Neutrophil Lymphocyte Ratio and Red Cell Distribution Width as a Marker of Preeclampsia: A Retrospective Study

Abstract

Background: Preeclampsia occurs in 3-7% of pregnancy and contributes to 18% maternal mortality. Unfortunately, proper diagnosis and prompt treatment for preeclampsia are limited in rural area due to limited facilities. Neutrophils, lymphocytes, and red distribution width, some of the inflammatory response, are considered as marker for preeclampsia. We evaluated the NTR and RDW as a reliable marker for preeclampsia in limited facilities health care.

Red cell distribution width and preeclampsia: a systematic review and meta-analysis

“…Eleven case-control studies fulfilling the inclusion criteria and were used in the met-analysis [14, 15, 17–19, 21–24, 34, 35]. All the 11 studies were of high quality with an Ottawa rating of 7 and 8 (Table 1).…”

“…The number of the cases per study ranged from 21 [35] to 143 [14], while the controls ranged from 50 [23] and 911 [14]. The median and variance was reported in three studies [18, 19, 21] and this was transformed to the mean (SD) using the prescribed formula [29, 30]. The mean (SD) of the RDW level was significantly higher in women with preeclampsia compared to controls [15.10 (2.48) % vs. 14.26(1.71) %, P < 0.001].…”

“…Since the I 2 test result showed high heterogeneity [I 2 = 76.67, P < 0.001], the continuous random effect model was used. Only one study investigated the RDW in early and late preeclampsia and showed the RDW level to be significantly higher in women with early preeclampsia [19].

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“…Then the outliers (3studies) were removed [14, 17, 23] to reduce the heterogeneity. The pooled meta-analysis of the remaining 8 studies [14, 15, 18, 19, 21, 24, 34, 35] showed a significant difference in the RDW between preeclamptic women compared with the controls. The mean difference was 0.93, 95% CI = 0.56–1.31, P < 0.001(Fig.…”

Clinical Ability of Neutrophil–Lymphocyte Ratio in Pregnancy as a Predictor of Preeclampsia

“…A complete blood cell examination is a routine blood test that can be carried out and borne by the state insurance agency "Jaminan Kesehatan Nasional." 23 An increase in NLR is associated with an increase in the risk of cardiovascular events, diabetes mellitus, and mortality in several malignant states. NLR was also previously used as a predictor of complications in pregnancy, but the results were inconsistent.…”