Correlation of maternal neutrophil to lymphocyte ratio with fetal birth weight in preeclampsia

Preeclampsia is a generalized inflammatory disorder complicating gestation, with most of the cases developing in the third trimester. To evaluate the neutrophil to lymphocyte ratio in diagnosed cases of preeclampsia and determine its correlation with fetal birth weight, a cross sectional analytical study was performed in Shaikh Zayed Medical Complex and Jinnah Hospital, Lahore. The participants included 60 cases of preeclampsia and 60 normotensive controls in the third trimester of pregnancy. All the participants were in the age group of 20 -40 years and body mass index of 18 -25. Total and differential leukocyte count was checked by automated hemoanalyzer, and the neutrophil lymphocyte ratio was calculated. Fetal birth weight was recorded immediately after birth. Statistical analysis was performed by SPSS (version 20). The p value of < 0.05 was considered significant. Neutrophil to lymphocyte ratio was significantly high (p value < 0.001) in the preeclamptic group with a median value of 2.64 (2.0-3.8) as compared to 1.87 (1.7-2.0) in the healthy group. The fetal birth weight was significantly low (p value < 0.001) in the pregnancies complicated with preeclampsia. High neutrophil to lymphocyte ratio was negatively correlated with fetal birth weight in preeclampsia (p value < 0.01). On logistic regression significant association of high neutrophil to lymphocyte ratio with low fetal birth weight was found after controlling for the confounder gestational age, with an odds ratio of 8.28 (95% confidence interval 2.84-24.17). The area under the receiver operating characteristic curve for neutrophil to lymphocyte ratio was 0.8. The optimum cutoff value of neutrophil to lymphocyte ratio was 2.3 with 79% sensitivity and 76% specificity. High maternal neutrophil to lymphocyte ratio in the third trimester in preeclampsia negatively correlates with fetal birth weight and is a simple promising biomarker to predict low fetal birth weight.