Relationship between changes in hemoglobin level in cesarean section and delta neutrophil index

Abstract

Aims: Accurate prediction of changes in hemoglobin (Hb) levels, an indicator of blood loss, in cesarean deliveries is critical for reducing maternal morbidity and mortality. This study evaluated the potential relationship between the preoperative delta neutrophil index (DNI), an inflammatory marker, and changes in Hb levels after cesarean section. Methods: Women with a history of a single cesarean section and who underwent a second cesarean section for delivery between 2018 and 2020 were retrospectively analyzed. The difference between the preoperative and postoperative 6th-hour and 24th-hour Hb levels was defined as the delta Hb 1 (ΔHb1) level and delta Hb 2 (ΔHb2) level, respectively. The primary outcome was the relationship between preoperative DNI with ΔHb1 level and ΔHb2 level. We also investigated the relationships of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with DNI and changes in Hb levels. Results: The study included 368 women with a mean age of 28 (19 to 45) years. The mean DNI was -0.82±5.62, NLR was 4.31±2.16, and PLR was 141.89±55.22. A positive correlation was found between DNI and ΔHb1 level (r=0.624, p<0.05) and ΔHb2 level (r=0.372, p=0.05). No significant correlation was found between PLR and NLR. Conclusions: Among women who underwent cesarean section, preoperative DNI showed a positive relationship with changes in postoperative Hb levels. The significance of DNI in predicting changes in Hb levels after cesarean section needs to be explored.

Keywords

• cesarean section
• delta neutrophil index
• hemoglobin
• neutrophil-to-lymphocyte ratio