve (AUC) 66.8%. By using a cut-off value 16.15 for PDW, sensitivity was 76.1% and specificity was 43.5% for TPL.

Conclusion: MPV seems to be lower in threatened preterm deliveries, whereas PDW levels were increased suggesting the possible high grade inflammation and platelet activation in the pathology. Anemia occurs more frequently in threatened preterm delivery. Increased PDW levels especially > 16.15 may alert the obstetrician for the risk of the preterm delivery. However, further studies are needed to state the usefulness of the platelet indices in the diagnosis and clinical follow-up of preterm labor.