OBJECTIVE

To evaluate the association between maternal neutrophil-to-lymphocyte ratio (NLR) and delivery within 24 h in women with preterm premature rupture of membranes (PPROM).

STUDY DESIGN AND SETTING

Retrospective cohort study in a single university-affiliated tertiary medical centre.

POPULATION

Women with PPROM at ≤ 36 + 6 weeks' gestation planning vaginal delivery. Exclusions included women who lacked complete blood count (CBC) data within the first 24 h from PPROM caesarean delivery.

METHODS

Maternal demographic and clinical data, including age, gestational age, body mass index, parity and mode of conception, were collected. Women who delivered within 24 h of membrane rupture were compared to those who did not via univariate and multivariate Cox analyses.

MAIN OUTCOME MEASURE

Women who delivered within 24 h from rupture of membrane.

RESULTS

Among 145 833 deliveries during the study period, 1498 women (0.9%) presented with PPROM. After exclusions, 371 women were included, with 173 (46.6%) delivering spontaneously within 24 h. Cox regression analysis identified NLR > 10 (HR = 1.60; 95% CI, 1.06-2.40; p = 0.025) as an independent risk factor for spontaneous delivery within 24 h.

CONCLUSION

Elevated maternal NLR is associated with delivery within 24 h in PPROM and may support clinical assessment for anticipating imminent preterm delivery, aiding in management decisions for this population.