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Trombosit Lenfosit Oranı ile Koryoamniyonit ve Yenidoğan Morbiditeleri Arasındaki İlişki

Year 2022, Volume: 12 Issue: 2, 256 - 262, 17.05.2022
https://doi.org/10.33631/sabd.1113911

Abstract

Amaç: Lenfopeni, nötropeniler ve trombositopeniler yeni doğan yoğun bakım ünitelerinde sık karşılaşılan problemlerdendir. Trombosit ve lenfositlerin inflamatuar durumlarda üretim, tüketim ve yaşam döngüleri değişmektedir. Bu çalışmada trombosit lenfosit oranları (TLO) ile yeni doğan morbiditeleri arasında ilişkinin incelenmesi amaçlanmıştır.
Gereç ve Yöntemler: Geriye dönük son 2 yılda yeni doğan yoğun bakım ünitesine yatışı yapılan 201 hastanın verileri incelendi. Demografik özellikleri morbidite ve mortalite verileri kaydedildi. Hastaların ilk yatışındaki trombosit lenfosit oranları hesaplandı. Trombosit lenfosit oranları ile koryoamniyonit ve yeni doğan morbiditleri arasındaki ilişki incelendi.
Bulgular: Vakaların ortalama gebelik haftası ve ağırlıkları sırasıyla 30,9±3,6 hafta ve 1492±660 gram idi. Vakaların %43,3’ünü 28-32 gebelik haftasında doğan bebekler oluşturmaktaydı. TLO klinik koryoaniyonitli annelerin bebeklerinde anlamlı derecede yüksek bulunurken (p=0,006), intrauterin büyüme kısıtlılığı olan bebeklerde de anlamlı derecede düşük bulundu (p=0,020). ROC eğrisi klinik koryoamniyoniti tahmin etme gücü yönünden Max c-reaktif protein (Crp) 1. hafta ve max Crp 2. hafta ile karşılaştırıldığında TLO’nun belirgin üstün olduğu gözlemlenmiştir (Area under the curve (AUC):0,696, p=0,032). Anne TLO ve bebek TLO oranları arasında da anlamlı bir korelasyon bulunmuştur (r=0,202 p=0,020). Antenatal steroidler, doğum şekli, çoğul gebelikler, annede hipertansiyon varlığı ve erken dönem yeni doğan morbiditeleriyle TLO arasında ilişki bulunmazken, premature retinopatisi açısından gruplar arasında anlamlı fark bulundu (p<0,001).
Sonuç: TLO kolay ulaşılabilir ve ucuz bir gösterge olarak klinik koryoamniyonitli anne bebeklerinin karşılaşabileceği yeni doğan morbiditeleri için yeni doğan hekimlerine yol gösterebilir.

References

  • Tita AT, Andrews WW. Diagnosis and management of clinical chorioamnionitis. Clin Perinatol. 2010; 37(2): 339-54. https://doi.org/ 10.1016/j.clp.2010.02.003
  • Eschenbach DA. Ureaplasma urealyticum and premature birth. Clin Infect Dis. 1993;17 Suppl 1:S100-S106. https:// doi:10.1093/clinids/17.supplement_1.s100
  • Gibbs RS, Duff P. Progress in pathogenesis and management of clinical intraamniotic infection. Am J Obstet Gynecol. 1991; 164(5Pt1): 1317-26. https://doi:10.1016/0002-9378(91)90707-x
  • Newton ER. Chorioamnionitis and intraamniotic infection. Clin Obstet Gynecol. 1993; 36(4): 795-808. https://doi:10.1097/00003081-199312000-00004
  • Riggs JW, Blanco JD. Pathophysiology, diagnosis, and management of intraamniotic infection. Semin Perinatol. 1998; 22(4): 251-9. https://doi:10.1016/s0146-0005(98)80013-x
  • Piper JM, Newton ER, Berkus MD, Peairs WA. Meconium: a marker for peripartum infection. Obstet Gynecol. 1998; 91(5Pt1): 741-5. https://doi:10.1016/s0029-7844(98)00048-9
  • Tran SH, Caughey AB, Musci TJ. Meconium-stained amniotic fluid is associated with puerperal infections. Am J Obstet Gynecol. 2003; 189(3): 746-50. https://doi:10.1067/s0002-9378(03)00767-1
  • Yoon BH, Romero R, Moon JB, Shim SS, Kim M, Kim G,et al. Clinical significance of intra-amniotic inflammation in patients with preterm labor and intact membranes. Am J Obstet Gynecol. 2001; 185(5): 1130-6. https://doi:10.1067/mob.2001.117680
  • Lau J, Magee F, Qiu Z, Hoube J, Von Dadelszen P, Lee SK. Chorioamnionitis with a fetal inflammatory response is associated with higher neonatal mortality, morbidity, and resource use than chorioamnionitis displaying a maternal inflammatory response only. Am J Obstet Gynecol. 2005; 193(3Pt1): 708-13. https://doi:10.1016/j.ajog.2005.01.017
  • Aziz N, Cheng YW, Caughey AB. Neonatal outcomes in the setting of preterm premature rupture of membranes complicated by chorioamnionitis. J Matern Fetal Neonatal Med. 2009; 22(9): 780-4. https://doi:10.3109/14767050902922581
  • Ramsey PS, Lieman JM, Brumfield CG, Carlo W. Chorioamnionitis increases neonatal morbidity in pregnancies complicated by preterm premature rupture of membranes. Am J Obstet Gynecol. 2005; 192(4): 1162-6. https://doi:10.1016/j.ajog.2004.11.035
  • Nikolsky E, Grines CL, Cox DA, Garcia E, Tcheng JE, Sadeghi M,et al. Impact of baseline platelet count in patients undergoing primary percutaneous coronary intervention in acute myocardial infarction (from the CADILLAC trial). Am J Cardiol. 2007; 99(8) :1055-61. https://doi:10.1016/j.amjcard.2006.11.066
  • Toprak E, Bozkurt M, Dinçgez Çakmak B, Özçimen EE, Silahlı M, Ender Yumru A, et al. Platelet-to-lymphocyte ratio: A new inflammatory marker for the diagnosis of preterm premature rupture of membranes. J Turk Ger Gynecol Assoc. 2017; 18(3): 122-6. https://doi:10.4274/jtgga.2017.0028
  • Nording HM, Seizer P, Langer HF. Platelets in inflammation and atherogenesis. Front Immunol. 2015; 6: 98. https://doi:10.3389/fimmu.2015.00098
  • Balta S, Ozturk C. The platelet-lymphocyte ratio: A simple, inexpensive and rapid prognostic marker for cardiovascular events. Platelets. 2015; 26(7): 680-1. https://doi:10.3109/09537104.2014.979340
  • Templeton GF. A two-step approach for transforming continuous variables to normal: implications and recommendations for IS research. Communications of the Association for Information Systems. 2011; 28(1): 41-58. https://doi.org/10.17705/1CAIS.02804
  • Zou L, Zhang H, Zhu J, Zhu J. The value of the soluable intercellular adhesion molecule-1 levels in matermal serum for determination of occult chorioamnionitis in premature rupture of membranes. J Huazhong Univ Sci Technolog Med Sci. 2004; 24(2): 154-7. https://doi:10.1007/BF02885417
  • Maeda K, Matsuzaki N, Fuke S, Mitsuda N, Shimoya K, Nakayama M, et al. Value of the maternal interleukin 6 level for determination of histologic chorioamnionitis in preterm delivery. Gynecol Obstet Invest. 1997; 43(4): 225-31. https://doi:10.1159/000291862
  • Van de Laar R, van der Ham DP, Oei SG, Willekes C, Weiner CP, Mol BW. Accuracy of C-reactive protein determination in predicting chorioamnionitis and neonatal infection in pregnant women with premature rupture of membranes: a systematic review. Eur J Obstet Gynecol Reprod Biol. 2009; 147(2): 124-9. https://doi:10.1016/j.ejogrb.2009.09.017
  • Arcagok BC, Karabulut B. Platelet to Lymphocyte Ratio in Neonates: A Predictor of Early onset Neonatal Sepsis. Mediterr J Hematol Infect Dis. 2019; 11(1): e2019055. https://doi:10.4084/MJHID.2019.055
  • Koroglu N, Tayyar A, Tola E N, Cetin B A, Ozkan B O, Bahat P, et al. Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, mean platelet volume and plateletcrit in isolated intrauterine growth restriction and prediction of being born small for gestational age. Arch Med Sci Civil Dis. 2017; 2: 139-44. https://doi.org/10.5114/amscd.2017.70892
  • Akgun N, Namli Kalem M, Yuce E, Kalem Z, Aktas H. Correlations of maternal neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) with birth weight. J Matern Fetal Neonatal Med. 2017; 30(17): 2086-91. https://doi:10.1080/14767058.2016.1237497
  • Parrozzani R, Nacci EB, Bini S, Marchione G, Salvadori S, Nardo D, et al. Severe retinopathy of prematurity is associated with early post-natal low platelet count. Sci Rep. 2021; 11(1): 891. https://doi:10.1038/s41598-020-79535-0
  • Celik K, Ekinci D, Asena M, Matur NO. Can hematological parameters be a indicator risk factor in the development of retinopathy of prematurity? Klin Padiatr. https://doi:10.1055/a-1289-0105

The Relationship Between Platelet Lymphocyte Ratio and Neonatal Morbidities, Chorioamnionitis

Year 2022, Volume: 12 Issue: 2, 256 - 262, 17.05.2022
https://doi.org/10.33631/sabd.1113911

Abstract

Aim: Lymphopenia, neutropenia, and thrombocytopenia are common problems in neonatal intensive care units. Production, consumption, and life cycles of platelets and lymphocytes in inflammatory conditions change. In this study, it was aimed to examine the relationship between Platelet lymphocyte ratio (PLR) and neonatal morbidity.
Material and Methods: The data of 201 patients who were admitted to the neonatal intensive care unit in the last 2 years were analyzed retrospectively. Demographic characteristics, morbidity, and mortality data were recorded. PLRs at the first hospitalization of the patients were calculated. The relationship between PLR and chorioamnionitis, neonatal morbidities was examined.
Results: Mean gestational age and birth weight of the cases were 30.9 ± 3.6 weeks and 1492 ± 660 grams, respectively. 43.3% of the cases were babies born between 28-32 weeks of gestation. PLR was found significantly higher in babies of mothers with clinical chorioamnionitis (p = 0.006), while it was significantly lower in babies with intrauterine growth restriction (p = 0.020). There was a significant correlation between maternal PLR and infant PLR (r = 0.202 p = 0.020). While no relationship was found between PLR and antenatal steroids, delivery type, multiple pregnancies, presence of maternal hypertension, and early neonatal morbidity, a significant difference was found between the groups in terms of especially in babies born from mothers with clinical chorioamnionitis.

References

  • Tita AT, Andrews WW. Diagnosis and management of clinical chorioamnionitis. Clin Perinatol. 2010; 37(2): 339-54. https://doi.org/ 10.1016/j.clp.2010.02.003
  • Eschenbach DA. Ureaplasma urealyticum and premature birth. Clin Infect Dis. 1993;17 Suppl 1:S100-S106. https:// doi:10.1093/clinids/17.supplement_1.s100
  • Gibbs RS, Duff P. Progress in pathogenesis and management of clinical intraamniotic infection. Am J Obstet Gynecol. 1991; 164(5Pt1): 1317-26. https://doi:10.1016/0002-9378(91)90707-x
  • Newton ER. Chorioamnionitis and intraamniotic infection. Clin Obstet Gynecol. 1993; 36(4): 795-808. https://doi:10.1097/00003081-199312000-00004
  • Riggs JW, Blanco JD. Pathophysiology, diagnosis, and management of intraamniotic infection. Semin Perinatol. 1998; 22(4): 251-9. https://doi:10.1016/s0146-0005(98)80013-x
  • Piper JM, Newton ER, Berkus MD, Peairs WA. Meconium: a marker for peripartum infection. Obstet Gynecol. 1998; 91(5Pt1): 741-5. https://doi:10.1016/s0029-7844(98)00048-9
  • Tran SH, Caughey AB, Musci TJ. Meconium-stained amniotic fluid is associated with puerperal infections. Am J Obstet Gynecol. 2003; 189(3): 746-50. https://doi:10.1067/s0002-9378(03)00767-1
  • Yoon BH, Romero R, Moon JB, Shim SS, Kim M, Kim G,et al. Clinical significance of intra-amniotic inflammation in patients with preterm labor and intact membranes. Am J Obstet Gynecol. 2001; 185(5): 1130-6. https://doi:10.1067/mob.2001.117680
  • Lau J, Magee F, Qiu Z, Hoube J, Von Dadelszen P, Lee SK. Chorioamnionitis with a fetal inflammatory response is associated with higher neonatal mortality, morbidity, and resource use than chorioamnionitis displaying a maternal inflammatory response only. Am J Obstet Gynecol. 2005; 193(3Pt1): 708-13. https://doi:10.1016/j.ajog.2005.01.017
  • Aziz N, Cheng YW, Caughey AB. Neonatal outcomes in the setting of preterm premature rupture of membranes complicated by chorioamnionitis. J Matern Fetal Neonatal Med. 2009; 22(9): 780-4. https://doi:10.3109/14767050902922581
  • Ramsey PS, Lieman JM, Brumfield CG, Carlo W. Chorioamnionitis increases neonatal morbidity in pregnancies complicated by preterm premature rupture of membranes. Am J Obstet Gynecol. 2005; 192(4): 1162-6. https://doi:10.1016/j.ajog.2004.11.035
  • Nikolsky E, Grines CL, Cox DA, Garcia E, Tcheng JE, Sadeghi M,et al. Impact of baseline platelet count in patients undergoing primary percutaneous coronary intervention in acute myocardial infarction (from the CADILLAC trial). Am J Cardiol. 2007; 99(8) :1055-61. https://doi:10.1016/j.amjcard.2006.11.066
  • Toprak E, Bozkurt M, Dinçgez Çakmak B, Özçimen EE, Silahlı M, Ender Yumru A, et al. Platelet-to-lymphocyte ratio: A new inflammatory marker for the diagnosis of preterm premature rupture of membranes. J Turk Ger Gynecol Assoc. 2017; 18(3): 122-6. https://doi:10.4274/jtgga.2017.0028
  • Nording HM, Seizer P, Langer HF. Platelets in inflammation and atherogenesis. Front Immunol. 2015; 6: 98. https://doi:10.3389/fimmu.2015.00098
  • Balta S, Ozturk C. The platelet-lymphocyte ratio: A simple, inexpensive and rapid prognostic marker for cardiovascular events. Platelets. 2015; 26(7): 680-1. https://doi:10.3109/09537104.2014.979340
  • Templeton GF. A two-step approach for transforming continuous variables to normal: implications and recommendations for IS research. Communications of the Association for Information Systems. 2011; 28(1): 41-58. https://doi.org/10.17705/1CAIS.02804
  • Zou L, Zhang H, Zhu J, Zhu J. The value of the soluable intercellular adhesion molecule-1 levels in matermal serum for determination of occult chorioamnionitis in premature rupture of membranes. J Huazhong Univ Sci Technolog Med Sci. 2004; 24(2): 154-7. https://doi:10.1007/BF02885417
  • Maeda K, Matsuzaki N, Fuke S, Mitsuda N, Shimoya K, Nakayama M, et al. Value of the maternal interleukin 6 level for determination of histologic chorioamnionitis in preterm delivery. Gynecol Obstet Invest. 1997; 43(4): 225-31. https://doi:10.1159/000291862
  • Van de Laar R, van der Ham DP, Oei SG, Willekes C, Weiner CP, Mol BW. Accuracy of C-reactive protein determination in predicting chorioamnionitis and neonatal infection in pregnant women with premature rupture of membranes: a systematic review. Eur J Obstet Gynecol Reprod Biol. 2009; 147(2): 124-9. https://doi:10.1016/j.ejogrb.2009.09.017
  • Arcagok BC, Karabulut B. Platelet to Lymphocyte Ratio in Neonates: A Predictor of Early onset Neonatal Sepsis. Mediterr J Hematol Infect Dis. 2019; 11(1): e2019055. https://doi:10.4084/MJHID.2019.055
  • Koroglu N, Tayyar A, Tola E N, Cetin B A, Ozkan B O, Bahat P, et al. Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, mean platelet volume and plateletcrit in isolated intrauterine growth restriction and prediction of being born small for gestational age. Arch Med Sci Civil Dis. 2017; 2: 139-44. https://doi.org/10.5114/amscd.2017.70892
  • Akgun N, Namli Kalem M, Yuce E, Kalem Z, Aktas H. Correlations of maternal neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) with birth weight. J Matern Fetal Neonatal Med. 2017; 30(17): 2086-91. https://doi:10.1080/14767058.2016.1237497
  • Parrozzani R, Nacci EB, Bini S, Marchione G, Salvadori S, Nardo D, et al. Severe retinopathy of prematurity is associated with early post-natal low platelet count. Sci Rep. 2021; 11(1): 891. https://doi:10.1038/s41598-020-79535-0
  • Celik K, Ekinci D, Asena M, Matur NO. Can hematological parameters be a indicator risk factor in the development of retinopathy of prematurity? Klin Padiatr. https://doi:10.1055/a-1289-0105
There are 24 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research Articles
Authors

Musa Silahlı This is me 0000-0003-0944-7178

Publication Date May 17, 2022
Submission Date April 22, 2021
Published in Issue Year 2022 Volume: 12 Issue: 2

Cite

Vancouver Silahlı M. Trombosit Lenfosit Oranı ile Koryoamniyonit ve Yenidoğan Morbiditeleri Arasındaki İlişki. VHS. 2022;12(2):256-62.