Aashray Singareddy1, Ashley S E Lee1, Patrick L Sweeney2, Abigael E Finkle1, Howard L Williams3, Paula M Buchanan1,4, Noah H Hillman1, Joyce M Koenig5,6. 1. Department of Pediatrics, Saint Louis University School of Medicine, St Louis, MO, USA. 2. University of Tennessee-Memphis School of Medicine, Memphis, TN, USA. 3. SSM Health Cardinal Glennon Children's Hospital, St. Louis, MO, USA. 4. Department of Health and Clinical Outcomes Research, Saint Louis University School of Medicine, St Louis, MO, USA. 5. Department of Pediatrics, Saint Louis University School of Medicine, St Louis, MO, USA. joyce.koenig@health.slu.edu. 6. Department of Molecular Microbiology & Immunology, Saint Louis University School of Medicine, St Louis, MO, USA. joyce.koenig@health.slu.edu.
Abstract
OBJECTIVE: Histologic chorioamnionitis (HCA) is a placental inflammation linked to preterm birth and adverse neonatal outcome. The neutrophil-lymphocyte ratio (NLR) can identify various inflammatory disorders, however its utility in HCA is not clear. Our goal was to examine NLR values and HCA diagnoses in at-risk pregnancies and neonates. STUDY DESIGN: We retrospectively analyzed the EHR of mothers and preterm (<33 wk GA) neonates with or without HCA (identified by placental histology). The NLR was calculated from complete blood counts in laboring women and in their neonates (0-24 h of life). RESULT: In 712 consecutive gestations, 50.8% had HCA (26.5% fetal HCA). The neonatal NLR (0-12 h, 13-24 h) predicted fetal HCA better than chance alone (p = 0.01 and 0.002, respectively). CONCLUSION: Early NLR elevation in preterm neonates is consistent with a diagnosis of fetal HCA. The NLR may identify preterm neonates at risk for HCA-related complications.
OBJECTIVE: Histologic chorioamnionitis (HCA) is a placental inflammation linked to preterm birth and adverse neonatal outcome. The neutrophil-lymphocyte ratio (NLR) can identify various inflammatory disorders, however its utility in HCA is not clear. Our goal was to examine NLR values and HCA diagnoses in at-risk pregnancies and neonates. STUDY DESIGN: We retrospectively analyzed the EHR of mothers and preterm (<33 wk GA) neonates with or without HCA (identified by placental histology). The NLR was calculated from complete blood counts in laboring women and in their neonates (0-24 h of life). RESULT: In 712 consecutive gestations, 50.8% had HCA (26.5% fetal HCA). The neonatal NLR (0-12 h, 13-24 h) predicted fetal HCA better than chance alone (p = 0.01 and 0.002, respectively). CONCLUSION: Early NLR elevation in preterm neonates is consistent with a diagnosis of fetal HCA. The NLR may identify preterm neonates at risk for HCA-related complications.