Role of Neutrophil Lymphocyte Ratio and Platelet Indices as Inflammatory Indicators and Its Association with Preeclampsia

Abstract

Background: Preeclampsia (PE) is a pregnancy-specific illness that can manifest as late as 4-6 weeks after delivery and often develops  after 20 weeks of gestation due to extensive endothelial dysfunction and vasospasm. PE affects between six and eight percent of  pregnancies globally and is an intractable obstetric condition with substantial mortality and morbidity.

Objectives: Neutrophil to lymphocyte ratio and platelet to lymphocytic ratio measurements in pre-eclamptic women and gestationally- matched healthy controls are used to measure the systemic inflammatory markers.

Methods: In this cross-sectional study, pregnant  patients with pre-eclampsia between the ages of 18 and 40 who were admitted to Department of Obstetrics and Gynaecology, Menoufia  University Hospital. Two equal groups of pregnant women were created: Group (A) included 84 preeclampsia pregnant women, and  group (B) included age- and gestational age-matched healthy 84 pregnant women.

Results: When comparing pre-eclamptic pregnant  women to normal pregnant women, there was a statistical significant increase in both neutrophil to lymphocytic ratio (NLR) and platelet  to lymphocytic ratio (PLR) (mean 4.3 vs 2.9 for NLR and 141.2 vs 113.4 for PLR, p < 0.001). In addition, women with severe pre-eclampsia  had much higher NLR and PLR than those with mild pre-eclampsia. There were the most effective predictors of pre-eclampsia, as  demonstrated by neutrophil to lymphocytic ratio and platelet to lymphocytic ratio. NLR was positively correlated with neutrophil counts,  diastolic and systolic blood pressure, and gestational age at birth. The relationship between NLR and platelets was inverse. There was a  positive connection between platelet to lymphocytic ratio and GA at delivery as well as platelets.

Conclusion: NLR and platelet to  lymphocytic ratio were significantly higher in pre-eclampsia women, which could be used as clinical predictors of preeclampsia and its  severity.