First trimester blood indices: a predictor of early and late onset preeclampsia
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20243601Keywords:
NLR, PLR, RDW, Blood indices, Hematocrit, PreeclampsiaAbstract
Background: Preeclampsia is a condition that falls under the hypertension spectrum and is more common in pregnant women who are 20 weeks or older. It causes complications in 2% to 8% of pregnancies. This study sought to identify haematological preeclampsia markers in pregnant women who received prenatal care at tertiary care centre at Vijayapur, Karnataka, India.
Methods: This was a case-control study conducted at a tertiary care centre in Vijayapura Karnataka, from 01 December 2023 to 31 May 2024. A total of 75 preeclamptic patients with early (<34 weeks of gestation) and late presentation (≥34 weeks of gestation) were selected as cases and equal number of normotensive pregnant females were taken as controls. All the cases and controls were analysed for blood indices. The means of continuous variables were compared with two tailed students t-test by using SPSS version 26.0 statistical software.
Results: In the present study, we observed that 75 patients with diagnosed cases of preeclampsia, among them, 42.1% were early onset preeclampsia and 56.6% were late onset. After comparing means of blood indices between early and late onset of preeclampsia showed, WBC (early- 17.92±0.98; late- 16.08±0.78), neutrophils (early- 77.52±1.22; late- 75.97±0.47), lymphocytes (early- 26.33±.2.78; late- 31.01±2.62), platelets (early- 128.59±2.22; late- 131.93±3.62), NLR (early- 2.97±0.28; late- 2.46±0.19), PLR (early- 4.93±0.46; late- 4.28±0.34) and the statistical significant difference (p<0.05) seen in these parameters. Blood indices of cases and controls were as follows, hemoglobin (cases-10.45±1.31; controls- 10.89±0.53), MCV (cases- 87.67±1.39; controls- 85.14±2.82), RDW (cases- 13.09±78; controls- 13.80±0.0), WBC (cases- 16.87±1.6; controls- 15.58±1.22), eosinophils (cases- 4.49±0.79; controls- 4.08±0.47), lymphocytes (cases- 29.01±3.54; controls- 22.73±0.86), platelets (cases- 130.16±3.50; controls- 132.16±3.98), NLR (cases- 2.68±0.34; controls- 3.65±4.09), PLR (cases- 4.55±0.51; controls- 5.82±0.24). There was a significant difference (p<0.05) between cases and controls in above parameters. According to these results, blood indices of preeclampsia with early and late onset differed significantly from healthy controls.
Conclusions: According to the study’s findings, elevated first-trimester RDW, WBC, neutrophils, lymphocytes, platelets, and NLR/PLR ratios may serve as clinically valuable indicators for preeclampsia prediction. Changes in several indicators point to a possible major role for inflammation in the pathophysiology of preeclampsia.
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References
Oglak SC, Ölmez F. First trimester mean platelet volume, neutrophil to lymphocyte ratio, and platelet to lymphocyte ratio values are useful markers for predicting preeclampsia. Ochsner J. 2021;21:364-70.
Avcıoğlu SN, Sezer SD, Altınkaya SÖ, Küçük M, Ömürlü İK, Yüksel H. Preeclampsia and Erythrocyte Indices, Meandros Med Dent J. 2015;16:35-42,
Gezer C, Ekin A, Özeren M, Taner CE, Avcı ME, Doğan A. The location of first trimester inflammation markers in early and late preeclampsia. Perinat J. 2014;22:128-32.
Tomimatsu T, Mimura K, Matsuzaki S, Endo M, Kumasawa K, Kimura T. Preeclampsia: maternal systemic vascular disorder caused by generalized endothelial dysfunction due to placental antiangiogenic factors. Int J Mol Sci. 2019;20(17):4246
Magro-Malosso ER, Saccone G, Di Tommaso M, Roman A, Berghella V. Exercise during pregnancy and risk of gestational hypertensive disorders: a systematic review and meta-analysis. Acta Obstet Gynecol Scand. 2017;96(8):921-31.
Gezer C, Ekin A, Ertas IE, Ozeren M, Solmaz U, Mat E, et al. High first-trimester neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios are indicators for early diagnosis of preeclampsia. Ginekol Polska. 2016;87(6):431-5.
Abd-elfattah AFM. Neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and c-reactive protein as markers for severity of pre-eclampsia. ROAIC. 2019;6:64-71.
Singgih R, Firmansyah Y, Dewi AK. Clinical ability of neutrophil-lymphocyte ratio in pregnancy as a predictor of preeclampsia. J South Asian Feder Obstet Gynecol. 2021;13(3):125-30.
Brown MA, Magee LA, Kenny LC, Karumanchi SA, McCarthy FP, Saito S, et al. Hypertensive disorders of pregnancy: ISSHP classification, diagnosis, and management recommendations for international practice. Hypertension. 2018;72(1):24-43.
Fox R, Kitt J, Leeson P, Aye CY, Lewandowski AJ. Preeclampsia: risk factors, diagnosis, management, and the cardiovascular impact on the offspring. J Clin Med. 2019;8(10):1625.
Wang J, Zhu QW, Cheng XY, Liu JY, Zhang LL, Tao YM, et al. Assessment efficacy of neutrophil-lymphocyte ratio and monocyte-lymphocyte ratio in preeclampsia. J Reprod Immunol. 2019;132:29-34.
Raymond D, Peterson E. A critical review of early-onset and lateonset preeclampsia. Obstet Gynecol Surv. 2011;66:497-5.
Wu K, Gong W, Ke HH, Hu H, Chen L. Impact of elevated first and second trimester white blood cells on prevalence of late-onset preeclampsia. Heliyon. 2022;8(11).
Örgül G, Aydın Haklı D, Özten G, Fadiloğlu E, Tanacan A, Beksaç MS. First trimester complete blood cell indices in early and late onset preeclampsia. Turk J Obstet Gynecol. 2019;16(2):112-7.
Mannaerts D, Heyvaert S, De Cordt C, Macken C, Loos C, Jacquemyn Y. Are neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and/or mean platelet volume (MPV) clinically useful as predictive parameters for preeclampsia? J Matern Fet Neonat Med. 2019;32(9):1412-9.
Aktün H, Karaca N, Akpak YK. Arslan E. The role of hematological and biochemical markers in preeclampsia prediction. J Clin Analyt Med. 2017;8(Supplement: 4):306-9.
Kirbas A, Ersoy AO, Daglar K, Dikici T, Biberoglu EH, Kirbas O, et al. Prediction of Preeclampsia by First Trimester Combined Test and Simple Complete Blood Count Parameters. J Clin Diagn Res. 2015;9(11):QC20-3.
Jeon Y, Lee WI, Kang SY, Kim MH. Modified complete blood count indices as predicting markers of preeclampsia from gestational hypertension: neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and platelet to neutrophil ratio. Clin Lab. 2017;63(11):1897-902.
Bhat T, Teli S, Rijal J, Bhat H, Raza M, Khoueiry G, et al. Neutrophil to lymphocyte ratio and cardiovascular diseases: a review. Expert Rev Cardiovasc Ther. 2013;11:55-9.
Yıldız C, Karakus S, Akkar OB, Topbas T, Cetin M, Yanık A, et al. The significance of neutrophil-lymphocyte ratio and mean corpuscular volume in diagnosis of preeclampsia. GORM. 2016;22:75-9.
