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

• DOI: 10.1038/s41372-021-00964-4
• Publication Date: 2021-02-20T10:05:28Z
• Authors: Aashray Singareddy; Ashley Sang Eun Lee; Patrick L. Sweeney; Abigael E. Finkle; Howard L. Williams; Paula M. Buchanan; Noah H. Hillman; Joyce M. Koenig
• Keywords: Neutrophils; Placenta; Infant, Newborn; 3. Good health; 03 medical and health sciences; Chorioamnionitis; 0302 clinical medicine; Pregnancy; Infant, Extremely Premature; Humans; Premature Birth; Female; Lymphocytes; Retrospective Studies

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.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).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).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.