Rosas-Cabral A, Ruiz Esparza-Mota JA, Gutiérrez-Campos R, Torres-Cabral G, Robles-Martínez MC, Hernández MM

Language: Spanish
References: 32
Page: 504-512
PDF size: 224.04 Kb.

ABSTRACT

Objective: To compare the neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and erythrocyte width distribution, of women with preeclampsia with or without severity criteria and those of women without.
Materials and Methods: Retrospective case-control study in 70 women with preeclampsia and 70 with normal pregnancy between January and December 2019.
Results: Seventy women with preeclampsia and 70 with pregnancy without this complication were studied. The neutrophil-lymphocyte ratio was significantly higher in women with preeclampsia (4.11 ± 2.76; 95%CI: 3.47-4.75), than in women with normal pregnancies (2.99 ± 1.6; 95%CI: 2.62-3.36; p = 0.004); which is similar for the platelet-lymphocyte ratio (117.61 ± 47.53, 95%CI: 106.48-128.24 vs 97.64 ± 43.67; 95%CI: 87.41-107.87; p = 0.006) and for the distribution of the width of the erythrocyte; (14.46 ± 1.9, CI95%: 14.02-14.9 vs 13.56 ± 1.38; CI95%: 13-13.72; p = 0.0002). None of these parameters was able to discriminate between patients with preeclampsia with or without severity criteria. A neutrophil-lymphocyte ratio ≥ 5.1 discriminates between women with a normal pregnancy and those with preeclampsia with or without severity criteria [area under the curve of 0.746, (95%CI: 0.664-0.827)], sensitivity 42%, specificity 91%, positive predictive value 82%, negative predictive value 60% and Odds Ratio 7.1 (95%CI: 2.7-18.6, p = 0.001).
The platelet-lymphocyte ratio ≥ 113.4 can discriminate between women with a normal pregnancy and preeclampsia with or without severity criteria, with an area under the curve of 0.617 (95% CI 0.525-0.709).
Conclusion: A neutrophil-lymphocyte ratio ≥ 5.1, and a platelet-lymphocyte ratio ≥ 113.1 are able to adequately discriminate between patients with normal pregnancy and those with preeclampsia with or without severity criteria.

REFERENCES

1. ACOG Practice Bulletin N°202. Gestational hypertensionand preeclampsia. Obstet Gynecol 2019; 133 (1):1.doi:10.1097-AOG.0000000000003018.

2. Romero-Arauz JF, Morales-Borrego E, García-Espinoza M,Peralta-Pedrero ML. Guía de práctica clínica. Preclampsiaeclampsia.Rev Med Inst Mex Seguro Soc 2012; 50 (5): 569-79. https:www.redalyc.org-pdf-4577-457745497022.pdf

3. Ives CW, Sinkey R, Rajapreyar I, Tita ATN, et al. Preeclampsiapathophysiology and clinical presentations: JACC State-ofthe-art Review. J Am Coll Cardiol 2020; 76 (14): 1690-702.doi: 10.1016-jack.2020.08.014.

4. Jeon HR, Jeong DH, Lee JY, Woo EY, et al. sFlt-1-PlGF ratioas a predictive and prognostic marker for preeclampsia. JObstet Gynaecol Res 2021; 47 (7): 2318-23. doi: 10.1111-jog.14815

5. Bhat T, Teli S, Ryal J, Bhat H, et al. Neutrophil to lymphocyteratio and cardiovascular disease: a review. ExpertRev Cardiovascular Ther 2013; 11 (1): 55.9. doi: 10.1586-14779072.2016.116509

6. Isaac V, Wu C, Huang C, Baune B, et al. Elevated neutrophilto lymphocyte ratio predicts mortality in medical inpatientswith multiple chronic conditions. Medicine 2016; 95 (23):e3832. doi: 10.1097-MD0000000000003832

7. Mozos I, Malainer C, Horbanczuck J, Gug C, et al. Inflammatorymarkers for arterial stiffness in cardiovasculardiseases. Front Immunol 2017; 31 (8):1058. doi.10.3389-fimmu.2017.01058

8. Haybar H, Pezeshki SMS, Saki N. Evaluation of completeblood count parameters in cardiovascular diseases: Anearly indicator of prognosis?. Exp Mol Pathol 2019; 110:1042267.doi.10.1016-j.yexmp.2019.104267

9. Budzianowski J, Pieszko K, Burchardt P, Rzezniczak J, et al.The role of hematological índices in patients with acutecoronary syndromes. Dis Markers. 2017; 2017: 3041565.doi. 10.1155-2017-3041565

10. Zhai G, Wang J, Liu Y, Zhou Y. Platelet-lymphocyte ratio asa new predictor of in-hospital mortality in cardiac intensivecare unit patients. Sci Rep. 2021; 11 (1): 23578. doi:10.1038-s41598-021-02686-1

11. Fava C, Catazzo F, Hu ZD, Lippi G, et al. The role of redblood cell distribution width (RDW) in cardiovascular riskassessment: useful or hype? Ann Transl Med 2019; 7 (20):581. doi: 10.21037-atm.2019.09.58

12. Oglak SC, Tunc S, Olmez F. First trimester mean plateletvolume, neutrophil to lymphocyte ratio, and platelet tolymphocyte ratio values are useful markers for predictingpreeclampsia. Ochsner J 2021; 21 (4): 364-70. doi:10.31486-toj.21.0026

13. Hypertension in pregnancy. Report of the American Collegeof Obstetricians and Gynecologists. Task Force onHypertension in pregnancy. Obstet Gynecol. 2013; 122 (5):1122-31. doi: 10.1097-01.AOG.0000437382.03

14. Gezer C, Ekin A, Egemen Ertas I, Ozeren M, et al. Highfirst-trimester neutrophil-to-lymphocyte and platelet-tolymphocyteratios are indicators for early diagnosis ofpreeclampsia. Ginekologia Polska 2016; 87 (6): 431-35.doi.10.5603-GP2016.0021

15. Jeon YL, Lee W, Kang SY, Kim MH. Modified complete bloodcounts indices as predicting markers of preeclampsia fromgestational hypertension: Neutrophil to lymphocyte ratio,platelet to lymphocyte ratio and platelet to neutrophilratio. Clin Lab 2017; 69 (11): 1897-902.doi:10.7754-Clin.Lab.2017:170705

16. Gogoi P, Sinha P, Gupta B, Firmal P, et al. Neutrophil-tolymphocyteratio and platelet indices in pre-eclampsia.Int J Gynaecol Obstet 2019; 144 (1): 16-20. doi.10.1002-ijgo.12701

17. Kang Q, Li W, Fan L, Zhang Y, et al. Predictive role of neutrophil-to-lymphocyte ratio in preeclampsia: A meta-analysisincluding 3982 patients. Pregnancy Hypertension 2020; 20:111-118. doi.10.1016-j.preghyp.202.03.09

18. Kirbas A, Ersoy A, Daglar K, Dikici T, et al. Prediction ofpreeclampsia by first trimester combined test and simpleblood count parameters. J Clin Diag Res 2015; 9 (11): QC20-3. doi.10.7860-JCDR-2015-15397.6833

19. Serin S, Avci F, Ercan O, Köstü, et al. Is neutrophil-lymphocyteratio a useful marker to predict the severity ofpreeclampsia? Pregnancy Hypertens 2016; 6 (1): 22-5.doi:10.1016-j.preghy.2016:01.005

20. Kurtoglu E, Kokcu A, Celik H, Tosun M, et al. May ratioof neutrophil to lymphocyte be useful in predicting therisk of developing preeclampsia? A pilot study. J MaternFetal Neonatal Med 2015; 28 (1): 97-9. doi: 10.3109-14767058.2014.905910

21. Yavuzcan A, Caglar M, Ustün Y, Dilbaz S, et al. Mean plateletvolume, neutrophil-lymphocyte ratio and plateletlymphocyteratio in severe preeclampsia. Ginekol Pol 2014;85 (3): 197-203. PMID:24783431

22. Ghelfi AM, Lassos MN, Diodati S, Halis EA. Utility of theneutrophil-lymphocyte ratio and the polimorphonuclearmononuclearratio in the prediction of preeclampsia.Hipertens Riesgo Vasc 2019; 36 (2): 63-69. doi: 10.1016-j.hipert.2018.06.001

23. Panwar M, Kumari A, Hp A, Arora R, et al. Raised neutrophillymphocyte ratio and serum beta hCG level in early secondtrimester of pregnancy as predictors for development andseverity of preeclampsia. Drug Discover Ther 2019; 13 (1):34-37. doi: 10.5582-ddt.2019.01006

24. Hershko Klement A, Hadi E, Asali A, Shavit T, et al. Neutrophilsto lymphocytes ratio and platelets to lymphocytesratio in pregnancy: A population study. Plos One 2018; 13(5): e196076. doi: 10.1371-journal.pone.0196706

25. Mannaerts D, Faes E, Cos P, Briede JJ, et al. Oxidativestress in healthy pregnancy and preeclampsia is linked tochronic inflammation, iron status and vascular function.Plos One 2018; 13 (9): e0202919. doi:10.1371-journal.pone.0202919

26. Whittaker PG, Macphail S, Lind T. Serial hematologicchanges and pregnancy outcome. Obstet Gynecol 1996;88: 33-9. doi: 10.1016-0029-7844(96)00095-6

27. Bulbul M, Uckardes F, Karacar T, Nacar MC, et al. Cancomplete blood count parameters that change accordingto trimester in pregnancy be used to predict severepreeclampsia? J Obstet Gynecol 2021; 41 (8): 1192-98.doi:10.1080-01443615.2020.1854697

28. Zheng WF, Zhan J, Chen A, Ma H, et al. Diagnostic valueof neutrophil-lymphocyte ratio in preeclampsia.A PRISMA-compliant systematic review and metaanalysis.Medicine 2019; 98 (5)1(e18496). doi: 10.1097-MD.00000000000018496

29. Kim MA, Han GH, Kwon JY, Kim YH. Clinical significance ofplatelet.to-lymphocyte ratio in women with preeclampsia.Am J Reprod Immunol 2018; 80 (1): e12973. doi.10.1111-aji.12973

30. Yucel B, Ustun B. Neutrophil to lymphocyte ratio, plateletto lymphocyte ratio, mean platelet volume, redcell distribution width and platelecrit in preeclampsia.Pregnancy Hypertens 2017; 29-32. doi.10.1016-j.prgehyp.2016.12.002.

31. Cintesun E, Cintesun FNI, Ezveci H, Akuyurk F, et al. Systemicinflammatory response markers in preeclampsia.J Lab Physcians 2018; 10 (3): 316-19. doi: 10.4103-JLP.JLP_144_17

32. Elmaradny E, Alneel G, Alkhattaf N, AlGadri T, et al.Predictive values of combined platelet count, neutrophillymphocyteratio, and platelet-lymphocyte ratio inpreeclampsia. J Obstet Gynaecol 2021; 1-7. doi: 10.1080-01443615.2021.1986476