Investigation of neutrophil/lymphocyte ratio and mean platelet volume in patients diagnosed with preterm labor

Abstract

Background: To investigate the level of neutrophil/lymphocyte ratio (NLO) and mean platelet volume (MPV) in preterm birth in patients who gave birth before 37 weeks.

Method: This study was conducted by a retrospective examination of the patients who gave birth with preterm labor diagnosis from January 2017 to May 2018 at Ankara Keçiören Training and Research Hospital, Obstetrics and Gynecology Clinic. The study included 138 patients. Patients were divided into three groups: Early Preterm (delivery before 34 weeks, Group I = 39), Late Preterm (delivery between 34 and 37 weeks, Group II = 59) and the Control Group (delivery after 37 weeks, Group III = 40). All three groups were compared with respect to demographic, obstetric and laboratory results, MPV and NLO parameters.

Results: The difference between the groups was not significant when the patients were compared in terms of age, gravida, parity, fetal sex and smoking. When the three groups were compared in terms of leukocyte, neutrophil, lymphocyte, hemoglobin, MPV and NLO, NLO was higher and MPV rate was lower in the preterm birth group, which was significant (p < 0.05). When the preterm delivery group was further divided as early preterm (<34 weeks) and late (34-37 weeks) preterm delivery group, the NLO rate was higher in the former group, while MPV was lower and the difference was significant (p < 0.05). When the patients were compared in terms of caesarean and vaginal delivery, 58.6% (81) of the total patients were delivered vaginally and 41.4% (57) were delivered by caesarean section. The most common cesarean indication was a previous caesarean section history. Subsequent indications included breech presentation, fetal distress, oligohydramnios, cephalo-pelvic disproportion (CPD), and placenta previa, respectively. The C-section rate was higher in the preterm group when the groups were compared in terms of the mode of delivery, and the difference between them was significant (p < 0.05).

Conclusion: NLO and MPV may be decisive as a proinflammatory process marker in patients who give birth before 37 weeks. Preterm births and fetuses of pregnant women with high NLO and low MPV may be considered to be likely to go to the neonatal care unit.

Keywords: Mean platelet volume; Neutrophil/lymphocyte ratio; Preterm labor.