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Maternal Neutrophil Inflammation Markers Predict Bronchopulmonary Dysplasia in Preeclamptic Pregnancies
Tifeng Xie1,2, Liping Hong1,2, Ruiting Yi1,2
1Department of Obstetrics and Gynecology, Neonatology; Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
Insights
Maternal white blood cell and neutrophil counts in preeclampsia patients predict offspring bronchopulmonary dysplasia risk. Elevated levels in preeclampsia, but not in normotensive mothers, are linked to increased risk in infants.
Area of Science:
- Obstetrics and Gynecology
- Neonatology
- Hematology
Background:
- Preeclampsia (PE) and bronchopulmonary dysplasia (BPD) are significant global health concerns affecting maternal and neonatal outcomes.
- Identifying predictive markers for BPD in offspring of mothers with PE is crucial for early intervention.
Purpose of the Study:
- To evaluate the predictive value of maternal hematologic indicators in preeclampsia patients for the risk of bronchopulmonary dysplasia in their offspring.
- To explore the interaction effects between maternal hematologic indicators and preeclampsia on neonatal BPD risk.
Main Methods:
- Retrospective cohort study of infants born before 34 weeks' gestation.
- Logistic regression analysis to assess associations between maternal hematologic indicators and offspring BPD.
- Subgroup analysis to investigate interaction effects of maternal hematologic indicators and PE on BPD.
Main Results:
- Maternal white blood cell count (WBC), absolute neutrophil count (ANC), and neutrophil-to-lymphocyte ratio (NLR) showed significant interaction effects with PE on offspring BPD risk.
- Elevated maternal WBC or ANC did not increase BPD risk in normotensive mothers.
- In PE patients, higher maternal WBC and ANC were independently associated with increased offspring BPD risk. Specific thresholds (WBC > 11.90, NLR > 7.65) were identified as predictors.
Conclusions:
- Neutrophil-related hematologic indicators (WBC, ANC, NLR) in preeclampsia patients are significant independent predictors of neonatal BPD.
- These findings suggest neutrophils as a potential focus for understanding the link between maternal PE and neonatal BPD.
Problem:
Preeclampsia (PE) and bronchopulmonary dysplasia (BPD) are severe disorders that significantly affect maternal and neonatal health worldwide. This study evaluated the predictive value of maternal hematologic indicators in PE patients for the risk of offspring BPD.
Method Of Study:
A retrospective cohort study was conducted enrolling infants born before 34 weeks' gestation between September 2017 and December 2019 at the Third Affiliated Hospital of Guangzhou Medical University. Logistic regression analysis was used to evaluate the association between maternal hematologic indicators and offspring BPD. Subgroup analysis was performed to explore the interaction effects between maternal hematologic indicators and PE on neonatal BPD risk.
Results:
Data from 510 preterm infants and their mothers were analyzed. After adjusting for potential confounders, interaction effects between maternal white blood cell count (WBC), absolute neutrophil count (ANC), and PE on offspring BPD were observed (p for interaction <0.05). Among normotensive mothers, elevated WBC or ANC did not significantly increase the risk of offspring BPD (OR [95% CI]: 1.02 [0.93-1.12] for both). In contrast, in PE patients, higher levels of WBC and ANC were independently associated with offspring BPD risk (OR [95% CI]: 1.24 [1.06-1.47] and 1.22 [1.05-1.44], respectively). Moreover, WBC > 11.90 and NLR > 7.65 in PE patients were identified as independent predictors of neonatal BPD (OR [95% CI]: 4.88 [1.27-21.04] and 4.67 [1.41-17.27], respectively).
Conclusions:
Neutrophil-related hematologic indicators, including WBC, ANC, and NLR in PE patients, are significantly and independently associated with the development of BPD. These findings highlight the potential of neutrophils as a promising focus for investigating the relationship between these maternal and neonatal disorders.
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