Neutrophil to Lymphocyte Ratio in Preeclampsia

Abstract

Abstract
 Objective: To determine the correlation between neutrophil to lymphocyte ratio and preeclampsia. To determine whether neutrophil to lymphocyte ratio can be used as a screening tool for preeclampsia.Methods: This study was conducted with a systematic review method. Articles that had been gathered and filtered were reviewed by QUADAS-2 tool. Guidelines from the American Congress of Obstetricians and Gynecologists (ACOG) and Pedoman Nasional Pelayanan Kedokteran were used as a diagnostic criteria for determining preeclampsiaResults: Studies conducted by Kirbas et al, Cakmak et al, Wang et al and Panwar et al stated that there is a correlation between neutrophil to lymphocyte ratio to preeclampsia (p-value < 0.05). Cut-off values are diverse between 3.5 - 5.6 with different sensitivity and specificity.Conclusion: This systematic review shows that there is a relationship between neutrophil to lymphocyte ratio and preeclampsia. Neutrophil to lymphocyte ratio can be used as screening tools for preeclampsia in the first trimester.Keywords: neutrophil to lymphocyte ratio, NLR, preeclampsia.
 Abstrak
 Tujuan: Mengetahui apakah terdapat hubungan antara rasio neutrofil terhadap limfosit dengan preeklampsia. Mengetahui apakah rasio neutrofil terhadap limfosit dapat dijadikan sebagai alat bantu skrining preeklampsia.Metode: Penelitian ini dilakukan dengan metode systematic review. Artikel yang disaring akan ditentukan kualitasnya menggunakan QUADAS-2. Kriteria diagnostik preeklampsia yang digunakan adalah American College of Obstetricians and Gynecologists (ACOG) untuk penelitian luar negeri dan Pedoman Nasional Pelayanan Kedokteran untuk penelitian dalam negeri.Hasil : Penelitian yang dilakukan oleh Kirbas et al, Cakmak et al, Wang et al, dan Panwar et al menyatakan bahwa terdapat hubungan antara rasio neutrofil terhadap limfosit dengan preeklampsia ( p-value < 0.05). Nilai cutoff dari rasio neutrofil terhadap preeklampsia beragam mulai dari 3.5 - 5.6 dengan sensitivitas dan spesifisitas yang berbeda-beda.Kesimpulan : Penelitian systematic review ini menunjukan bahwa rasio neutrofil terhadap limfosit memiliki hubungan dengan penyakit preeklampsia. Rasio neutrofil terhadap limfosit dapat dijadikan sebagai alat bantu skrining untuk preeklampsia pada trimester pertama.Kata kunci: rasio neutrofil terhadap Limfosit, NLR, preeklamsia.

Comparison of neutrophil lymphocyte ratio (NLR), mean platelet volume (MPV) and platelet lymphocyte ratio (PLR) in preeclampsia and normotensive pregnancies

“…Therefore, the NLR is considered as a provider of diagnostic and prognostic value in preeclampsia. [18][19][20][21][22] Mannaerts et al 10 reported that patients with preeclampsia have NLR value higher than normotensive pregnancies, although it is not significantly different. In contrast, some studies reported that the NLR value of patients with preeclampsia is significantly different compare with normotensive pregnancies.…”

“…Singhal et al 20 found that the NLR has a cutt-off value of ≥ 4.86 with a sensitivity of 68.6% and a specificity of 80.0% in predicting preeclampsia. Prasetyo et al 22 found that the NLR is associated with preeclampsia with cut-off values between 3.5-5.6 in different sensitivity and specificity. In this study, it was found a cut-off value of 4.0 with a sensitivity of 64.5% and specificity of 71%.…”

“…Whereas, another meta-analysis conducted by Kang et al 19 concluded that NLR can be used as a laboratory marker for clinical prediction and severity of preeclampsia, with NLR values higher than in normal pregnancies. In addition, a systematic review conducted by Prasetyo et al 22 concluded that there is a relationship between NLR and preeclampsia with a various cut-off point values between 3.5 -5.6 in differences in sensitivity and specificity.…”