Elevated neutrophil-lymphocyte ratios in extremely preterm neonates with histologic chorioamnionitis

J Perinatol. 2021 Jun;41(6):1269-1277. doi: 10.1038/s41372-021-00964-4. Epub 2021 Feb 18.

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.

MeSH terms

  • Chorioamnionitis* / diagnosis
  • Female
  • Humans
  • Infant, Extremely Premature
  • Infant, Newborn
  • Lymphocytes
  • Neutrophils
  • Placenta
  • Pregnancy
  • Premature Birth*
  • Retrospective Studies