![]() In this work, we propose that characterising the changes that occur within women over the course of their pregnancy and relating these changes to pregnancy outcomes, may improve understanding of the course of pregnancy and facilitate better patient screening. However, women differ in how their physiology changes throughout pregnancy, and observing a large change in CBC value relative to a previous measurement (a within-individual comparison), may be more indicative of pregnancy outcome, than only a single observation compared to a baseline range (a between-individual comparison). A number of studies describe the typical ranges of CBC measurements observed during the course of pregnancy, characterising the differences observed among women, and allowing identification of women with abnormal measurements for follow-up 1, 2, 5– 7. Modelling trimester-specific associations with pregnancy outcomes, in a way that fully utilizes repeated measures data, provides greater understanding of the complex changes in blood count values that occur through pregnancy and provides indicators to guide the stratification of patients into risk groups.Ĭomplete blood cell count (CBC) values measured during the course of pregnancy can provide an indicator of a range of clinical risk factors and birth outcomes 1– 4. Differences among women in the course of blood cell counts throughout pregnancy have an important role in shaping pregnancy outcome. We find evidence that almost all complete blood count values show trimester-specific associations with postpartum hemorrhage and that tracking blood count value changes through pregnancy improves identification of women at increased risk, with increased area under the receiver operator curve in independent patient samples. We find significant differences, at a p < 0.001 level, among women in how blood count values change through pregnancy for mean corpuscular hemoglobin, mean corpuscular volume, mean platelet volume, platelet count and red cell distribution width. ![]() We present a prospective cohort of 4,082 births recorded at the University Hospital, Lausanne, Switzerland between 20 where full labour records could be obtained, along with complete blood count data taken at hospital admission. Here, we develop a series of statistical analyses of repeated measures data to reveal the degree to which women differ in the course of pregnancy, predict the changes that occur, and determine the importance of these changes for post-partum hemorrhage which is one of the leading causes of maternal mortality. The extent to which women differ in the course of blood cell counts throughout pregnancy, and the importance of these changes to pregnancy outcomes has not been well defined. ![]()
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