The reliability of peripheral blood hematological parameters as a severity predictor of preeclampsia in a cohort of Egyptian patients

Background: Preeclampsia is a leading contributor to perinatal morbidity and mortality around the world. Early prediction is urgent to avoid adverse outcomes. Maladapted maternal immune and inflammatory responses are suggested theories of pathogenesis. Systemic inflammatory response markers which obtained from complete blood picture parameters are used in diagnosis of some inflammatory diseases. Aim: To compare NLR between severe preeclampsia, less severe preeclampsia, and normotensive pregnant control. Comparison and significance of white blood cells and platelet indices as a preeclampsia severity predictor marker done as a secondary outcome. Methods: case control study included (96) pregnant females divided into 3 groups 32 subjects in each, recruited from the emergency unit of obstetrics and gynecology department, Cairo university. Venous samples collected from each subject and analyzed on automated hematology analyzer. Results: Statistically significant difference was found between the three groups regarding monocyte count, Pct and PDW. No significant difference detected in other parameters. ROC analysis revealed predictive significance for severe preeclampsia of monocytes with a cutoff point 6.5, sensitivity (68.8%), specificity (59.4%), (p value 0.038), AUC (0.644). Pct and PDW significantly predict preeclampsia (p value 0.012, <0.001) respectively. Pct cutoff value was 0.216 with (70.3%) sensitivity, (56.3%) specificity, AUC (0.644). PDW cutoff value was 17.55 with (56.3%) sensitivity, (81.3%) specificity, AUC (0.700). Conclusions: Depending on obtained results NLR couldn’t be used as preeclampsia severity predictor. Monocyte considered a useful preeclampsia severity discriminator. PDW and Pct can predict preeclampsia. Grander scale research is required to highlight the monocyte role in severity prediction of preeclampsia.