Clinical Ability of Neutrophil–Lymphocyte Ratio in Pregnancy as a Predictor of Preeclampsia

Abstract

Aim and objective: Preeclampsia is part of the hypertension spectrum that occurs during the pregnancy period, especially when the gestational age is 20 weeks or more. Preeclampsia has a broad impact not only on pregnant women but also on the fetus they contain. It is said that in preeclampsia, there is an increase in inflammatory stimulation and an abnormal immune response so that routine blood values increase. Neutrophil-lymphocyte ratio (NLR) values reported in several studies have risen notably in the incidence of preeclampsia. Materials and methods: A cross-sectional observational analysis study was conducted on 924 pregnant respondents from January to December 2019 at Cimacan District Hospital, Cianjur. Statistical analysis test of the average difference between the two groups and the prediction test of NLR values was conducted between the healthy pregnant women group of 838 respondents and the group of 86 pregnant women with preeclampsia. Results: In statistical tests regarding the differences in the mean of the two groups, a significant NLR value was obtained (p = 0.004). Then the NLR value was tested again by the receiver-operating characteristic (ROC) curve method, and the results of the area under the curve (AUC) on the variable values were obtained in the form of AUC: 0.595/p-value: 0.035. Conclusion and clinical significance: Despite the differences in the mean NLR in the two groups, however, the NLR of women in predicting the incidence of pregnancy with preeclampsia is very low.

Predictive biomarkers of preeclampsia severity in a low resource setting: Role of red blood cell indices, NLR, and albumin-to-creatinine ratio

“…In 2019, Indonesia encountered considerable challenges in providing maternal healthcare, as reflected by its maternal mortality rate of 305 per 100,000 live births [3]. PE or eclampsia, hemorrhage, and infection, respectively, comprised 28%, 24%, and 11% of the direct obstetric causes of maternal death in the country [4,5]. Notably, 7-10% of pregnancies in Indonesia resulted in PE, highlighting the critical need for focused treatments and enhanced facilities for maternal healthcare [4].…”

“…Notably, 7-10% of pregnancies in Indonesia resulted in PE, highlighting the critical need for focused treatments and enhanced facilities for maternal healthcare [4]. diverse strategy is needed to address these obstetric causes of maternal death but given the limited resources in most Indonesian healthcare facilities, optimizing existing resources becomes crucial [3][4][5].…”

Association Between Highly-Sensitive C- Reactive Protein and Neutrophil to Lymphocyte Ratio as Markers of Inflammation Among Adult Nigerians with Essential Hypertension

“…It is derived from the full blood count values as the ratio of absolute neutrophil count to absolute lymphocyte count. This parameter is increasingly being utilized as an index of systemic inflammation in a plethora of clinical conditions such as sickle cell disease, [13] preeclampsia, [14] Diabetes mellitus, [15] cancers, [16] and in anaemia [17] among pregnant women. Clinical research confirmed the sensitivity of NLR in the diagnosis and stratification of systemic infections, sepsis, and bacteraemia as well as its robust predictive and prognostic values.…”

The combination of NLR and MEOWS as a potential modality for detecting the severity of preeclampsia: A systematic review

“…11 PE is the leading cause of fetomaternal morbidity and mortality. 12 Neonatal risks include intra-uterine growth restriction and low birth weight, perinatal death, and premature iatrogenic due to placental dysfunction and hypoxia. 13 Normal pregnancy occurs because there is a semi-allograph reaction.…”

“…Changes occur in inflammatory cells in the blood, subsets of T lymphocytes, acute protein reactive, plasma inflammatory cytokine factors, complement activity, and coagulation systems that can later cause PE. 10,12 Neutrophil/lymphocyte ratio (NLR) is one of the inflammatory markers and is being widely studied today. The combination of two essential mechanisms in PE pathogenesis, the abnormal immune and inflammatory responses is the basis for evaluating the value of NLR as a prognostic modality to determine the severity of PE.…”