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Assessment of some hematologic markers of Systemic Inflammatory Response (SIR) as eliable bio¬markers in detecting preeclampsia; a comparative cross-sectional study in Enugu, Nigeria


Theresa Ukamaka Nwagha
Helen Chioma Okoye
Joseph Tochukwu Enebe
Emmanuel Obiora Izuka
Kingsley Emeka Ekwuazi
Chiamaka Queenet Onyebuchukwu
Samuel Nnamdi Obi
Uchenna Ifeanyi Nwagha

Abstract

Background: Systemic inflammatory response (SIR) occurs in normal pregnancy and is exacerbated in pre-eclampsia (PE). Most markers of SIR are expensive to measure, require trained personnel, and thus are limited for routine application in resource-limited settings. Thus, we aim to determine the clinical utility of hematologic markers of systemic inflammatory response in Preeclampsia in a resource limited setting.


Methods: A cross-sectional comparative study was conducted in Enugu from April to October 2021. Forty-five women with pre-eclampsia (PE) and 45 matched normotensive (NT) pregnant women were recruited. Hematological markers of systemic inflammatory response (red cell distribution width (RDW), neutrophil-lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), monocyte lymphocyte ratio (MLR), and platelet indices) were measured using the automated Mythic 22 Orphee hematology analyzer. Statistical analysis was by student T-test, receiver operating characteristics (ROC) curve, and Pearson correlation test. A P value of < 0.05 was considered significant.


Results: The age difference between the groups was not significant (P = 0.76). Pregnant women with preeclampsia had significantly higher RDWS (P=0.02) and NLR (P <0.001) but a significantly lower PLR (P =0.04). The NLR had the largest area under the ROC curve (AUC 0.82, 95% CI (0.74-0.906, P <0.001), cut-off >2.56, sensitivity 71.1%; specificity 22.2%) followed by MLR (AUC 0.68, 95% CI (0.58-0.80, P =0.002) cut-off >0.18, sensitivity 64.4%; specificity: 28.9 %;)


Conclusion: The NLR and MLR were good and affordable biomarkers of Systemic Inflammatory response (SIR) in Preeclampsia, thus possible alternative in resource-limited settings.


Keywords: Preeclampsia; hematology markers; systemic inflammatory response; pregnancy; resource limited settings.


Journal Identifiers


eISSN: 1729-0503
print ISSN: 1680-6905