Easily generated hematological biomarkers and prediction of placental abruption

• Published in: Journal of gynecology obstetrics and human reproduction Vol. 50; no. 8; p. 102082
• Main Authors: Alfandari, Liad, Pariente, Gali, Yohay, David, Levy, Ofir, Weintraub, Adi Y., Rotem, Reut
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01-10-2021
• Subjects: Abruptio Placentae - blood; Abruptio Placentae - diagnosis; Abruptio Placentae - epidemiology; Adult; Biomarkers - analysis; Biomarkers - blood; Case-Control Studies; Chi-Square Distribution; Female; Hematological indices; Humans; Israel - epidemiology; Neutrophil to lymphocyte ratio; Placental abruption; Platelet to lymphocyte ratio; Predication; Pregnancy; Statistics, Nonparametric; Israel; Platelet to lymphocyte ratio; Hematological indices; Placental abruption; Neutrophil to lymphocyte ratio; Predication
• ISSN: 2468-7847; 2468-7847
• DOI: 10.1016/j.jogoh.2021.102082

•Hematological biomarkers are associated with inflammation and may serve as a predictive tool in different medical fields.•Hematological biomarkers taken in 1st trimester, have been shown to predict the development of later complications.•Placental abruption is an acute severe occurrence, but is associated with inflammatory processes.•In this study, no association was demonstrated between 1st trimester hematological indices and further placental abruption.•Further larger studies are needed in order to address this potential predictable tool.
Placental abruption (PA) is associated with adverse maternal and neonatal outcomes. Increasing evidence has shown an association between abruption and inflammation as well as utilization of hematological biomarkers to predict the later. We aimed to evaluate the feasibility of using neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ration (PLR) taken early in pregnancy in predicting later occurrence of PA.
A nested case control study, which compared parturient with PA (cases) to parturient without PA (controls). Parturient were matched by hospitalization date and maternal age. Demographic, clinical, and obstetrical characteristics were retrieved. Hematological indices derived from complete blood count taken during the first trimester of pregnancy, specifically NLR and PLR were retrieved and compared between the groups. Mann-Whitney and T-test were performed for not normally and normally distributed continuous variables respectively, categorical variables were analyzed using Chi-Square or Fisher Exact test as appropriate.
The study comprised of 232 patients. Of these, 131 had suffered from PA and 131 without PA. Parturient who had PA has significantly higher rates of hypertensive disorders of pregnancy, mean neutrophil, lymphocyte and platelet count did not differ between the groups. A comparison of NLR and PLR between the study groups yielded no significant differences.
NLR and PLR taken early in the course of pregnancy were not found associated with PA. Given the potentially severe consequences of PA, the biological plausibility and the readiness of these hematological markers, further investigation of this method with larger, prospective studies are needed.