Ozel Aysegul, Alici Davutoglu Ebru, Yurtkal Aslihan, Madazli Riza
Department of Obstetrics and Gynecology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
J Obstet Gynaecol. 2020 Feb;40(2):195-199. doi: 10.1080/01443615.2019.1621807. Epub 2019 Sep 1.
The aim of the study was to investigate peripheral blood platelets, neutrophils and lymphocytes counts in women with preterm premature rupture of membranes (PPROM) and threatened preterm labour (TPL) compared with gestation-matched controls in order to learn how they change. This study was conducted on 60 women with PPROM, 50 women with TPL and 47 healthy pregnant women. Laboratory parameters (including complete blood count, C-reactive protein (CRP)) of all the participants were recorded. The neutrophil-to-lymphocyte ratio (NLR) values were significantly higher in PPROM group than TPL group and healthy control group (6.1 ± 3.9, 4.4 ± 1.7, 4.4 ± 2.2, = .007, = .018, respectively). At a cut-off level of 5.14, NLR accurately predicted occurrence of neonatal sepsis (AUC = 0.717 (95% confidence interval 0.610-0.824), = .001) with sensitivity and specificity rates of 69.7% and 72.0%, respectively. In the management of the patients with PPROM, NLR can be used as a more cost-effective method than other blood parameters that require the use of a kit.IMPACT STATEMENT There is only one study in the literature evaluating blood count parameters (such as platelet-to-lymphocyte ratio (PLR), NLR) in PPROM pregnancies. That study demonstrated PLR and NLR were both higher in the PPROM group. The present study demonstrates that only NLR is higher in the PPROM group. Furthermore, we have also demonstrated distinctively that NLR can predict occurrence of neonatal sepsis. High values of NLR may be useful for predicting adverse outcomes in PPROM and TPL patients as a cost-effective method. Further studies are needed to determine whether these parameters can be used to predict if a pregnant woman who is at risk of preterm labour will result in adverse perinatal outcome.
本研究旨在调查胎膜早破(PPROM)和先兆早产(TPL)女性与孕周匹配的对照组相比外周血血小板、中性粒细胞和淋巴细胞计数,以了解其变化情况。本研究纳入了60例PPROM女性、50例TPL女性和47例健康孕妇。记录了所有参与者的实验室参数(包括全血细胞计数、C反应蛋白(CRP))。PPROM组的中性粒细胞与淋巴细胞比值(NLR)值显著高于TPL组和健康对照组(分别为6.1±3.9、4.4±1.7、4.4±2.2,P = 0.007,P = 0.018)。在截断值为5.14时,NLR准确预测了新生儿败血症的发生(曲线下面积 = 0.717(95%置信区间0.610 - 0.824),P = 0.001),敏感性和特异性分别为69.7%和72.0%。在PPROM患者的管理中,与其他需要使用试剂盒的血液参数相比,NLR可作为一种更具成本效益的方法。影响声明:文献中仅有一项研究评估了PPROM妊娠中的血细胞计数参数(如血小板与淋巴细胞比值(PLR)、NLR)。该研究表明PPROM组中PLR和NLR均较高。本研究表明PPROM组中仅NLR较高。此外,我们还独特地证明了NLR可预测新生儿败血症的发生。NLR高值作为一种具有成本效益的方法,可能有助于预测PPROM和TPL患者的不良结局。需要进一步研究以确定这些参数是否可用于预测有早产风险的孕妇是否会导致不良围产期结局。