Ergani Seval Yılmaz, Aksan Alperen, Kamacı Ceren Polat, Şeyhanlı Zeynep, İbanoǧlu Müjde Can, Reis Yıldız Akdaş, Erdoǧan Kadriye, Çelen Şevki
Department of Perinatology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Ankara, Turkey.
Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Ankara, Turkey.
Malawi Med J. 2024 Oct 16;36(3):208-212. doi: 10.4314/mmj.v36i3.6. eCollection 2024 Oct.
To investigate the prognostic significance of delta-neutrophil index (DNI) and neutrophil/lymphocyte ratio (NLR) in women with intrauterine growth retardation (IUGR) and normal pregnant women.
Normal pregnant women who delivered at Health Sciences University Etlik Zübeyde Hanim Women's Health Training and Research Hospital between January 2015 and July 2020 and pregnant women with IUGR were included in the study. 486 pregnant women and 400 normally pregnant women diagnosed with IUGR according to Delphi criteria were included in the analysis. Data available at presentation for delivery or within four weeks before delivery were used for analysis of DNI and other laboratory values in both the patient and control groups.
The mean age of study group was 28.3±4.6 and control group was 27.2±5.6 years. There were significant differences between the study and control groups regarding maternal age, prepregnancy BMI, BMI at delivery and gestational age at admission and delivery, hemoglobin(Hb) levels, hematocrit (Hct) values, WBC values, lymphocyte, monocyte, neutrophile, thrombocyte counts, NLRs, DNI values, between the two groups. The median NLRs were 4.6 (range, 1.54±44.29), the mean DNI value of IUGR was --0.26±3.4 and the mean DNI value of control group was -3.7±5.8 (p<0.001, p<0.001, respectively). The NLR and DNI levels are significantly higher in the IUGR group. The optimal cut-off value for NLR was 3.84, with a sensitivity of 70.6% a specificity of 70.5%, and an area under the receiver operating characteristic curve of 0.780. The optimal cutoff value for DNI was -1.18, with a sensitivity of 53.9%, a specificity of 52%, and an area under the ROC curve of 0.692. The Odds Ratio of the DNI was 1.2, and NLR was 5.7.
Considering its sensitivity and specificity, the NLR value shows that inflammatory events are much more effective in pregnant women with IUGR than we thought.
探讨δ-中性粒细胞指数（DNI）和中性粒细胞/淋巴细胞比值（NLR）在宫内生长受限（IUGR）孕妇和正常孕妇中的预后意义。
纳入2015年1月至2020年7月在健康科学大学埃特利克·祖贝德·哈尼姆妇女健康培训与研究医院分娩的正常孕妇以及IUGR孕妇。根据德尔菲标准，486例孕妇和400例诊断为IUGR的正常孕妇纳入分析。分娩时或分娩前四周内可获得的数据用于分析患者组和对照组的DNI及其他实验室值。
研究组平均年龄为28.3±4.6岁，对照组为27.2±5.6岁。研究组和对照组在产妇年龄、孕前体重指数、分娩时体重指数、入院和分娩时孕周、血红蛋白（Hb）水平、血细胞比容（Hct）值、白细胞值、淋巴细胞、单核细胞、中性粒细胞、血小板计数、NLR、DNI值方面存在显著差异。IUGR组的NLR中位数为4.6（范围，1.54±44.29），IUGR组的平均DNI值为-0.26±3.4，对照组的平均DNI值为-3.7±5.8（分别为p<0.001，p<0.001）。IUGR组的NLR和DNI水平显著更高。NLR的最佳截断值为3.84，敏感性为70.6%，特异性为70.5%，受试者工作特征曲线下面积为0.780。DNI的最佳截断值为-1.18，敏感性为53.9%，特异性为52%，ROC曲线下面积为0.692。DNI的优势比为1.2，NLR为5.7。
考虑到其敏感性和特异性，NLR值表明炎症事件在IUGR孕妇中的影响比我们想象的要大得多。
