High neutrophils to lymphocytes ratio in maternal blood serum as risk factor for preterm premature rupture of membrane
DOI:
https://doi.org/10.18203/2320-6012.ijrms20233364Keywords:
Inflammation, Neutrophil-to-lymphocyte ratio, Preterm premature rupture of membranesAbstract
Background: Neutrophil-to-lymphocyte ratio has been extensively studied as a prognostic factor for various diseases based on systemic inflammation. Premature rupture of membranes is an obstetric problem that does not only occur in term pregnancies but can also occur in preterm pregnancies. One of the main etiologies for premature rupture of membranes is inflammation. Knowing the difference in the NLR between preterm premature rupture of membranes and without PPROM is important to increase understanding of the crucial role of NLR in predicting the incidence of PPROM.
Methods: This analytic case-control study compared NLR values in maternal blood serum between PPROM and without PPROM. This research was conducted in the emergency delivery room and obstetrics and gynecology outpatient clinic at Prof. dr. I.G.N.G. Ngoerah Hospital Denpasar from February to June 2022.
Results: A high NLR in maternal blood serum may be a risk factor for PPROM. Patients with a high NLR had a 4.5 times greater likelihood of experiencing PPROM than those with a low NLR (OR=4.5; 95% CI=1.4-13.83; p=0.007).
Conclusions: A high NLR in maternal blood serum is a marker of inflammation with an increased risk of 4.5 times for the occurrence of PPROM.
References
Clinical Management Guidelines for Obstetrician-Gynecologists. Available at: https://www.acog.org/ clinical/clinical-guidance/practice-bulletin. Accessed on 20 February 2023.
Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. William Obstetrics. 23rd ed. United States: The McGraw-Hill Companies; 2018.
Buonacera A, Stancanelli B, Colaci M, Malatino L. Neutrophil to lymphocyte ratio: an emerging marker of the relationships between the immune system and diseases. Int J Mol Sci. 2022;23(7):3636.
Getahun D, Strickland D, Ananth CV. Recurrence of preterm premature rupture of membranes in relation to interval between pregnancies. Am J Obstet Gynecol. 2010;202:570-86.
Wiradharma W, Kardana IM, Dharma IW. Risiko Asfiksia pada Ketuban Pecah Dini di RSUP Sanglah. Sari Pediatr. 2016;14(5):316.
Budijaya, Negara, S. Profil Persalinan Dengan Ketuban Pecah Dini di RSUP Sanglah Denpasar. Laporan Penelitian Deskriptif. 2016.
Zhan F, Zhu S, Liu H, Wang Q, Zhao G. Blood routine test is a good indicator for predicting premature rupture of membranes. J Clin Lab Anal. 2019;33(2):e22673.
Pradana T, Surya I. Karakteristik ibu bersalin dengan ketuban pecah dini (aterm & preterm) di rumah sakit umum pusat sanglah denpasar. J Med Udayana. 2016; 9(7):92-7.
Hackenhaar AA, Albernaz EP, da Fonseca TM. Preterm premature rupture of the fetal membranes: association with sociodemographic factors and maternal genitourinary infections. J Pediatr. 2014; 90(2):197-202.
Movahedi M, Rezaie M, Taefnia AM. Maternal and fetal outcomes of preterm premature rupture of membrane. J Isfahan Med School. 2013;30(216):2134-9.
Manuaba A. Pengantar Kuliah Obstetri. Jakarta: EGC; 2010.
Varney H. Varneys midwife pocket book. Jakarta: EGC; 2002.
Locatteli A, Andreani M, Vergani P. Preterm Premature of Membrane (PPROM). In: Berghella V, eds. Obstetric Evidence Based Guideline. UK: Informa Ltd; 2012:138-49.
Ozel A, Alici Davutoglu E, Yurtkal A, Madazli R. How do platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio change in women with preterm premature rupture of membranes, and threaten preterm labour? J Obstet Gynaecol. 2020;40(2):195-9.
Toprak E, Bozkurt M, Dinçgez Çakmak B, Özçimen EE, Silahlı M, Ender Yumru A, et al. Platelet-to-lymphocyte ratio: A new inflammatory marker for the diagnosis of preterm premature rupture of membranes. J Turk Ger Gynecol Assoc. 2017;18(3):122-6.
Melissa CL. Neutrophil to Lymphocyte Ratio and Red Blood Cell Distribution Width Levels in Preterm vs. Term Births. J Mol Genet Med. 2008;12(1):1-3.
Kim MA, Lee YS, Seo K. Assessment of predictive markers for placental inflammatory response in preterm births. PLoS One. 2014;9(10):e107.
Bastek JA, Sammel MD, Srinivas SK, McShea MA, Foreman MN, Elovitz MA, et al. Clinical prediction rules for preterm birth in patients presenting with preterm labor. Obstet Gynecol. 2012;119(6):1119-28.
Mubark AM. Neutrophil to lymphocyte ratio & cervical length for prediction of spontaneous preterm delivery in threatened preterm labour. J Mol Genet Med. 2015:11(19):34-9.
Akboga MK, Canpolat U, Yuksel M, Yayla C, Yilmaz S, Turak O, et al. Platelet to lymphocyte ratio as a novel indicator of inflammation is correlated with the severity of metabolic syndrome: A single center large-scale study. Platelets. 2016;27(2):178-83.
Zhan F, Zhu S, Liu H, Wang Q, Zhao G. Blood routine test is a good indicator for predicting premature rupture of membranes. J Clin Lab Anal. 2019;33(2):e22673.
Bozoklu Akkar O, Sancakdar E, Karakus S, Yildiz C, Akkar I, Arslan M, et al. Evaluation of Maternal Serum 25-Hydroxyvitamin D, Paraoxonase 1 Levels, and Neutrophil-to-Lymphocyte Ratio in Spontaneous Preterm Birth. Med Sci Monit. 2016;22:1238-43.
Daglar HK, Kirbas A, Kaya B, Kilincoglu F. The value of complete blood count parameters in predicting preterm delivery. Eur Rev Med Pharmacol Sci. 2016; 20(5):801-5.
Balciuniene G, Kvederaite-Budre G, Gulbiniene V, Dumalakiene I, Viliene R, Pilypiene I, et al. Neutrophil-lymphocyte ratio for the prediction of histological chorioamnionitis in cases of preterm premature rupture of membranes: a case-control study. BMC Pregn Childbirth. 2021;21(1):656.
Gezer C, Ekin A, Solmaz U, Sahingoz YAG, Dogan A, Ozeren M. Identification of preterm birth in women with threatened preterm labour between 34 and 37 weeks of gestation. J Obstet Gynaecol. 2018;38(5): 652-7.
Lakshmi MPAS, Sravani VL. Role of neutrophil-lymphocyte ratio in determining the outcomes of preterm premature rupture of membranes. Int J Reprod Contracept Obstet Gynecol. 2021;10(4):1617.
Wesche DE, Lomas-Neira JL, Perl M, Chung CS, Ayala A. Leukocyte apoptosis and its significance in sepsis and shock. J Leukocyte Biol. 2005;78:325-37.
Zahorec R. Ratio of neutrophil to lymphocyte counts-rapid and simple parameter of systemic inflammation and stress in critically ill. Bratislavske Lekarske List. 2005;102:5-14.
Roth E, Pircher H. IFN-gamma promotes Fas ligand- and perforinmediated liver cell destruction by cytotoxic CD8 T cells. J Immunol. 2004;172:1588-94.
