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Published on: December 31, 2015
Red Cell Distribution Width-to-Platelet Ratio and Other Hematological Markers as Early Predictors of Bronchopulmonary
Baran Cengiz Arcagok1, Ibrahim Kandemir2
1Department of Pediatrics, Division of Neonatology, School of Medicine, Acibadem University, Istanbul 34752, Turkey.
Insights
Hematological markers like platelet-to-lymphocyte ratio (PLR), red cell distribution width (RDW), and red cell distribution width-to-platelet ratio (RPR) can help predict bronchopulmonary dysplasia (BPD) in preterm infants. These simple blood tests offer a cost-effective way for early risk assessment.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Hematology
Background:
- Bronchopulmonary dysplasia (BPD) is a common complication in preterm infants, leading to long-term health issues.
- Early prediction of BPD is crucial for timely intervention but remains a clinical challenge.
Purpose of the Study:
- To evaluate the predictive capability of hematological inflammatory markers: platelet-to-lymphocyte ratio (PLR), red cell distribution width (RDW), and red cell distribution width-to-platelet ratio (RPR) for BPD development in preterm neonates.
- To assess the utility of routine complete blood count (CBC) parameters for early BPD risk stratification.
Main Methods:
- A retrospective cohort study of 100 infants born before 32 weeks' gestation.
- Collection and analysis of CBC parameters (including PLR, RDW, RPR) at birth, 72 hours, 1 week, and 2 weeks of life.
- Multivariate regression and receiver operating characteristic (ROC) curve analyses to determine predictive performance.
Main Results:
- Infants who developed BPD showed significantly higher RDW, PLR, and RPR values at various time points compared to those who did not.
- Gestational age, respiratory distress syndrome, and specific hematological indices independently predicted BPD development.
- ROC analysis indicated good predictive performance for RDW, PLR at 72 hours, and RPR at 7 and 14 days; a combined scoring system demonstrated high sensitivity and specificity.
Conclusions:
- Hematological inflammatory markers (RDW, PLR, RPR) from routine CBC tests are accessible and cost-effective tools for early BPD risk stratification in preterm infants.
- These markers, particularly RPR, show promise for identifying neonates at higher risk for BPD.
- Further research is warranted to validate these findings and integrate them into clinical practice.
Abstract:
Background/Objectives: Bronchopulmonary dysplasia (BPD) frequently affects preterm infants and is associated with lasting morbidity. Early prediction remains challenging. The present study investigated whether hematological inflammatory markers-platelet-to-lymphocyte ratio (PLR), red cell distribution width (RDW), and red cell distribution width-to-platelet ratio (RPR)-can predict the development of BPD in preterm neonates. Methods: We performed a retrospective cohort study involving 100 infants born at less than 32 weeks' gestation. Complete blood count (CBC) parameters were collected at birth, 72 h, 1 week, and 2 weeks of life. Associations between PLR, RDW, RPR, and BPD development were analyzed. Multivariate regression and receiver operating characteristic (ROC) curve analyses were carried out to evaluate the predictive performance of the markers. Results: Forty-nine percent of infants developed BPD. Those with BPD had significantly higher RDW, PLR, and RPR values, and lower lymphocyte and platelet counts at various time points. Gestational age, respiratory distress syndrome, and hematological indices independently predicted BPD. ROC analysis showed that RDW ≥ 67.2 and PLR ≥ 98.13 at 72 h, and RPR ≥ 0.3 at 7 and 14 days had good predictive performance. A combined scoring system, including clinical and hematological markers, achieved high sensitivity and specificity. Conclusions: Hematological inflammatory markers, especially RPR, PLR, and RDW, derived from routine CBC tests may serve as accessible, cost-effective tools for early BPD risk stratification in preterm infants. Additional studies are needed to confirm these results and better define their relevance in clinical practice.
