Relationship between Antenatal Maternal Neutrophil-to-Lymphocyte Ratio and Early Onset Neonatal Sepsis in Preterm Neonates

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Published: Apr 1, 2020
DOI: https://doi.org/10.14456/tjog.2020.13
Keywords:
Preterm neonates early onset neonatal sepsis neutrophil to lymphocyte ratio

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Thitiphan Chayawongrungreung
Department of Obstetrics and Gynecology, Chareonkrung Pracharak Hospital, Medical Service Department, Bangkok Metropolitan Administration, Bangkok, Thailand
Jiraporn Luengmettakul
Department of Obstetrics and Gynecology, Chareonkrung Pracharak Hospital, Medical Service Department, Bangkok Metropolitan Administration, Bangkok, Thailand
Aungsumalin Srilar
Department of Obstetrics and Gynecology, Chareonkrung Pracharak Hospital, Medical Service Department, Bangkok Metropolitan Administration, Bangkok, Thailand

Abstract

Objective: To determine the relationship between maternal neutrophil to lymphocyte ratio (NLR) and early onset neonatal sepsis (EONS) in preterm neonates.


Materials and Methods: Between 2012 to 2016, a total of 485 cases of preterm delivery were retrospectively reviewed. Study group consisted of 97 neonates diagnosed with EONS and other 388 without EONS were randomly selected as a comparison group (1:4 ratio). Data were extracted from medical records, including baseline characteristics, obstetric and delivery data. Maternal NLR was calculated from laboratory results within 72 hours prior to delivery.


Results: Neonates with EONS were significantly more likely to deliver at <34 weeks (p<0.001), had PPROM (p=0.043), and had maternal fever (p=0.016). White blood cell and neutrophil counts were significantly higher in EONS group while lymphocyte counts were comparable. Median NLR was significantly higher in EONS group (4.7 vs. 4.1, p=0.005). NLR of >5 significantly increased the risk of EONS (26.8% vs. 16.4%, p=0.007). Logistic regression analysis showed that delivery at <34 weeks and maternal fever were independently associated with EONS (adjusted OR 11.5, 95% CI 6.7-19.7, and 3.4, 95% CI 1.1-11.3, respectively). Subgroup analysis showed that NLR of >5 independently increased the risk of EONS in those delivered at <34 weeks (adjusted OR 3.5, 95% CI 1.4-9.1) and maternal fever independently increased the risk of EONS in those delivered at >34 weeks (adjusted OR 6.1, 95% CI 1.8-20.3).


Conclusion: Maternal NLR was significantly associated with EONS in preterm neonates, especially those delivered at <34 weeks.

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How to Cite
(1)
Chayawongrungreung, T.; Luengmettakul, J.; Srilar, A. Relationship Between Antenatal Maternal Neutrophil-to-Lymphocyte Ratio and Early Onset Neonatal Sepsis in Preterm Neonates. Thai J Obstet Gynaecol 2020, 28, 94-102.
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VOL. 28, NO. 2: (April - June 2020)
Section
Original Article

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