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Role of Neutrophil-Lymphocyte Ratio (NLR) and Platelet-Lymphocyte Ratio (PLR) as predicting
markers in Pre-eclampsia: A retrospective case – control study


Soundariya K¹,
Deepika V²,
Prasana Venkatesh S³,
¹Professor, Department of Physiology,
²Associate Professor, Department of Physiology,
³Intern, Sri Manakula, Vinayagar Medical College and Hospital,
Puducherry,

Abstract
  • Background: Pre-eclampsia is a disorder of vascular endothelial dysfunction, diagnosed by new onset
    hypertension after 20 weeks of gestation with proteinuria or end organ dysfunction. Hyperactivation of inflammatory response is proposed in the pathophysiology of pre-eclampsia.
  • Aim: The present study aimed to assess the predictive role of simple, cost-effective systemic inflammatory markers Neutrophil Lymphocyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) in the diagnosis of pre-eclampsia.
  • Materials and Methods: This retrospective case-control study compared the hematological parameters (RBC Count, Total Leucocyte Count, Platelet Count, NLR and PLR) between 20 diagnosed preeclampsia cases and age and gestational age matched 20 healthy pregnant females. Independent t test was used to compare the parameters between cases and controls, The predictive role of NLR was assessed using the ROC curve analysis. p<0.05 was considered statistically significant.
  • Results: The NLR was comparatively higher in the patients with pre eclampsia (5.09 ± 2.22) compared to healthy controls (3.87 ± 1.17) and it was statistically significant (p<0.05). There was no significant difference between the cases and controls in RBC Count, Leucocyte count, Platelet Count and PLR. The ROC analysis showed significant diagnostic accuracy of NLR to discriminate cases and controls (area under the curve [AUC] = 0.72, p < 0.05) at cut-off value of >= 3.59, with 80% sensitivity, and 55% specificity.
  • Conclusion: NLR may serve as simple, reliable, cost-effective investigation that may help to predict
    and diagnose individuals with pre-eclampsia, which may help in planning appropriate therapeutic intervention at an early stage.

Keywords: lymphocyte, neutrophil, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, normotensives, pre-eclampsia