Simple Hematological Markers in Predicting the Severity of Transient Tachypnea of Newborn: New Wine in Old Bottles

Abstract Objectives To evaluate the validity of red cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and platelet mass index (PMI) of patients with transient tachypnea of the newborn (TTN), and to find out their roles in predicting severity of TTN. Patients and Methods In this prospective study, hematological parameters (RDW, PMI) and ratios (NLR, PLR) of 147 patients with TTN and 147 full-term healthy controls were evaluated and compared at birth and at 72nd h of life. patient s with TTN and 147 full-term healthy controls were evaluated and compared at birth and at 72nd hours of life. Results RDW and NLR were not only significantly higher in patients with TTN at birth (p = 0.001) and at 72nd hours of life (p: 0.001), but also were correlated with days of nasal continuous positive airway pressure therapy, duration of O2 therapy, TTN clinical scores, hospitalization and TTN duration. At a cut-off value of 2.40, NLR had a sensitivity of 82.5% and specificity of 77.5% to predict TTN, the most striking parameter at 72nd hours of life. RDW of 17.75 was also determined as the predictive cutoff value of TTN (sensitivity 72.5%; specificity 67.5%; area under the receiver–operating characteristic curve 0.80; p = 0.001). Multivariate analysis model adjusted for delivery, gestational age, male gender revealed that RDW and NLR were significantly and independently associated with TTN. Conclusion RDW and NLR both at birth and at 72nd hours of life can be used as biomarkers to distinguish TTN patients from healthy newborns and to predict the severity of TTN.