Assessment of some hematologic markers of Systemic Inflammatory Response (SIR) as eliable biomarkers in detecting preeclampsia; a comparative cross-sectional study in Enugu, Nigeria

TL;DR

This study evaluates affordable blood markers to detect preeclampsia in Nigeria, finding that NLR and MLR are promising and cost-effective options.

Contribution

Identifies NLR and MLR as reliable, low-cost biomarkers for preeclampsia in resource-limited settings.

Findings

Preeclamptic women had significantly higher NLR and RDW compared to normotensive controls.

NLR showed the best diagnostic performance with an AUC of 0.82 and a cut-off of >2.56.

NLR and MLR are proposed as affordable alternatives for detecting preeclampsia in low-resource areas.

Abstract

Systemic inflammatory response (SIR) occurs in normal pregnancy and is exacerbated in pre-eclampsia (PE). Most markers of SIR are expensive to measure, require trained personnel, and thus are limited for routine application in resource-limited settings. Thus, we aim to determine the clinical utility of hematologic markers of systemic inflammatory response in Preeclampsia in a resource limited setting.

A cross-sectional comparative study was conducted in Enugu from April to October 2021. Forty-five women with pre-eclampsia (PE) and 45 matched normotensive (NT) pregnant women were recruited. Hematological markers of systemic inflammatory response (red cell distribution width (RDW), neutrophil-lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), monocyte lymphocyte ratio (MLR), and platelet indices) were measured using the automated Mythic 22 Orphee hematology analyzer. Statistical analysis was by student T-test, receiver operating characteristics (ROC) curve, and Pearson correlation test. A P value of < 0.05 was considered significant.

The age difference between the groups was not significant (P = 0.76). Pregnant women with preeclampsia had significantly higher RDWS (P=0.02) and NLR (P <0.001) but a significantly lower PLR (P =0.04). The NLR had the largest area under the ROC curve (AUC 0.82, 95% CI (0.74-0.906, P <0.001), cut-off >2.56, sensitivity 71.1%; specificity 22.2%) followed by MLR (AUC 0.68, 95% CI (0.58-0.80, P =0.002) cut-off >0.18, sensitivity 64.4%; specificity: 28.9 %;)

The NLR and MLR were good and affordable biomarkers of Systemic Inflammatory response (SIR) in Preeclampsia, thus possible alternative in resource-limited settings.