The role of platelet-lymphocyte ratio and neutrophil-lymphocyte ratio in early gestational week in predicting missed abortion

Mehmet Nuri Duran; Kübra Özkan Karacaer; Serem Kel; Bülent Demir

doi:10.18203/2320-6012.ijrms20222862

Authors

Mehmet Nuri Duran Department of Obstetrics and Gynecology, Midyat State Hospital, Mardin, Turkey http://orcid.org/0000-0001-6925-711X
Kübra Özkan Karacaer Department of Obstetrics and Gynecology, Ezine State Hospital, Çanakkale, Turkey
Serem Kel Department of Obstetrics and Gynecology, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
Bülent Demir Department of Obstetrics and Gynecology, Çanakkale Onsekiz Mart University, Çanakkale, Turkey

DOI:

https://doi.org/10.18203/2320-6012.ijrms20222862

Keywords:

Missed abortion, NLR, PLR

Abstract

Background: The definition of abortion was made by the World Health Organization based on the weight of the pregnancy material or the duration of pregnancy. According to this expression, the expulsion of all or some of the pregnancy material weighing less than 500 grams or before the 20^th week of pregnancy from the uterine cavity is called abortion. Platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR), which are among the inflammation parameters likely to be increased in abortion, were compared in groups that resulted in abortion and did not result in abortion.

Methods: The study included 120 patients who had a diagnosis of <14 weeks of abortion and 120 healthy pregnant women who applied to the gynecology and obstetrics clinic of a tertiary care hospital between January 2018 and December 2021. Those who had a previous fetal heartbeat or intracavitary pregnancy and aborted before the 14^th gestational week were included in the selection of the abortus group.

Results: NLR and PLR were analyzed with ROC curve analysis. The area under the curve (AUC) for NLR was 0.498, with 95% confidence intervals (0.424-0.572), and was not statistically significant (p=0.38). The area under the curve (AUC) for PLR was 0.480 at 95% confidence intervals (0.406-0.557), and was not statistically significant (p=0.38).

Conclusions: NLR and PLR ratios were similar in both groups. As a result of the present study, it was found that there were no significant differences between the abortion NLR and PLR values between the groups (p>0.05).

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Author Biography

Mehmet Nuri Duran, Department of Obstetrics and Gynecology, Midyat State Hospital, Mardin, Turkey

Midyat Devlet Hastanesi, Kadın Hastalıkları ve Doğum, Mardin, Türkiye

References

Cunningham F, Leveno K, Bloom S, Spong CY, Dashe J. Williams Obstetrics, 24th edn. McGraw-Hill New York, NY: USA; 2014.

Wilcox AJ, Weinberg CR, O’Connor JF, Baird DD, Schlatterer JP, Canfield RE, et al. Incidence of early loss of pregnancy. N Engl J Med. 1988;319(4):189-94.

Soler A, Morales C, Mademont-Soler I, Margarit E, Borrell A, Borobio V, et al. Overview of chromosome abnormalities in first trimester miscarriages: a series of 1,011 consecutive chorionic villi sample karyotypes. Cytogen Gen Res. 2017;152(2):81-9.

Levy B, Sigurjonsson S, Pettersen B, Maisenbacher MK, Hall MP, Demko Z, et al. Genomic imbalance in products of conception. Obstet Gynecol. 2014;124(2):202-9.

Romero ST, Geiersbach KB, Paxton CN, Rose NC, Schisterman EF, Branch DW, et al. Differentiation of genetic abnormalities in early pregnancy loss. Ultrasound Obstet Gynecol. 2015;45(1):89-94.

Leitich H, Kiss H. Asymptomatic bacterial vaginosis and intermediate flora as risk factors for adverse pregnancy outcome. Best Pract Res Clin Obstet Gynaecol. 2007;21(3):375-90.

McNamee K, Dawood F, Farquharson R. Recurrent miscarriage and thrombophilia: an update. Curr Opin Obstet Gynecol. 2012;24(4):229-34.

Regan L, Rai R. Epidemiology and the medical causes of miscarriage. Baillieres Best Pract Res Clin Obstet Gynaecol. 2000;14(5):839-54.

Huang Y, Deng W, Zheng S, Feng F, Huang Z, Huang Q, et al. Relationship between monocytes to lymphocytes ratio and axial spondyloarthritis. Int Immunopharmacol. 2018;57:43-6.

Pantzaris ND, Platanaki C, Pierrako C, Karamouzos V, Velissaris D. Neutrophil-to-lymphocyte ratio relation to sepsis severity scores and inflammatory biomarkers in patients with community-acquired pneumonia: a case series. J Translat Intern Med. 2018;6(1):43-6.

Loo B van der, Martin JF. 6 Megakaryocytes and platelets in vascular disease. Baillière’s Clin Haematol. 1997;10(1):109-23.

A. Jagroop, I. Clatworthy, J. Lewin, DP Mikhailidis I. Shape change in human platelets: measurement with a channelyzer and visualisation by electron microscopy. Platelets. 2000;11(1):28-32.

Mantovani A, Cassatella MA, Costantini C, Jaillon S. Neutrophils in the activation and regulation of innate and adaptive immunity. Nat Rev Immunol. 2011;11(8):519-31.

Joshi VD, Kalvakolanu DV, Cross AS. Simultaneous activation of apoptosis and inflammation in pathogenesis of septic shock: a hypothesis 1. FEBS Lett. 2003;555(2):180-4.

Soler A, Morales C, Mademont-Soler I, Margarit E, Borrell A, Borobio V, et al. Overview of chromosome abnormalities in first trimester miscarriages: a series of 1,011 consecutive chorionic villi sample karyotypes. Cytogen Gen Res. 2017;152(2):81-9.

Çakıroğlu Y, Vural F, Vural B. The inflammatory markers in polycystic ovary syndrome: association with obesity and IVF outcomes. J Endocrinol Investig. 2016;39(8):899-907.

Sales KJ, Jabbour HN. Cyclooxygenase enzymes and prostaglandins in pathology of the endometrium. Reproduction. 2003;126(5):559-67.

Nadeau-Vallée M, Obari D, Palacios J, Brien MÈ, Duval C, Chemtob S, et al. Sterile inflammation and pregnancy complications: a review. Reproduction. 2016;152(6):R277-92.

Mihu D, Razvan C, Malutan A, Mihaela C. Evaluation of maternal systemic inflammatory response in preeclampsia. Taiwanese J Obstet Gynecol. 2015;54(2):160-6.

Jauniaux E, Nicolaides KH, Hustin J. Perinatal features associated with placental mesenchymal dysplasia. Placenta. 1997;18(8):701-6.

Jauniaux E, Poston L, Burton GJ. Placental-related diseases of pregnancy: involvement of oxidative stress and implications in human evolution. Hum Reprod Update. 2006;12(6):747-55

Boilard E, Nigrovic PA, Larabee K, Watts GF, Coblyn JS, Weinblatt ME, et al. Platelets amplify inflammation in arthritis via collagen-dependent microparticle production. Science. 2010;327(5965):580-3.

Koh CH, Bhoo-Pathy N, Ng KL, Jabir RS, Tan GH, See MH, et al. Utility of pre-treatment neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as prognostic factors in breast cancer. Br J Cancer. 2015;113(1):150-8.

Gogoi P, Sinha P, Gupta B, Firmal P, Rajaram S. Neutrophil-to-lymphocyte ratio and platelet indices in pre-eclampsia. Int J Gynaecol Obstet. 2019;144(1):16-20.

Kim Y. Retrospective analysis of prognostic value of the neutrophil-to-lymphocyte ratio in early miscarriages: A 8-year survey. Medicine. 2020;99(27):e20888.

Christoforaki V, Zafeiriou Z, Daskalakis G, Katasos T, Siristatidis C. First trimester neutrophil to lymphocyte ratio (NLR) and pregnancy outcome. J Obstet Gynaecol. 2020;40(1):59-64.