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

• Published in: Journal of perinatology Vol. 41; no. 6; pp. 1269 - 1277
• Main Authors: Singareddy, Aashray, Lee, Ashley Sang Eun, Sweeney, Patrick L., Finkle, Abigael E., Williams, Howard L., Buchanan, Paula M., Hillman, Noah H., Koenig, Joyce M.
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01.06.2021; Nature Publishing Group
• Subjects: 631/250/256; 692/53/2423; Chorioamnionitis; Complications; Complications and side effects; Diagnosis; Fetal diseases; Fetuses; Health aspects; Histology; Infants (Premature); Inflammation; Inflammatory diseases; Leukocytes (neutrophilic); Lymphocytes; Measurement; Medicine; Medicine & Public Health; Neonates; Neutrophils; Newborn babies; Pediatric research; Pediatric Surgery; Pediatrics; Placenta; Premature birth; Risk factors; United States
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/s41372-021-00964-4

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.