The Association of Inflammatory Biomarkers of Neutrophil-to-Lymphocyte Ratio with Spontaneous Preterm Delivery

Tavan Adnan  Khdhir; Sallama Nasir  Kamil

doi:10.56056/400

Authors

Tavan Adnan Khdhir MBChB, KHCMS/Obstetrics and Gynecology, Sulaimani Maternity Teaching Hospital, Sulaimani Directorate of Health, Sulaymaniyah, Iraq.
Sallama Nasir Kamil MBChB, HDOG, FICOG, GABOG, Assistant Professor of Obstetrics and Gynecology at Department of Clinical Sciences, College of Medicine, University of Sulaimani, Kurdistan Region/ Iraq

DOI:

https://doi.org/10.56056/400

Keywords:

Inflammatory biomarkers, Laboratory indicators, Neutrophil-lymphocyte ratio, Preterm birth

Abstract

Background and objectives: Preterm birth is a significant contributor to infant mortality that is closely associated with the inflammatory process. The neutrophil-to-lymphocyte ratio reflects the balance between pro-inflammatory neutrophils and anti-inflammatory lymphocytes. This study assessed the relationship between the neutrophil-to-lymphocyte ratio and spontaneous preterm delivery.

Methods: A case-control study was conducted at Sulaimani Maternity Teaching Hospital from May 2022 to May 2023 on 100 women (50 with preterm labour and 50 with full-term labour). In-person interviews were conducted to collect patients’ data. White blood cell, neutrophil, and lymphocyte counts were determined, and then the neutrophil-to-lymphocyte ratio was calculated during the second trimester and at labour onset.

Results: The preterm group had significantly elevated white blood cell and neutrophil counts throughout the second trimester and at labour than the control group (p?0.05). The lymphocyte and neutrophil-to-lymphocyte ratio in the preterm group was non-significantly (p>0.05) increased throughout the second trimester and significantly (p?0.05) increased at labour compared to the control group. Blood values were significantly (p?0.05) lower in the preterm group during the second trimester than at labour for all parameters except for neutrophil-to-lymphocyte ratio (p>0.05). All blood parameters were elevated during labour compared to the second trimester, with significant changes to WBC and lymphocyte counts (p?0.05) and non-significant changes (p>0.05) for neutrophils and NRL.

Conclusion: The laboratory blood parameters have variable impacts on clinical prediction and emphasizing the possible relevance of inflammatory biomarkers to preterm birth risks.

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