Association between glucose-to-lymphocyte ratio and hematological parameters, delivery timing, and neonatal outcomes in pregnancies complicated by preterm premature rupture of membranes

Abstract

Aims: To evaluate the diagnostic significance of the glucose/lymphocyte ratio (GLR) of preterm premature rupture of membranes (PPROM) and its prognostic ability in predicting adverse neonatal outcomes. Methods: A retrospective assessment was performed on 321 pregnant women who delivered at a tertiary center between January 2023 and January 2025. The study included 156 women diagnosed with PPROM at a gestational age of ≤34+6 weeks. The control group comprised 165 women without PPROM, matched for maternal age, body-mass index (BMI) and gestational week. A poor prognosis was defined as neonatal intensive care unit (NICU) admission, 5-minute APGAR score <7, respiratory distress syndrome (RDS), or neonatal sepsis. GLR, glucose, lymphocyte, and albumin levels were obtained from laboratory data. Results: No significant difference in GLR was observed between the PPROM and control groups (p>0.05). GLR values remained consistent across latency periods (<72 and ≥72 hours). However, GLR was significantly higher in neonates with poor prognosis (50.9 vs. 41.3, p=0.016). ROC analysis revealed an AUC of 0.621 for GLR (cut-off: 42.6; sensitivity 64.6%, specificity 56%). The AUC for lymphocyte count was 0.619, and for gestational age at diagnosis 0.799, the latter being the strongest predictor. In multivariate logistic regression, gestational age at diagnosis emerged as the only independent predictor of adverse neonatal outcomes (OR=0.61, 95% CI: 0.50–0.74, p<0.001). Conclusion: GLR is not useful for diagnosing PPROM but may serve as a prognostic marker for neonatal outcomes. Gestational age at diagnosis remains the strongest determinant of prognosis.

Keywords

• Preterm premature rupture of membranes
• prognosis
• glucose/lymphocyte ratio
• lymphocytes
• glucose
• pregnancy complications

Preterm erken membran rüptürü olan gebelerde glukoz/lenfosit oranı ile hematolojik parametreler, doğum zamanlaması ve neonatal sonuçlar arasındaki ilişki

Abstract

Amaç Bu çalışma, erken preterm erken membran rüptürü (PPROM) olan gebelerde glukoz/lenfosit oranı (GLR), ek hematolojik parametreler ile doğum zamanı ve neonatal sonuçlar arasındaki ilişkiyi araştırmayı amaçladı. Gereç ve Yöntem Ocak 2023 ile Haziran 2025 tarihleri arasında üçüncü basamak bir sağlık merkezinde doğum yapan toplam 321 gebe üzerinde retrospektif bir analiz gerçekleştirildi. Çalışma grubunu, 34. gebelik haftasından önce PPROM tanısı almış 156 gebe oluştururken; kontrol grubunu ise benzer gebelik haftasında doğum yapan ve herhangi bir obstetrik komplikasyon bulunmayan 165 sağlıklı gebe oluşturdu. Gruplar demografik, laboratuvar ve perinatal veriler açısından analiz edildi. GLR, glukoz konsantrasyonunun (mg/dL), mutlak lenfosit sayısına (10³/µL) bölünmesi ile hesaplandı. Membran rüptürünü takiben 72 saat içinde doğum gerçekleşme durumu ve bileşik olumsuz neonatal sonuçların varlığı değerlendirildi. Bulgular Lökosit ve lenfosit sayıları PPROM grubunda belirgin şekilde yüksek bulundu (p<0.05). GLR değerleri PPROM ve kontrol grupları arasında benzerdi. Bununla birlikte, 72 saat içinde doğum yapan PPROM olgularında GLR anlamlı derecede düşük bulundu (p=0.034). Ayrıca, bileşik olumsuz neonatal sonuç gözlenen olgularda GLR yüksek, lenfosit düzeyi ise düşük bulundu (p<0.05). Sonuç GLR’nin, PPROM olgularında 72 saat içinde doğum gerçekleşmesi ve olumsuz neonatal sonuçlarla ilişkili olduğu saptandı. Rutin laboratuvar verilerinden kolayca hesaplanabilmesi nedeniyle GLR, obstetrik pratikte uygulanabilir, düşük maliyetli ve non-invaziv bir parametre olarak değerlendirilebilir.

Keywords

• Fetal membranların erken rüptürü
• Glukoz
• Lenfositler
• biyobelirteçler
• gebelik sonuçları
• infant
• yenidoğan

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