Observational Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Obstet Gynecol. May 11, 2023; 12(3): 17-27
Published online May 11, 2023. doi: 10.5317/wjog.v12.i3.17
Clinical implication of platelet to lymphocyte ratio in early onset preeclampsia: A single-center experience
Wisam Akram, Zina Abdullah Hussein, Mazin Hameed Humadi, Wassan Nori
Wisam Akram, Zina Abdullah Hussein, Wassan Nori, Obstetrics and Gynecology, Mustansiriyah University, Baghdad 10052, Iraq
Mazin Hameed Humadi, Department of Inspection, Ministry of Health, Baghdad 10052, Iraq
Author contributions: Akram W contributed to conception and statistical analysis; Abdullah Hussein Z and Hameed Humadi M contributed to data collection and scientific editing; Nori W wrote, edited, and drafted the final version; all authors read and approved the final version.
Institutional review board statement: The study was reviewed and approved by the ethical committee of Mustansiriyah University (No. 160).
Informed consent statement: All participants gave informed consent after we explained the study aims and methods prior to enrollment.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Data sharing statement: The data that support this study are available upon reasonable request to the corresponding author.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wassan Nori, PhD, Academic Editor, Academic Research, Senior Researcher, Obstetrics and Gynecology, Mustansiriyah University, Al Amin Street, Al Saydyia, No. 38 House, Baghdad 10052, Iraq. dr.wassan76@uomustansiriyah.edu.iq
Received: January 26, 2023
Peer-review started: January 26, 2023
First decision: February 8, 2023
Revised: February 8, 2023
Accepted: April 4, 2023
Article in press: April 4, 2023
Published online: May 11, 2023
Research background

Preeclampsia (PE) is a pregnancy condition with an unknown origin that includes two subtypes based on 34 wk of gestation: Early and late onset PE; inflammation was postulated as an explanation. The platelet to lymphocyte ratio (PLR), an inflammatory biomarker, was investigated as a predictor of poor maternal-neonatal outcome in patients with early-onset PE (EoPE).

Research motivation

Much research has shown that inflammation may be an underlying pathology that triggers PE development. There is an increased need for new methods with enhanced predictive ability. Demonstrating changes in blood indices, PLR seems an appealing option given the promising results declared by earlier work.

Research objectives

To ascertain if PLR in cases with early-onset PE can be linked to essential predictors of fetomaternal wellbeing during the intrapartum period. The second goal is to analyze the reliability of PLR as a helpful marker for monitoring prenatal predictors in women with early-onset PE.

Research methods

Cross-sectional research at University Hospital involved 60 pregnant women with EoPE (at 32-30 wk of gestation). Platelet counts and indices (mean platelet volume and platelet distribution width), PLR, Doppler study, which produced estimated fetal weight (EFW), amniotic fluid index (AFI), resistance index (RI), and pulsatility index (PI) were all gathered. Participants were tracked until birth, when maternal outcomes such as delivery style and reason for cesarean section were documented, as well as newborn outcomes such as fetal growth restriction (FGR), meconium-stained fluids, five-minute Apgar score, and admission to the critical care unit.

Research results

A cesarean section trend has been noted. Sixty-one-point two percent (37/60) fetuses were hospitalized to the newborn care unit, 70% had meconium-stained liquid, and 56.7% had FGR. PLR was shown to be favorably connected with AFI and EFW (r = 0.98, 0.97, P < 0.001), and negatively correlated with PI and RI (r = -0.99, -0.98, P < 0.001). The Apgar score and the number of days admitted to the critical care unit had a positive and negative connection (r = 0.69, -0.98, P < 0.001), respectively. The PLR cutoff value derived by receiver operating characteristic (7.49) differentiated FGR with 100% sensitivity and 80% specificity.

Research conclusions

PLR had substantial P value associations with FGR measures and poor neonatal outcomes, making it a promising biomarker for screening EoPE-related problems. More research is needed to determine the influence on maternal-neonatal health.

Research perspectives

Defining reliable biomarkers that are antenatal clinics based with no added expense can be a promising option, especially for low-resource settings.