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The Predictive Role of Maternal Biological Markers and Inflammatory Scores NLR, PLR, MLR, SII, and SIRI for the Risk of Preterm Delivery
In many countries, preterm birth, defined as birth before 37 completed weeks of gestation, is the primary cause of infant death and morbidity. An increasing body of research suggests that inflammation (both clinical and subclinical) plays a significant role in inducing preterm labor or developing pr...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9738289/ https://www.ncbi.nlm.nih.gov/pubmed/36498555 http://dx.doi.org/10.3390/jcm11236982 |
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author | Hrubaru, Ingrid Motoc, Andrei Moise, Marius Liviu Miutescu, Bogdan Citu, Ioana Mihaela Pingilati, Raja Akshay Popescu, Daniela-Eugenia Dumitru, Catalin Gorun, Florin Olaru, Flavius Erdelean, Izabella Forga, Marius Nicolae, Nicoleta Citu, Cosmin |
author_facet | Hrubaru, Ingrid Motoc, Andrei Moise, Marius Liviu Miutescu, Bogdan Citu, Ioana Mihaela Pingilati, Raja Akshay Popescu, Daniela-Eugenia Dumitru, Catalin Gorun, Florin Olaru, Flavius Erdelean, Izabella Forga, Marius Nicolae, Nicoleta Citu, Cosmin |
author_sort | Hrubaru, Ingrid |
collection | PubMed |
description | In many countries, preterm birth, defined as birth before 37 completed weeks of gestation, is the primary cause of infant death and morbidity. An increasing body of research suggests that inflammation (both clinical and subclinical) plays a significant role in inducing preterm labor or developing pregnancy problems that lead to premature birth. Consequently, the purpose of this research was to determine the predictive value of the Neutrophil-Lymphocyte Ratio (NLR), derived Neutrophil-Lymphocyte Ratio (dNLR), Monocytes-to-Lymphocyte Ratio (MLR), Platelets-to-Lymphocyte Ratio (PLR), Systemic immune-inflammation index (SII), and systemic inflammatory response index (SIRI), for premature delivery. A retrospective study analyzed a total of 243 eligible pregnancies that resulted in a preterm birth during 2020 and 2021. A control group without a history of preterm birth was matched by age and trimester of laboratory analysis at a 1:1 ratio. Although the number of comorbidities was similar among study groups, the body-mass index estimated for the week of gestation was significantly higher among the patients from the prematurity group, as well as the prevalence of urinary tract infections and smoking. Laboratory data showed that patients with a preterm birth had significantly higher white blood cell count and monocytes, but significantly lower lymphocytes, platelets, and hemoglobin. The NLR, dNLR, PLR, and MLR scores showed to be significantly higher among patients from the prematurity group, but SII and SIRI were not significantly different between the study groups. It was observed that the AUC values of NLR, dNLR, PLR, and MLR were higher than 0.600, respectively NLR had the highest value among the tested scores (AUC = 0.694) and the highest sensitivity in this study (71%). The highest sensibility was achieved by dNLR, with 70%, and an AUC value of 0.655 (p-value = 0.022). PLR had the second-highest AUC value (0.682) and the best score in terms of sensitivity (70%) and sensibility (69%) (p-value = 0.015). Lastly, MLR had the lowest significant AUC score (0.607) and lowest sensitivity/sensibility. The significant cut-off values for the inflammatory scores were 9.0 for NLR, 9.8 for dNLR, 250 for PLR, and 4.07 for MLR. After evaluating the importance of these inflammatory scores, further clinical applications should be conducted to confirm the results and improve therapy and care to reduce the burden of premature deliveries. |
format | Online Article Text |
id | pubmed-9738289 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-97382892022-12-11 The Predictive Role of Maternal Biological Markers and Inflammatory Scores NLR, PLR, MLR, SII, and SIRI for the Risk of Preterm Delivery Hrubaru, Ingrid Motoc, Andrei Moise, Marius Liviu Miutescu, Bogdan Citu, Ioana Mihaela Pingilati, Raja Akshay Popescu, Daniela-Eugenia Dumitru, Catalin Gorun, Florin Olaru, Flavius Erdelean, Izabella Forga, Marius Nicolae, Nicoleta Citu, Cosmin J Clin Med Article In many countries, preterm birth, defined as birth before 37 completed weeks of gestation, is the primary cause of infant death and morbidity. An increasing body of research suggests that inflammation (both clinical and subclinical) plays a significant role in inducing preterm labor or developing pregnancy problems that lead to premature birth. Consequently, the purpose of this research was to determine the predictive value of the Neutrophil-Lymphocyte Ratio (NLR), derived Neutrophil-Lymphocyte Ratio (dNLR), Monocytes-to-Lymphocyte Ratio (MLR), Platelets-to-Lymphocyte Ratio (PLR), Systemic immune-inflammation index (SII), and systemic inflammatory response index (SIRI), for premature delivery. A retrospective study analyzed a total of 243 eligible pregnancies that resulted in a preterm birth during 2020 and 2021. A control group without a history of preterm birth was matched by age and trimester of laboratory analysis at a 1:1 ratio. Although the number of comorbidities was similar among study groups, the body-mass index estimated for the week of gestation was significantly higher among the patients from the prematurity group, as well as the prevalence of urinary tract infections and smoking. Laboratory data showed that patients with a preterm birth had significantly higher white blood cell count and monocytes, but significantly lower lymphocytes, platelets, and hemoglobin. The NLR, dNLR, PLR, and MLR scores showed to be significantly higher among patients from the prematurity group, but SII and SIRI were not significantly different between the study groups. It was observed that the AUC values of NLR, dNLR, PLR, and MLR were higher than 0.600, respectively NLR had the highest value among the tested scores (AUC = 0.694) and the highest sensitivity in this study (71%). The highest sensibility was achieved by dNLR, with 70%, and an AUC value of 0.655 (p-value = 0.022). PLR had the second-highest AUC value (0.682) and the best score in terms of sensitivity (70%) and sensibility (69%) (p-value = 0.015). Lastly, MLR had the lowest significant AUC score (0.607) and lowest sensitivity/sensibility. The significant cut-off values for the inflammatory scores were 9.0 for NLR, 9.8 for dNLR, 250 for PLR, and 4.07 for MLR. After evaluating the importance of these inflammatory scores, further clinical applications should be conducted to confirm the results and improve therapy and care to reduce the burden of premature deliveries. MDPI 2022-11-26 /pmc/articles/PMC9738289/ /pubmed/36498555 http://dx.doi.org/10.3390/jcm11236982 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Hrubaru, Ingrid Motoc, Andrei Moise, Marius Liviu Miutescu, Bogdan Citu, Ioana Mihaela Pingilati, Raja Akshay Popescu, Daniela-Eugenia Dumitru, Catalin Gorun, Florin Olaru, Flavius Erdelean, Izabella Forga, Marius Nicolae, Nicoleta Citu, Cosmin The Predictive Role of Maternal Biological Markers and Inflammatory Scores NLR, PLR, MLR, SII, and SIRI for the Risk of Preterm Delivery |
title | The Predictive Role of Maternal Biological Markers and Inflammatory Scores NLR, PLR, MLR, SII, and SIRI for the Risk of Preterm Delivery |
title_full | The Predictive Role of Maternal Biological Markers and Inflammatory Scores NLR, PLR, MLR, SII, and SIRI for the Risk of Preterm Delivery |
title_fullStr | The Predictive Role of Maternal Biological Markers and Inflammatory Scores NLR, PLR, MLR, SII, and SIRI for the Risk of Preterm Delivery |
title_full_unstemmed | The Predictive Role of Maternal Biological Markers and Inflammatory Scores NLR, PLR, MLR, SII, and SIRI for the Risk of Preterm Delivery |
title_short | The Predictive Role of Maternal Biological Markers and Inflammatory Scores NLR, PLR, MLR, SII, and SIRI for the Risk of Preterm Delivery |
title_sort | predictive role of maternal biological markers and inflammatory scores nlr, plr, mlr, sii, and siri for the risk of preterm delivery |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9738289/ https://www.ncbi.nlm.nih.gov/pubmed/36498555 http://dx.doi.org/10.3390/jcm11236982 |
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