Subclinical inflammation markers in hyperemesis gravidarum and ketonuria: A case–control study

Abstract

INTRODUCTION: Subclinical inflammation markers play a significant role in hyperemesis gravidarum (HEG). Simple hematological markers such as mean platelet volume (MPV), platelet distribution width (PDW), neutrophil-to-lymphocyte ratio (NLR), red cell distribution width (RDW), plateletcrit (PCT), and platelet-to-lymphocyte ratio (PLR) have been shown to reflect inflammatory burden and disease activity in several disorders. Ketonuria is a parameter used in the diagnosis of severe HEG, but its correlation with disease severity remains controversial. The relationship of subclinical inflammation markers with degree of ketonuria has not been examined previously. In this study, we aimed to determine the diagnostic value of these subclinical inflammation markers and the relationship between these markers and grade of ketonuria in patients with HEG. MATERIALS AND METHODS: A total of 94 pregnant women with a diagnosis of HEG and 100 gestational age-matched healthy pregnant women were enrolled in this retrospective study. MPV, PDW, NLR, PLR, PCT, and ketonuria were calculated and analyzed from complete blood cell counts and total urine analyses. RESULTS: Lymphocyte count was significantly higher in the control group (P < 0,001); NLR and PLR values were significantly higher in the HEG group (P < 0,001). Among inflammation markers, RDW increased significantly (P = 0,008) with an increase in ketonuria in patients with HEG. A statistically significant correlation was found between white blood cell (WBC) and NLR, PLR, PCT. A moderate uphill relationship was observed between NLR and WBC and a weak uphill linear relationship was observed between WBC and PLR and between WBC and PCTCONCLUSIONS: PLR and NLR can be considered effective markers to aid in the diagnosis of HEG. No marker was found to correlate with ketonuria grade except RDW, although the relationship of the severity of ketonuria with severity of disease is controversial. RDW increases as the degree of ketonuria increases.

The Role of Systemic Inflammatory Markers in the Diagnosis of Hyperemesis Gravidarum

“…High RDW values are thought to reflect increased inflammation and oxidative stress (23). However, in two recent studies, the RDW value of patients with HG was similar to that of the control group (24,25). In our study, similar results were obtained from these two studies.…”

“…However, Beyazit et al showed that MPV and PDW values in patients with HG were similar to healthy pregnant women (24). In the study of Cintesun et al, there was no significant difference between the HG group and the control group in terms of PCT, PDW, and MPV (25). In our study, PDW, MPV, and PCT values of both groups were similar.…”

“…Kurt et al found that NLR levels are increased in HG patients compared to control group subjects (29). In the study of Cintesun et al, both NLR and PLR values were significantly higher in the HG group than those of the control group (25). In this study, when the groups were compared, NLR and PLR values were significantly higher in the HG group than in the healthy pregnant women.…”

The role of hematological parameters in the diagnosis of hyperemesis gravidarum

“…Beyazıt et al [11] found no significant difference in terms of PDW level between hyperemesis and control groups. Çintesun et al [18] also found similar PDW levels among the groups. In our study, the mean PDW level in hyperemesis patients decreased significantly compared to the control group.…”

Links between perinatal risk factors and maternal psychological distress: A network analysis

“…Lower levels of inflammatory markers, such as interleukin‐10, in late pregnancy have been shown to increase the risk of developing depressive symptoms postpartum 23 . This mechanism could also come into play for hyperemesis gravidarum and smoking during pregnancy, which have also been shown to be associated with changes in levels of inflammatory markers 24,25 …”