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High first-trimester neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios are indicators for early diagnosis of preeclampsia.

OBJECTIVES
The aim of our study is to determine whether first-trimester neutrophil-to-lymphocyte ratio (NLR) and plate-let-to-lymphocyte ratio (PLR) would be useful as new predictors of subsequent preeclampsia.


MATERIAL AND METHODS
Medical records of women with preeclampsia and healthy controls from a tertiary referral center were retrospectively evaluated. The two groups were compared in terms of clinical characteristics and first-trimester levels of hemoglobin, leukocyte, neutrophil, lymphocyte, platelet, NLR and PLR. Receiver operating characteristic curve (ROC) analysis was performed to identify the optimal NLR and PLR levels predicting preeclampsia.


RESULTS
Neutrophil (p < 0.001), platelet (p < 0.001), NLR (p < 0.001) and PLR (p < 0.001) levels were significantly elevated, whereas hemoglobin concentration (p = 0.003) was significantly lower in the group with preeclampsia as compared to the control group. On multivariate regression analysis, NLR (OR 1.43; 95% CI 1.21-1.76; p = 0.005) and PLR (OR 1.38; 95% CI 1.15-1.63; p = 0.008) were the most powerful predictive variables. The area under the ROC was 0.716 and 0.705 for NLR and PLR, respectively. The cut-off values of NLR ≥ 3.08 and PLR ≥ 126.8 predicted preeclampsia with the sensitivity of 74.6% and 71.8% and specificity of 70.1% and 72.4%, respectively.


CONCLUSIONS
High NLR and PLR during the first trimester are independent predictors of subsequent preeclampsia.