Can High First Trimester NLR And PLR is Early Predictor for Preeclampsia?: An Experience of Single Tertiary Care Center

Objective: Aim of present study was to determine whether first-trimester neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) would be useful indicators of subsequent preeclampsia.

Material and Methods: Medical records of 146 women (age range 20-36 years; mean age 27.27 years) with preeclampsia and healthy controls were retrospectively evaluated at our hospital. Both groups were evaluated in terms of clinical characteristics and first-trimester haematological parameters including hemoglobin, neutrophil, lymphocyte, platelet, NLR and PLR. Receiver operating characteristic curve (ROC) analysis was also performed to identify the optimal NLR and PLR levels predicting preeclampsia.

Results: Of the 146 patients, 70 (~47.9%) were preeclamptic patients and remaining 76 (52.1%) were normotensive in present study. In the haematological parameters, lymphocyte (p < 0.001), NLR (p < 0.0001) and PLR (p < 0.0001) levels were significantly elevated in the preeclampsia women. Whereas other parameters neutrophil (p~0.07), platelet (p~0.124) hemoglobin concentration (p~0.436) were not significantly high or low in the preeclamptic women. On multivariate regression analysis, NLR (OR 2.17; 95% CI 1.04-4.51; p = 0.03) and PLR (OR 1.02; 95% CI 1.01-1.04; p = 0.01) were the independent powerful predictive variables. In the ROC analysis, for both NLR and PLR area under curve was 0.800. The cut-off values of NLR >2.78 and PLR >109 predicted preeclampsia with the sensitivity of 80.0% and 85.7% and specificity of 71.1% and 65.8%, respectively.

Conclusions: We concluded that high NLR and PLR in the first trimester is the strong predictor of subsequent preeclampsia.

Keywords: neutrophil to lymphocyte ratio (NLR); platelet to lymphocyte ratio (PLR); preeclampsia.