Ersin CİNTESUN, Nur Dlara SARIHAN, Emine AYTEKİN, Çetin ÇELİK
Perinatal Journal - 2026;34(3):11-19
This study aimed to investigate the predictive utility of hematologic markers for absent fetal heart rate variability with recurrent late decelerations during uterine contractions. This retrospective case-control study was conducted at Selçuk University Faculty of Medicine between January 2019 and July 2026. A total of 546 pregnant women were enrolled: 182 patients with Category III fetal heart rate patterns (study group) and 364 women with Category I non-stress test patterns who underwent spontaneous vaginal delivery (control group), according to NICHD criteria. Hematologic markers including Hb, PDW, MPV, NLR, and PLR were compared between groups. ROC curve analysis and univariate and multivariate logistic regression analyses were performed. PDW was significantly lower in the study group (16.3+/-1.7 vs. 17.8+/-0.8, p<0.001), whereas MPV and NLR were significantly higher (p<0.001). ROC analysis revealed that PDW had the highest discriminative performance (AUC: 0.850, 95% CI: 0.812-0.889). Multivariate logistic regression identified PDW (OR: 0.15), MPV (OR: 2.19), and NLR (OR: 1.13) as independent predictors after adjusting for gestational age, gravida, and BMI. PDW and MPV were identified as independent predictors of absent fetal heart rate variability with recurrent late decelerations, with PDW demonstrating superior discriminative performance at a cut-off value of <=17.05%. These readily available and inexpensive markers may facilitate antenatal identification of patients at risk for intrapartum fetal distress.
