Abstract
Amaç: Çalışmamızın amacı preeklampsiyi öngörmede biyokimyasal belirteçlerin rolünü değerlendirmektir.
Gereç ve Yöntem: Mart 2018 - 2024 tarihleri arasında gebelik takipleri ve doğumları tarafımızca gerçekleştirilen 7240 kadın retrospektif olarak tarandı. Çalışma grubundaki hastalar <34 gebelik haftasında preeklampsi tanısı konulan 102 kadından, kontrol grubundaki hastalar ise ≥37 gebelik haftasında doğum yapan 118 kadından oluştu. İki grubun demografik özellikleri, obstetrik ve biyokimyasal sonuçları birbirleriyle karşılaştırıldı.
Bulgular: Preeklampsi grubunda vücut kitle indeksi kontrol grubuna göre anlamlı yüksek saptandı (p=0.016). Doğum ağırlığı preeklampsi grubunda kontrol grubuna göre anlamlı düşük saptandı (p<0.001). Doğumdaki gebelik haftası preeklampsi grubunda kontrol grubuna göre anlamlı düşük saptandı (p<0.001). Lenfosit ve trombosit sayıları preeklampsi grubunda kontrol grubuna göre anlamlı düşük saptandı (p<0.001 ve p<0.001, sırasıyla). NLR ve SII değeri preeklampsi grubunda kontrol grubuna göre anlamlı yüksek saptandı (p=0.022, p<0.001, sırasıyla).
Sonuç: Çalışmamız, preeklamptik gebelerde önemli klinik ve laboratuvar farklılıklarını ortaya koymaktadır. Artmış inflamatuar belirteçlerin preeklamptik gebeliklerin bir özelliği olduğu bulunmuştur ve mevcut literatürle tutarlıdır. Bulgularımız, preeklampsi ile ilişkili riskleri en aza indirmek için erken tanı ve kapsamlı yönetim stratejilerini belirlemek için kullanılabilir.
References
- Choi Y, Jeon Y, Cho S, Park T, Lee WI, Kim Y, et al. Mean Platelet Volume in Patients with Preeclampsia: Single Center Study and Literature Review. Clin Lab. 2016;62(09/2016).
- Metz TD, Berry RS, Fretts RC, Reddy UM, Turrentine MA. Obstetric Care Consensus #10: Management of Stillbirth. Am J Obstet Gynecol. 2020 Mar;222(3):B2–20.
- Romero R, Lockwood C, Oyarzun E, Hobbins JC. Toxemia: new concepts in an old disease. Semin Perinatol. 1988 Oct;12(4):302–23.
- Laresgoiti-Servitje E. A leading role for the immune system in the pathophysiology of preeclampsia. J Leukoc Biol. 2013 Apr 30;94(2):247–57.
- Kirbas A, Biberoglu E, Daglar K, İskender C, Erkaya S, Dede H, et al. Neutrophil-to-lymphocyte ratio as a diagnostic marker of intrahepatic cholestasis of pregnancy. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2014 Sep;180:12–5.
- Arbel Y, Finkelstein A, Halkin A, Birati EY, Revivo M, Zuzut M, et al. Neutrophil/lymphocyte ratio is related to the severity of coronary artery disease and clinical outcome in patients undergoing angiography. Atherosclerosis. 2012 Dec;225(2):456–60.
- Guthrie GJK, Charles KA, Roxburgh CSD, Horgan PG, McMillan DC, Clarke SJ. The systemic inflammation-based neutrophil–lymphocyte ratio: Experience in patients with cancer. Crit Rev Oncol Hematol. 2013 Oct;88(1):218–30.
- Atlıhan U, Yavuz O, Avşar HA, Ata C, Erkılınç S, Bildacı TB. Vitamin D evaluation in adenomyosis: A retrospective cross-sectional study. Turk J Obstet Gynecol. 2024 Jun;21(2):98-103. doi:10.4274/tjod.galenos.2024.41662.
- Atlıhan, U., Bıldacı, T. B., Erkılınç, S., Yavuz, O., Avşar, H. A., & Ata, C. (2024). The Role of Neutrophil/Lymphocyte Ratio, Platelet/Lymphocyte Ratio and Mean Platelet Volume in Diagnosis of Hydrosalpinx. Ege Tıp Dergisi, 63(3), 449-456.
- Canzoneri B, Lewis D, Groome L, Wang Y. Increased Neutrophil Numbers Account for Leukocytosis in Women with Preeclampsia. Am J Perinatol. 2009 Nov 18;26(10):729–32.
- Lurie S, Frenkel E, Tuvbin Y. Comparison of the Differential Distribution of Leukocytes in Preeclampsia versus Uncomplicated Pregnancy. Gynecol Obstet Invest. 1998;45(4):229–31.
- Yang SW, Cho SH, Kwon HS, Sohn IS, Hwang HS. Significance of the platelet distribution width as a severity marker for the development of preeclampsia. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2014 Apr;175:107–11.
- Roberts JM, Bell MJ. If we know so much about preeclampsia, why haven’t we cured the disease? J Reprod Immunol. 2013 Sep;99(1–2):1–9.
- Kanat‐Pektas M, Yesildager U, Tuncer N, Arioz DT, Nadirgil‐Koken G, Yilmazer M. Could mean platelet volume in late first trimester of pregnancy predict intrauterine growth restriction and pre‐eclampsia? Journal of Obstetrics and Gynaecology Research. 2014 Jul 23;40(7):1840–5.
- ACOG Practice Bulletin No. 202: Gestational Hypertension and Preeclampsia. Obstet Gynecol. 2019;133(1):1.
- Huang Y, Gao Y, Wu Y, Lin H. Prognostic value of systemic immune-inflammation index in patients with urologic cancers: a meta-analysis. Cancer Cell Int. 2020 Oct 12; 20 :499. doi: 10.1186/s12935-020-01590-4. PMID: 33061851; PMCID: PMC7552553.
- Qi, Qi, et al. A novel systemic inflammation response index (SIRI) for predicting the survival of patients with pancreatic cancer after chemotherapy. Cancer 122.14 (2016): 2158-2167.
- Robillard, P. Y., Dekker, G., Scioscia, M., Bonsante, F., Iacobelli, S., Boukerrou, M., & Hulsey, T. C. (2019). Increased BMI has a linear association with late-onset preeclampsia: A population-based study. PloS one, 14(10), e0223888.
- Sohlberg, S., Stephansson, O., Cnattingius, S., & Wikström, A. K. (2012). Maternal body mass index, height, and risks of preeclampsia. American journal of hypertension, 25(1), 120-125.
- An, H., Jin, M., Li, Z., Zhang, L., Li, H., Zhang, Y., ... & Li, N. (2022). Impact of gestational hypertension and pre-eclampsia on preterm birth in China: a large prospective cohort study. BMJ open, 12(9), e058068.
- Bossung, V., Fortmann, M. I., Fusch, C., Rausch, T., Herting, E., Swoboda, I., ... & Humberg, A. (2020). Neonatal outcome after preeclampsia and HELLP syndrome: a population-based cohort study in Germany. Frontiers in pediatrics, 8, 579293.
- Gunnarsdottir, J., Cnattingius, S., Lundgren, M., Selling, K., Högberg, U., & Wikström, A. K. (2018). Prenatal exposure to preeclampsia is associated with accelerated height gain in early childhood. PLoS One, 13(2), e0192514.
- Walle, M., Gelaw, Y., Getu, F., Asrie, F., & Getaneh, Z. (2022). Preeclampsia has an association with both platelet count and mean platelet volume: a systematic review and meta-analysis. PLoS One, 17(9), e0274398.
- Toptas, M., Asik, H., Kalyoncuoglu, M., Can, E., & Can, M. M. (2016). Are neutrophil/lymphocyte ratio and platelet/lymphocyte ratio predictors for severity of preeclampsia?. Journal of Clinical Gynecology and Obstetrics, 5(1), 27-31.
- Oğlak, S. C., Tunç, Ş., & Ölmez, F. (2021). First trimester mean platelet volume, neutrophil to lymphocyte ratio, and platelet to lymphocyte ratio values are useful markers for predicting preeclampsia. Ochsner Journal, 21(4), 364-370.
- Zheng, W. F., Zhan, J., Chen, A., Ma, H., Yang, H., & Maharjan, R. (2019). Diagnostic value of neutrophil-lymphocyte ratio in preeclampsia: A PRISMA-compliant systematic review and meta-analysis. Medicine, 98(51), e18496.
- Çallıoğlu, N., Gül, D. K., Arslan, İ. Ö., Geyikoğlu, İ., & Demirçivi, E. (2024). Inflammatory markers in systemic immune-inflammatory index and inflammatory response index to predict early pregnancy loss. Saudi Medical Journal, 45(8), 808.
- Akdulum, M. F. C., Demirdağ, E., Arık, S. İ., Safarova, S., Erdem, M., Bozkurt, N., & Erdem, A. (2023). Is the first-trimester systemic immune-inflammation index associated with preeclampsia? Cureus, 15(8).
Abstract
Aim: The aim of our study was to evaluate the role of biochemical markers in predicting preeclampsia.
Materials and Methods: 7240 women whose pregnancy follow-ups and deliveries were carried out by us between March 2018 and March 2024 were retrospectively screened. Patients in the study group consisted of 102 women diagnosed with preeclampsia at <34 weeks of gestation, and patients in the control group consisted of 118 women who gave birth at ≥37 weeks of gestation. Demographic characteristics and obstetric and biochemical outcomes of the two groups were compared with each other.
Results: The body mass index (BMI) value was significantly higher in the preeclampsia group compared with the controls group (p=0.016). The birth weight value was significantly lower in the preeclampsia group compared with the controls group (p<0.001). The gestational week at delivery was significantly lower in the preeclampsia group compared with the controls group (p<0.001). Lymphocyte and platelet counts were significantly lower in the preeclampsia group compared with the controls group (p<0.001 and p<0.001, respectively). NLR and SII value were significantly higher in the preeclampsia group compared with the controls group (p=0.022, p<0.001, respectively).
Conclusion: Our study reveals important clinical and laboratory differences in preeclamptic pregnancies. Increased inflammatory markers were found to be a feature of preeclamptic pregnancies and are consistent with the existing literature. Our findings can be used to determine early diagnosis and comprehensive management strategies to minimize the risks associated with preeclampsia.
References
- Choi Y, Jeon Y, Cho S, Park T, Lee WI, Kim Y, et al. Mean Platelet Volume in Patients with Preeclampsia: Single Center Study and Literature Review. Clin Lab. 2016;62(09/2016).
- Metz TD, Berry RS, Fretts RC, Reddy UM, Turrentine MA. Obstetric Care Consensus #10: Management of Stillbirth. Am J Obstet Gynecol. 2020 Mar;222(3):B2–20.
- Romero R, Lockwood C, Oyarzun E, Hobbins JC. Toxemia: new concepts in an old disease. Semin Perinatol. 1988 Oct;12(4):302–23.
- Laresgoiti-Servitje E. A leading role for the immune system in the pathophysiology of preeclampsia. J Leukoc Biol. 2013 Apr 30;94(2):247–57.
- Kirbas A, Biberoglu E, Daglar K, İskender C, Erkaya S, Dede H, et al. Neutrophil-to-lymphocyte ratio as a diagnostic marker of intrahepatic cholestasis of pregnancy. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2014 Sep;180:12–5.
- Arbel Y, Finkelstein A, Halkin A, Birati EY, Revivo M, Zuzut M, et al. Neutrophil/lymphocyte ratio is related to the severity of coronary artery disease and clinical outcome in patients undergoing angiography. Atherosclerosis. 2012 Dec;225(2):456–60.
- Guthrie GJK, Charles KA, Roxburgh CSD, Horgan PG, McMillan DC, Clarke SJ. The systemic inflammation-based neutrophil–lymphocyte ratio: Experience in patients with cancer. Crit Rev Oncol Hematol. 2013 Oct;88(1):218–30.
- Atlıhan U, Yavuz O, Avşar HA, Ata C, Erkılınç S, Bildacı TB. Vitamin D evaluation in adenomyosis: A retrospective cross-sectional study. Turk J Obstet Gynecol. 2024 Jun;21(2):98-103. doi:10.4274/tjod.galenos.2024.41662.
- Atlıhan, U., Bıldacı, T. B., Erkılınç, S., Yavuz, O., Avşar, H. A., & Ata, C. (2024). The Role of Neutrophil/Lymphocyte Ratio, Platelet/Lymphocyte Ratio and Mean Platelet Volume in Diagnosis of Hydrosalpinx. Ege Tıp Dergisi, 63(3), 449-456.
- Canzoneri B, Lewis D, Groome L, Wang Y. Increased Neutrophil Numbers Account for Leukocytosis in Women with Preeclampsia. Am J Perinatol. 2009 Nov 18;26(10):729–32.
- Lurie S, Frenkel E, Tuvbin Y. Comparison of the Differential Distribution of Leukocytes in Preeclampsia versus Uncomplicated Pregnancy. Gynecol Obstet Invest. 1998;45(4):229–31.
- Yang SW, Cho SH, Kwon HS, Sohn IS, Hwang HS. Significance of the platelet distribution width as a severity marker for the development of preeclampsia. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2014 Apr;175:107–11.
- Roberts JM, Bell MJ. If we know so much about preeclampsia, why haven’t we cured the disease? J Reprod Immunol. 2013 Sep;99(1–2):1–9.
- Kanat‐Pektas M, Yesildager U, Tuncer N, Arioz DT, Nadirgil‐Koken G, Yilmazer M. Could mean platelet volume in late first trimester of pregnancy predict intrauterine growth restriction and pre‐eclampsia? Journal of Obstetrics and Gynaecology Research. 2014 Jul 23;40(7):1840–5.
- ACOG Practice Bulletin No. 202: Gestational Hypertension and Preeclampsia. Obstet Gynecol. 2019;133(1):1.
- Huang Y, Gao Y, Wu Y, Lin H. Prognostic value of systemic immune-inflammation index in patients with urologic cancers: a meta-analysis. Cancer Cell Int. 2020 Oct 12; 20 :499. doi: 10.1186/s12935-020-01590-4. PMID: 33061851; PMCID: PMC7552553.
- Qi, Qi, et al. A novel systemic inflammation response index (SIRI) for predicting the survival of patients with pancreatic cancer after chemotherapy. Cancer 122.14 (2016): 2158-2167.
- Robillard, P. Y., Dekker, G., Scioscia, M., Bonsante, F., Iacobelli, S., Boukerrou, M., & Hulsey, T. C. (2019). Increased BMI has a linear association with late-onset preeclampsia: A population-based study. PloS one, 14(10), e0223888.
- Sohlberg, S., Stephansson, O., Cnattingius, S., & Wikström, A. K. (2012). Maternal body mass index, height, and risks of preeclampsia. American journal of hypertension, 25(1), 120-125.
- An, H., Jin, M., Li, Z., Zhang, L., Li, H., Zhang, Y., ... & Li, N. (2022). Impact of gestational hypertension and pre-eclampsia on preterm birth in China: a large prospective cohort study. BMJ open, 12(9), e058068.
- Bossung, V., Fortmann, M. I., Fusch, C., Rausch, T., Herting, E., Swoboda, I., ... & Humberg, A. (2020). Neonatal outcome after preeclampsia and HELLP syndrome: a population-based cohort study in Germany. Frontiers in pediatrics, 8, 579293.
- Gunnarsdottir, J., Cnattingius, S., Lundgren, M., Selling, K., Högberg, U., & Wikström, A. K. (2018). Prenatal exposure to preeclampsia is associated with accelerated height gain in early childhood. PLoS One, 13(2), e0192514.
- Walle, M., Gelaw, Y., Getu, F., Asrie, F., & Getaneh, Z. (2022). Preeclampsia has an association with both platelet count and mean platelet volume: a systematic review and meta-analysis. PLoS One, 17(9), e0274398.
- Toptas, M., Asik, H., Kalyoncuoglu, M., Can, E., & Can, M. M. (2016). Are neutrophil/lymphocyte ratio and platelet/lymphocyte ratio predictors for severity of preeclampsia?. Journal of Clinical Gynecology and Obstetrics, 5(1), 27-31.
- Oğlak, S. C., Tunç, Ş., & Ölmez, F. (2021). First trimester mean platelet volume, neutrophil to lymphocyte ratio, and platelet to lymphocyte ratio values are useful markers for predicting preeclampsia. Ochsner Journal, 21(4), 364-370.
- Zheng, W. F., Zhan, J., Chen, A., Ma, H., Yang, H., & Maharjan, R. (2019). Diagnostic value of neutrophil-lymphocyte ratio in preeclampsia: A PRISMA-compliant systematic review and meta-analysis. Medicine, 98(51), e18496.
- Çallıoğlu, N., Gül, D. K., Arslan, İ. Ö., Geyikoğlu, İ., & Demirçivi, E. (2024). Inflammatory markers in systemic immune-inflammatory index and inflammatory response index to predict early pregnancy loss. Saudi Medical Journal, 45(8), 808.
- Akdulum, M. F. C., Demirdağ, E., Arık, S. İ., Safarova, S., Erdem, M., Bozkurt, N., & Erdem, A. (2023). Is the first-trimester systemic immune-inflammation index associated with preeclampsia? Cureus, 15(8).
Details
| Primary Language | English |
|---|---|
| Subjects | Obstetrics and Gynaecology |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | June 10, 2025 |
| Submission Date | December 27, 2024 |
| Acceptance Date | March 10, 2025 |
| Published in Issue | Year 2025Volume: 64 Issue: 2 |
