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Role of hematological indices in predicting preeclampsia and its severity: retrospective case-control study
1College of Pharmacy, Gilgamesh University, Baghdad, Iraq.
Insights
Changes in hematological indices, specifically the platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR), effectively predict preeclampsia (PE) and its severity in pregnant women. Monitoring these ratios offers a valuable tool for early detection and management of PE.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Maternal-Fetal Medicine
Background:
- Preeclampsia (PE) poses significant risks to both mother and infant, necessitating early detection for improved outcomes.
- Hematological indices are accessible markers with potential for predicting PE and its severity.
- Current diagnostic methods for PE can be improved with readily available biomarkers.
Purpose of the Study:
- To evaluate the diagnostic utility of hematological indices in predicting preeclampsia and its severity.
- To assess the predictive value of changes in platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) between pregnancy trimesters.
- To compare the predictive power of dynamic changes in PLR and NLR versus single-point measurements.
Main Methods:
- Retrospective case-control study involving 252 pregnant women.
- Categorization into three groups: healthy controls, non-severe PE, and severe PE (84 women each).
- Complete blood counts analyzed in the first and third trimesters to calculate PLR and NLR.
Main Results:
- Changes in PLR between trimesters demonstrated excellent ability to differentiate severe PE from controls (AUC=0.954) and good ability to differentiate severe from non-severe PE (AUC=0.841).
- Neutrophil to lymphocyte ratio (NLR) changes showed good to excellent discriminatory power between severe PE, non-severe PE, and controls across trimesters.
- Dynamic changes in NLR and PLR offered stronger predictive value for PE and its severity than individual measurements at different stages.
Conclusions:
- The percentage change in neutrophil to lymphocyte ratio and platelet to lymphocyte ratio between the first and third trimesters are strong predictors of preeclampsia and its severity.
- Monitoring dynamic changes in these hematological ratios provides a more robust diagnostic tool than static measurements.
- Hematological indices, particularly their trimester-based changes, represent a promising, accessible approach for early preeclampsia detection and risk stratification.
Abstract:
Preeclampsia (PE) is a serious condition that threatens pregnancy with severe sequelae on both the mother and infant. Early detection of PE will lead to favorable outcomes, and using readily available markers like hematological indices is an attractive choice. Examine the diagnostic utility of hematological indices in pregnant women to predict preeclampsia and its severity. In a retrospective case-control study that included 252 women, all had their complete blood picture evaluated during their first and third trimesters as part of their outpatient antenatal care during their pregnancy. They were also divided into 3 groups: healthy pregnant women (control), non-severe PE, and severe PE, each involving 84 women. The changes in platelet to lymphocyte ratio (PLR) between 1st and 3rd trimesters showed an excellent ability to differentiate between severe PE and control (area under the curve = 0.954, cutoff ≤ -5.45%) and a good ability to differentiate between severe PE and non-severe PE (area under the curve = 0.841, cutoff ≤ -7.89%). Neutrophil to lymphocyte ratio showed a good to excellent ability to differentiate between severe PE and non-severe PE compared to control in the first and third trimesters and the percentage change between them. Changes in neutrophil to lymphocyte ratio and PLR strongly predict preeclampsia and its severity since they offer more predictive values than measuring NLP and PLR at different stages of pregnancy individually.
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