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Peripheral blood neutrophil-to-lymphocyte ratio in preterm infants with intraventricular hemorrhage

Alan A Stein1, Stephanie Eyerly-Webb2, Rachele Solomon2

  • 1Florida Atlantic University, College of Medicine, 777 Glades Road, Boca Raton, FL, 33431, USA.

Clinical Neurology and Neurosurgery
|April 1, 2019
PubMed

Insights

Higher neutrophil-to-lymphocyte ratio (NLR) in preterm infants with intraventricular hemorrhage (IVH) is linked to seizures. This finding suggests NLR may predict seizure development in premature infants with IVH.

Area of Science:

  • Neonatal Medicine
  • Pediatric Neurology
  • Hematology

Background:

  • Intraventricular hemorrhage (IVH) is a serious complication in premature infants, increasing risks for hydrocephalus and seizures.
  • The neutrophil-to-lymphocyte ratio (NLR) has shown prognostic value in adult intracranial hemorrhage, but its role in preterm infants with IVH is unexplored.

Purpose of the Study:

  • To investigate the prognostic value of NLR in preterm infants diagnosed with IVH.
  • To determine if NLR levels correlate with complications such as seizures or the need for shunt placement in this population.

Main Methods:

  • A retrospective observational cohort study of preterm infants with IVH and a neonatal reservoir (2013-2018).
  • Peripheral blood and cerebrospinal fluid laboratory results were averaged within 50 days of IVH diagnosis.
  • Neutrophil-to-lymphocyte ratio (NLR) was calculated and analyzed for correlations with seizures, shunt placement, sepsis, and meningitis.

Main Results:

  • Analysis of 13 surviving preterm infants revealed a mean peripheral NLR of 1.6 ± 1.3.
  • Significantly higher peripheral blood NLR was observed in infants who experienced seizures (p < 0.000001).
  • An NLR > 3 was correlated with seizure outcomes (p = 0.0035) and also observed in infants with sepsis or meningitis, but independently of seizures.

Conclusions:

  • Elevated peripheral blood NLR (>3) is associated with an increased risk of seizures in preterm infants with IVH, independent of sepsis or meningitis.
  • NLR did not show a significant correlation with the development of hydrocephalus.
  • Further prospective studies are needed to validate NLR as a predictive marker for seizures in preterm neonates with IVH.
Abstract

Keywords:
Intraventricular hemorrhageNeonatesNeutrophil-to-lymphocyte ratioPosthemorrhagic hydrocephalusPreterm infantsSeizures

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