Neutrophil and Platelet to Lymphocyte Ratio in Prevailing the Oxidative Stress and Its Relation with the Endothelial Dysfunction in Preeclampsia

Abstract

Background: Preeclampsia (PE) is a pregnancy specific, hypertensive disorder. It affects 2-8% pregnancies. Oxidative stress and systemic inflammation are proposed to contribute significantly to the preeclampsia pathophysiology. The present study, aim is to determine and compare the markers of oxidative stress, endothelial dysfunction, systemic inflammatory markers Neutrophil/Lymphocyte Ratio (NLR) and Platelet/ Lymphocyte Ratio (PLR) in preeclampsia and gestational age matched healthy controls. Material and Methods: This study was conducted in the Department of Biochemistry and Department of Obstetrics and Gynecology, Sri Devaraj Urs Medical College, Kolar, Karnataka. The study included 98 preeclamptic women and 98 normotensive pregnant women. Five ml venous blood was collected from all the study subjects. Blood sample in EDTA vials was used for the complete blood count. NLR and PLR were calculated. Plasma was used for Ferric Reducing Ability of Plasma (FRAP) assay. Serum was used for the estimation of Malondialdehyde (MDA), nitric oxide, blood sugar, renal parameters and liver enzymes i.e., Aspartate Transaminase (AST), Alanine Transaminase (ALT), Lactate Dehydrogenase (LDH) and magnesium. Corresponding urine samples were collected for urinary protein analysis by dipstick method. Fetal outcome was recorded. Results: Gestational age was significantly low in preeclamptic women as compared to those of controls. Blood pressure (Systolic and diastolic), mean arterial pressure, body mass index, pulse rate, serum creatinine, uric acid, AST, ALT, LDH, MDA and NLR were increased significantly in preeclamptic women as compared to those of controls. In subgroup analysis, NLR was increased significantly in severe preeclamptics as compared to mild preeclamptics. Serum Nitric Oxide (NO) and FRAP levels were decreased significantly in preeclamptic women as compared to those of controls. Significantly decreased birth weight was observed in babies born to preeclamptic mothers compared with controls. Conclusion: The present study results conclude that increased oxidative stress in terms increased MDA, decreased NO and reduced antioxidant status (FRAP) in preeclamptic women, results in adverse perinatal outcome. In addition, maternal NLR could be considered as a marker for severity of preeclampsia.

Keywords

• ferric reducing ability of plasma
• fetal outcome
• malondialdehyde
• nitric oxide