To study the predictive values of the levels of nitric oxide (NO), platelet count (PLT) and 25 hydroxyvitamin D (25(OH)D). Methods: The clinical data of 75 pregnant women admitted to hospital from January 2020 to January 2023 were collected retrospectively. According to the postpartum hemorrhage occurred or not, these women were divided into group A (30 women with postpartum hemorrhage) and group B (45 women without postpartum hemorrhage). The clinical data of the women in the two groups were collected, and the risk factors of the postpartum hemorrhage of the women in the two were analyzed. The levels of serum NO, PLT and 25(OH)D of the women in the two groups were detected, and the predictive values of which for the postpartum hemorrhage of the women was analyzed by receiver operating characteristic (ROC) curve. Results: There were no significant differences in the body mass index, the gestational weeks at delivery, and the incidence of anemia during pregnancy of the women between the two groups (P>0.05). There were significant differences in the age, the abortion number, the parity, the delivery mode, the neonatal weight, the pregnancy complications rate, and the incidences of placental adhesion and placenta
previa of the women between the two groups (P<0.05). The level of serum NO (104.66±13.45μmol/L) of the women in group A was significantly higher than that (74.29±9.14μmol/L) of the women in group B. The levels of 25(OH)D (11.40±2.61 ng/ml) and PLT (190.50±20.87×109/L) of the women in group A were significantly lower than those (14.30±3.35 ng/ml and 211.35±21.32×109/L) of the women in group B (all P<0.05). Multivariate unconditional logistic analysis showed that the age ≥35 years old, the abortion number ≥2 times, the parity ≥2 times, the cesarean section history, the fetal weight ≥4000g, the pregnancy complications, the placental adhesion, the placenta previa, the low level of NO and the high levels of PLT and 25(OH)D of the women were the independent risk factors for their postpartum hemorrhage (P<0.05). ROC analysis showed that the area under the curve (AUC) of the serum NO level of the women for predicting their postpartum hemorrhage was 0.961, the sensitivity of which was 86.1%, the specificity of which was 89.3%, and the cut0off value of which was 89.56μmol/L. The AUC of the serum PLT level of the women for predicting their postpartum hemorrhage was 0.824, the sensitivity of which was 81.3%, the specificity of which was 86.1%, and the cut-off value of which was 197.24×109/L. The AUC of the serum 25(OH)D level of the women for predicting their postpartum hemorrhage was 0.740, the sensitivity of which was 82.2%, the specificity of which was 83.6%, and the cut-off value of which was 12.35 ng/ml. Conclusion: The expressions of the serum NO, PLT and 25(OH)D of the women with postpartum hemorrhage are abnormal and are the independent risk factors for the postpartum hemorrhage of the women, and which can predict the occurrence of the postpartum hemorrhage of the women.