The neutrophil-to-lymphocyte ratio (NLR), which gained popularity and acceptance during the early phase of the Covid-19 pandemic as a prognostic marker, has found another clinical application. Results of a new single-center study presented at the 2022 Women in Medicine Summit held in Chicago last week suggest a role for NLR in the first trimester of pregnancy as a predictor of risk of preeclampsia.

To examine the association between baseline NLR and a diagnosis of pre-eclampsia, researchers from the Philippines recruited 105 nulliparous girls and women, aged 15-35 years, at 11 to 14 weeks of gestation. NLR was increased in 56 women at the start of the study, while it was normal in 49. Those who developed preeclampsia had elevated NLR at the time of their enrollment in the study in comparison to those who did not have preeclampsia and this association was found to be statistically significant (p < .001). NLR >4.19 during the first trimester of pregnancy was identified as the cut-off for the risk of preeclampsia, with a specificity of 86.3% and sensitivity of 90.7%.

NLR is the ratio of absolute neutrophil count and absolute lymphocyte count. The normal values range between 1-2, while values greater than 3.0 and below 0.7 are indicative of a pathology (Bratisl Lek Listy. 2021;122(7):474-488). It is an easily available test and simple to calculate making it a cost-effective tool to predict the risk of pre-eclampsia to identify women at risk. Preeclampsia contributes significantly to maternal morbidity and mortality. A more thorough antenatal check-up and follow-up of at-risk women may prevent complications of preeclampsia, both pregnancy related (such as IUGR, preterm birth, eclampsia, placental abruption) and non-obstetric (such as heart disease, stroke, kidney failure, hepatic failure, etc.).

Source

1. https://www.healio.com/news/womens-health-ob-gyn/20220919/promising-first-trimester-neutrophiltolymphocyte-ratio-may-predict-preeclampsia