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Updated: Aug 30, 2025
Isolation of Leukocytes from the Human Maternal-fetal Interface
Published on: May 21, 2015
Maternal β-hCG and Neutrophil Lymphocyte Ratio during Pregnancy to Predict High-Risk Neonates: an Observational Study
Megha Panwar1, Akansha Mohanty1, Nidhi Ahuja1
1Dept. of Obstetrics and Gynaecology, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Insights
High maternal levels of neutrophil-to-lymphocyte ratio (NLR) and beta-human chorionic gonadotropin (β-hCG) are linked to adverse neonatal outcomes, including low birth weight and poor APGAR scores. Further research is recommended to explore these biomarker impacts for improved fetal outcomes.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Neonatal Outcomes
Background:
- Maternal serum biomarkers are crucial for identifying potential maternal and fetal complications during pregnancy.
- This study investigated the predictive value of beta-human chorionic gonadotropin (β-hCG) and neutrophil-to-lymphocyte ratio (NLR) for high-risk infant delivery, specifically focusing on low birth weight and poor APGAR scores.
Discussion:
- Maternal NLR and β-hCG levels demonstrated a negative correlation with neonatal outcomes such as low birth weight and low APGAR scores.
- Significantly higher mean NLR values were observed in neonates experiencing poor outcomes (low birth weight, low APGAR).
Key Insights:
- β-hCG showed good sensitivity (83%) and specificity (66-90%) in predicting poor APGAR scores at different gestational weeks (16-18 and 32-34 weeks).
- NLR also demonstrated predictive capabilities for poor APGAR scores, with sensitivities ranging from 78% to 89% and specificities from 53% to 61% across gestational periods.
- Elevated maternal NLR and β-hCG levels are associated with increased risk of low birth weight and poor neonatal APGAR scores.
Outlook:
- The findings suggest that elevated maternal NLR and β-hCG levels are significant indicators of adverse neonatal outcomes.
- Further large-scale investigations are warranted to fully elucidate the negative impact of these biomarkers on fetal development.
- Understanding and monitoring these biomarkers could lead to strategies for reducing poor fetal outcomes.
Abstract:
Background: Maternal serum biomarkers assist in identifying various maternal and foetal complications. In this manner, the present study was conducted to assess the birth of high-risk infants using β-hCG level and neutrophil lymphocyte ratio and their correlation with the development of low birth weight and poor APGAR score. Methods:A tertiary hospital-based prospective observation study was conducted among primi gravida attending the Department of Obstetrics & Gynaecology of Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India. Written informed consent was obtained from prim gravida who met the eligibility criteria. Basic details on socio-demographics and selective blood investigations, i.e., β-hCG and neutrophil-to-lymphocyte ratio (NLR), were examined and followed-up until postdelivery to assess the neonatal outcome. Data was analysed using SPSS version 21.0 with appropriate statistical methods. Sample size: The contamination rate was calculated by dividing the total number of contaminated blood cultures by the total number of cultures multiplied by 100. Results:The mean (±SD) age of participants (N=440) was 23.7 (±1.6). Overall, the mean (±SD) of birth weight and APGAR score at five minutes were 2.6 (±0.6), and 8.8 (±1.2), respectively, within the normal limits. Maternal values of NLR and β-hCG (IU/mL) were negatively correlated to neonatal outcomes, i.e., low birth weight and poor APGAR score. The mean values of NLR were significantly high in neonates with poor outcomes (LBW, poor APGAR). The sensitivity and specificity of β-hCG as a predictor for poor APGAR score was 83% and 66% at 16-18 weeks (AUC -0.82, cut-off 22721) and 83%, and 90%, respectively at 32-34 weeks (AUC-0.79, cut-off 14825). The sensitivity and specificity of NLR as a predictor for poor APGAR score were 78% and 61% at 16-18 weeks (AUC-0.76, cut-off 4.5), and 89% and 53%, respectively at 32-34 weeks (AUC-0.74, cut-off 4.5). Conclusion:High levels of maternal NLR and β-hCG resulted in low birth weight neonates and poor APGAR score. The negative impact of these biomarkers should be further explored on a larger scale basis. Ascertaining this would lead to reduction in poor fetal outcomes.
