Association Between Complete Blood Count Components and Intrahepatic Cholestasis of Pregnancy

Area of Science:

• Obstetrics and Gynecology
• Hematology
• Reproductive Medicine

Background:

• Inflammatory markers like neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are recognized biomarkers for obstetric conditions such as preeclampsia.
• The potential role of these complete blood count (CBC) components and ratios in diagnosing intrahepatic cholestasis of pregnancy (ICP) remains underexplored.

Purpose of the Study:

• To investigate the association between routine complete blood count (CBC) parameters and their ratios with intrahepatic cholestasis of pregnancy (ICP).
• To evaluate if CBC components and ratios can serve as potential biomarkers for ICP diagnosis.

Main Methods:

• A retrospective case-control study was conducted comparing 33 pregnancies with ICP to 33 matched healthy pregnancies.
• White blood cells (WBC), hemoglobin, neutrophils, lymphocytes, NLR, PLR, platelets, red cell distribution width (RDW), and mean platelet volume (MPV) were analyzed in the first and third trimesters.
• Comparisons were also made between mild and severe ICP cases based on serum total bile acid (TBA) levels in the third trimester.

Main Results:

• No significant differences in CBC parameters were observed between ICP cases and controls in the first trimester.
• In the third trimester, women with ICP showed decreased white blood cells (WBC), neutrophil counts, and neutrophil-to-lymphocyte ratio (NLR) compared to controls.
• Mean platelet volume (MPV) was significantly higher in the third trimester for ICP patients, while RDW was lower in mild ICP compared to severe ICP.

Conclusions:

• Decreased WBC, neutrophil counts, NLR, and altered MPV levels in the third trimester are associated with intrahepatic cholestasis of pregnancy (ICP).
• These CBC-derived markers may potentially augment the diagnostic criteria for ICP.
• Further research is warranted to elucidate the underlying molecular mechanisms.