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Article

Neutrophil to Lymphocyte Ratio in Maternal Blood: A Clue to Suspect Amnionitis

1
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul 03080, Korea
2
Institute of Reproductive Medicine and Population, Seoul National University Medical Research Center, Seoul 03080, Korea
3
Department of Pathology, Seoul National University College of Medicine, Seoul 03080, Korea
*
Author to whom correspondence should be addressed.
Academic Editor: Rinat Gabbay-Benziv
J. Clin. Med. 2021, 10(12), 2673; https://doi.org/10.3390/jcm10122673
Received: 25 March 2021 / Revised: 13 June 2021 / Accepted: 15 June 2021 / Published: 17 June 2021
(This article belongs to the Collection Clinical Diagnosis and Management of Pregnancy Complications)
There is no information about whether maternal neutrophil to lymphocyte ratios (NLRs) progressively increase with respect to the progression of acute histologic chorioamnionitis (acute-HCA) and increased maternal NLR is a risk factor for amnionitis, known as advanced acute-HCA, in pregnant women at risk for spontaneous preterm birth (PTB). The objective of the current study is to examine this issue. The study population included 132 singleton PTB (<34 weeks) due to either preterm labor or preterm-PROM with both placental pathology and maternal CBC results within 48 h before delivery. We examined maternal NLRs according to the progression of acute-HCA in extra-placental membranes (EPM) (i.e., group-0, inflammation-free EPM; group-1, inflammation restricted to decidua; group-2, inflammation restricted to the membranous trophoblast of chorion and the decidua; group-3, inflammation in the connective tissue of chorion but not amnion; group-4, amnionitis). Maternal NLRs significantly and progressively increased with the progression of acute-HCA (Spearman’s rank correlation test, γ = 0.363, p = 0.000019). Moreover, the increased maternal NLR (≥7.75) (Odds-ratio 5.56, 95% confidence-interval 1.26-24.62, p < 0.05) was a significant independent risk factor for amnionitis even after the correction for potential confounders. In conclusion, maternal NLRs significantly and progressively increased according to the progression of acute-HCA and the increased maternal NLR (≥7.75) was an independent risk factor for amnionitis in spontaneous PTB. The evaluation of the performance of NLR should clearly require a prospective description of this parameter in a cohort of patients with either threatened PTL or preterm-PROM. View Full-Text
Keywords: amnionitis; maternal blood; neutrophil to lymphocyte ratio; preterm birth amnionitis; maternal blood; neutrophil to lymphocyte ratio; preterm birth
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MDPI and ACS Style

Lee, J.-H.; Park, C.-W.; Moon, K.-C.; Park, J.-S.; Jun, J.-K. Neutrophil to Lymphocyte Ratio in Maternal Blood: A Clue to Suspect Amnionitis. J. Clin. Med. 2021, 10, 2673. https://doi.org/10.3390/jcm10122673

AMA Style

Lee J-H, Park C-W, Moon K-C, Park J-S, Jun J-K. Neutrophil to Lymphocyte Ratio in Maternal Blood: A Clue to Suspect Amnionitis. Journal of Clinical Medicine. 2021; 10(12):2673. https://doi.org/10.3390/jcm10122673

Chicago/Turabian Style

Lee, Joon-Hyung, Chan-Wook Park, Kyung-Chul Moon, Joong-Shin Park, and Jong-Kwan Jun. 2021. "Neutrophil to Lymphocyte Ratio in Maternal Blood: A Clue to Suspect Amnionitis" Journal of Clinical Medicine 10, no. 12: 2673. https://doi.org/10.3390/jcm10122673

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