JHSM
Journal of Health Sciences and Medicine

Journal of Health Sciences and Medicine (JHSM) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

ISSN: Active
eISSN: 2636-8579
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Submit Manuscript

Index
Original Article
The performance of various serum parameters in blood during the first trimester in the early detection of pre-eclampsia
Abstract
Aims: The aim of this study is to examine the alterations in various serum parameters within the circulatory system throughout the first trimester and assess their efficacy in identifying pre-eclampsia at an early stage.
Methods: This retrospective analysis undertook an examination of the medical records pertaining to 225 pregnancies that met the eligibility criteria at a tertiary referral center, spanning the years 2018 to 2021. Furthermore, an examination of laboratory parameters during the first trimester was performed, which included neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune inflammation index, systemic inflammation response index, pan-immune inflammation value, AST-to-platelet ratio index, delta neutrophil index, and prognostic nutritional index (PNI). A receiver operating characteristic curve analysis was performed to determine the optimal cut-off values for inflammatory and nutritional biomarkers to predict early- onset pre-eclampsia.
Results: The group of individuals with early-onset pre-eclampsia displayed notably elevated levels of neutrophil, lymphocyte, PCT, MPV, ALT, and creatinine, while displaying significantly reduced levels of albumin, bilirubin, PLR, MLR, and PNI (p<0.05, for all). The statistical significance of the area under the curve for PNI, albumin, PLR, MLR, and bilirubin values was observed to be greater than 0.5 (p<0.05, for all).
Conclusion: This article is the first to examine the efficacy of the first trimester PNI value in early detection of pre-eclampsia patients. According to this study, PNI, albumin, PLR, MLR, and bilirubin show potential as useful indicators for predicting the likelihood of developing pre-eclampsia at an early stage in the first trimester.

Keywords : Serum markers, pregnancy, first trimester, high-risk, pre-eclampsia

Download Article


1. ACOG Practice Bulletin No. 202: Gestational Hypertension and Preeclampsia. <em>Obstet Gynecol</em>. 2019;133(1):1. doi:10.1097/AOG.0000000000003018
2. Sahai K, Saraswathy S, Yadav TP, Arora D, Krishnan M. Pre-eclampsia: molecular events to biomarkers. <em>Med J Armed Forces India</em>. 2017;73(2):167-174. doi:10.1016/j.mjafi.2016.09.001
3. Laresgoiti-Servitje E. A leading role for the immune system in the pathophysiology of preeclampsia. <em>J Leukoc Biol</em>. 2013;94(2):247-257. doi:10.1189/jlb.1112603
4. Shah TJ, Walsh SW. Activation of NF-kappaB and expression of COX-2 in association with neutrophil infiltration in systemic vascular tissue of women with preeclampsia. <em>Am J Obstet Gynecol</em>. 2007;196(1):48.e1-8. doi:10.1016/j.ajog.2006.08.038
5. Mate A, Reyes-Goya C, Santana-Garrido &Aacute;, V&aacute;zquez CM. Lifestyle, maternal nutrition and healthy pregnancy. <em>Curr Vasc Pharmacol</em>. 2021;19(2):132-140. doi:10.2174/1570161118666200401112955
6. Dou W, Zhao X, L&uuml; Q, et al. Association between nutrition factors in the third trimeter and preeclampsia:a case-control study. <em>Wei Sheng Yan Jiu</em>. 2019;48(2):232-237.
7. Belovic DK, Ple&scaron;inac S, Dotlic J, et al. Biochemical markers for prediction of hypertensive disorders of pregnancy. <em>J Med Biochem</em>. 2019;38(1):71-82. doi:10.2478/jomb-2018-0001
8. Karaşin SS, &Ccedil;ift T. The role of ischemia-modified albumin as a biomarker in preeclampsia. <em>Rev Bras Ginecol Obstet</em>. 2020; 42:133-139.
9. Afrose D, Chen H, Ranashinghe A, et al. The diagnostic potential of oxidative stress biomarkers for preeclampsia: systematic review and meta-analysis. <em>Biol Sex Differ</em>. 2022;13(1):26. doi:10. 1186/s13293-022-00436-0
10. Bayram F, Karaşin SS. The predictive role of neutrophil-lymphocyte ratio, platelet lymphocyte ratio, and other complete blood count parameters in eclampsia and HELLP syndrome. <em>J Sur Med</em>. 2021;5(12):1202-1205.
11. Mirkovic L, Tulic I, Stankovic S, Soldatovic I. Prediction of adverse maternal outcomes of early severe preeclampsia. <em>Pregnancy Hypertens</em>. 2020;22:144-150. doi:10.1016/j.preghy.2020.09.009
12. Magee LA, Smith GN, Bloch C, et al. Guideline No. 426: Hypertensive disorders of pregnancy: diagnosis, prediction, prevention, and management. <em>J Obstet Gynaecol Can</em>. 2022; 44(5):547-571.e1. doi:10.1016/j.jogc.2022.03.002
13. Tan MY, Syngelaki A, Poon LC, et al. Screening for pre-eclampsia by maternal factors and biomarkers at 11-13 weeks&rsquo; gestation. <em>Ultrasound Obstet Gynecol</em>. 2018;52(2):186-195. doi:10.1002/uog. 19112
14. &Ccedil;endek BD, Bayraktar B, K&ouml;rpe B, Ustun Y, Keskin HL, Erel &Ouml;. Ischemia-modified albumin levels in threatened abortion and missed abortion compared to healthy pregnancies. <em>J Exper Clin Med</em>. 2024;41(1):102-107.
15. Rossi A, Bortolotti N, Vescovo S, et al. Ischemia-modified albumin in pregnancy. <em>Eur J Obstet Gynecol Reprod Biol</em>. 2013; 170(2):348-351.
16. Berry EB, Eykholt R, Helliwell RJ, Gilmour RS, Mitchell MD, Marvin KW. Peroxisome proliferator-activated receptor isoform expression changes in human gestational tissues with labor at term. <em>Mol Pharmacol</em>. 2003;64(6):1586-1590.
17. Szilagyi JT, Avula V, Fry RC. Perfluoroalkyl substances (PFAS) and their effects on the placenta, pregnancy, and child development: a potential mechanistic role for placental peroxisome proliferator-activated receptors (PPARs). <em>Curr Envir Health Rpt</em>. 2020;7(3):222-230. doi:10.1007/s40572-020-00279-0
18. Peng L, Yang H, Ye Y, et al. Role of peroxisome proliferator-activated receptors (PPARs) in trophoblast functions. <em>Int J Molecular Sci</em>. 2021;22(1):433.
19. Pham J, Rajan KAN, Li P, Parast MM. The role of Sirtuin1-PPAR&gamma; axis in placental development and function. <em>J Molecular Endocrinology</em>. 2018;60(4):R201-R212.
20. Psilopatis I, Vrettou K, Fleckenstein FN, Theocharis S. The role of peroxisome proliferator-activated receptors in preeclampsia. <em>Cells</em>. 2023;12(4):647.
21. &Ccedil;intesun E, Incesu &Ccedil;intesun FN, Ezveci H, Aky&uuml;rek F, &Ccedil;elik &Ccedil;. Systemic inflammatory response markers in preeclampsia. <em>J Lab Physicians</em>. 2018;10(3):316-319. doi:10.4103/JLP.JLP_144_17
22. Serin S, Avcı F, Ercan O, K&ouml;st&uuml; B, Bakacak M, Kıran H. Is neutrophil/lymphocyte ratio a useful marker to predict the severity of pre-eclampsia? <em>Pregnancy Hypertension: Int J Women&rsquo;s Cardiovas Health</em>. 2016;6(1):22-25.
23. Wang J, Zhu QW, Cheng XY, et al. Assessment efficacy of neutrophil-lymphocyte ratio and monocyte-lymphocyte ratio in preeclampsia. <em>J Reprod Immunol</em>. 2019;132:29-34. doi:10.1016/j.jri.2019.02.001
24. Kudret U, &Ouml;z&ccedil;il MD. Predicting severe preeclampsia ımportance of hemogram ınflammatory markers. <em>Medical J Mustafa Kemal Uni</em>. 2022;13(45):86-96. doi:10.17944/mkutfd.1034264
25. Seyhanli Z, Bayraktar B, Baysoz OB, et al. The role of first trimester serum inflammatory indexes (NLR, PLR, MLR, SII, SIRI, and PIV) and the &beta;-hCG to PAPP-A ratio in predicting preeclampsia. <em>J Reprod Immunol</em>. 2024;162:104190. doi:10.1016/j.jri.2023.104190
26. Bektaş O, Bektaş K, Taşın C. The role of systemic inflammatory indexes in predicting preeclampsia and its severity. <em>Perinatal J</em>. 2019;27(2).
27. Cui HX, Chen C, Jung YM, et al. Neutrophil-to-lymphocyte ratio (NLR) as a predictive index for liver and coagulation dysfunction in preeclampsia patients. <em>BMC Pregnancy Childbirth</em>. 2023;23(1):4. doi:10.1186/s12884-022-05335-1
28. Pyo JY, Park JS, Park YB, Lee SK, Ha YJ, Lee SW. Delta neutrophil index as a marker for differential diagnosis between flare and infection in febrile systemic lupus erythematosus patients. <em>Lupus</em>. 2013;22(11):1102-1109. doi:10.1177/0961203313499957
29. Cho HY, Jung I, Kim SJ, Park YW, Kim YH, Kwon JY. Increased delta neutrophil index in women with severe preeclampsia. <em>Am J Reprod Immunol</em>. 2017;78(3). doi:10.1111/aji.12705
30. Ozkan D, Ibanoglu MC, Adar K, et al. Efficacy of blood parameters in predicting the severity of gestational hypertension and preeclampsia. <em>J Obstet Gynaecol</em>. 2023;43(1):2144175. doi:10.1080/01443615.2022.2144175
31. American College of Obstetricians and Gynecologists, Society for Maternal-Fetal Medicine in collaboration with, Metz TD, et al. Obstetric Care Consensus #10: Management of Stillbirth: (Replaces Practice Bulletin Number 102, March 2009). <em>Am J Obstet Gynecol</em>. 2020;222(3):B2-B20. doi:10.1016/j.ajog.2020.01.017
32. Şaşmaz Mİ, Ayvaz MA, D&uuml;lger AC, Kuday Kaykısız EK, G&uuml;ven R. Aspartate-aminotransferase to platelet ratio index score for predicting HELLP syndrome. <em>Am J Emerg Med</em>. 2020;38(3):459-462. doi:10.1016/j.ajem.2019.02.014
33. Loaeza-del-Castillo A, Paz-Pineda F, Oviedo-C&aacute;rdenas E, S&aacute;nchez-Avila F, Vargas-Vor&aacute;ckov&aacute; F. AST to platelet ratio index (APRI) for the noninvasive evaluation of liver fibrosis. <em>Ann Hepatol</em>. 2008;7(4):350-357.
34. Maziashvili G, Juliana K, Siva Subramania Pillai Kanimozhi V, et al. The use of systemic inflammatory markers from routine blood tests in predicting preeclampsia and the impact of age on marker levels. <em>Cureus</em>. 2023;15(3):e35836. doi:10.7759/cureus.35836
35. Amaral LM, Wallace K, Owens M, LaMarca B. Pathophysiology and current clinical management of preeclampsia. <em>Curr Hypertens Rep</em>. 2017;19(8):61. doi:10.1007/s11906-017-0757-7
36. Laresgoiti-Servitje E, G&oacute;mez-L&oacute;pez N, Olson DM. An immunological insight into the origins of pre-eclampsia. <em>Hum Reprod Update</em>. 2010;16(5):510-524. doi:10.1093/humupd/dmq007
37. Achamrah N, Ditisheim A. Nutritional approach to preeclampsia prevention. <em>Curr Opinion Clin Nutr Metabol Care</em>. 2018;21(3):168-173.
38. Wolf HT, Hegaard HK, Huusom LD, Pinborg AB. Multivitamin use and adverse birth outcomes in high-income countries: a systematic review and meta-analysis. <em>Am J Obstetrics Gynecol</em>. 2017;217(4):404-e1.
39. Feng Z, Wen H, Ju X, et al. The preoperative prognostic nutritional index is a predictive and prognostic factor of high-grade serous ovarian cancer. <em>BMC Cancer</em>. 2018;18(1):883. doi:10.1186/s12885-018-4732-8
40. Komura N, Mabuchi S, Yokoi E, et al. Prognostic significance of the pretreatment prognostic nutritional index in patients with epithelial ovarian cancer. <em>Oncotarget</em>. 2019;10(38):3605.
41. Horwich TB, Kalantar-Zadeh K, MacLellan RW, Fonarow GC. Albumin levels predict survival in patients with systolic heart failure. <em>Am Heart J</em>. 2008;155(5):883-889. doi:10.1016/j.ahj.2007.11.043
42. Wei S, Lian L, Li G, Wang J, Chen G, Yu L. Low prognostic nutritional index contributes to high adverse events in preeclampsia. <em>Dis Markers</em>. 2022;2022:1187742. doi:10.1155/2022/ 1187742
Article available in :
Volume 7, Issue 4, 2024
Page : 451-458
https://doi.org/10.32322/jhsm.1500190
Article Information
Received : 12 Haz 2024
Accepted : 19 Tem 2024
Published : 30 Tem 2024
Corresponding Author :

Büşra Demir Çendek: Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara, Turkiye

[email protected]
Citation : Demir Çendek B, Ağbal T, Akay A, Can İbanoğlu M, Engin Üstün Y. The performance of various serum parameters in blood during the first trimester in the early detection of pre-eclampsia. J Health Sci Med. 2024;7(4):451-458.

Read: 255
Cited: 0
Download : 73
_Footer