First-trimester biochemical inflammatory markers (NHR and NLR) as predictors of preeclampsia risk

Background: Preeclampsia (PE) remains a leading cause of maternal and perinatal morbidity. The early identification of high-risk pregnancies requires accessible and cost-effective laboratory markers. This study aimed to evaluate first-trimester blood count-derived inflammatory indices, with a focus on the neutrophil-to-HDL ratio (NHR) and neutrophil-to-lymphocyte ratio (NLR), for PE risk prediction. Methods: A retrospective analysis was conducted involving 90 patients with PE and 90 healthy pregnant women. Routine hematological and biochemical parameters were measured using an automated hematology analyzer and an automated biochemical analyzer respectively, and derived indices (NLR, NHR, m H r, SII) were calculated. Independent risk factors were determined through multivariate logistic regression, and a predictive model was validated by receiver operating characteristic (ROC) curve analysis. Results: PE patients exhibited significantly higher NLR, NHR, and SII levels, compared with controls (all p < 0.001). Multivariate logistic regression identified NLR, NHR, and body mass index (BMI) as independent predictors of PE. The combined model incorporating these factors achieved excellent predictive performance, with an area under the ROC curve of 0.909 (95% CI: 0.866-0.952). Conclusions: The first-trimester NHR and NLR, combined with BMI, constitute a clinically useful panel for early PE prediction. This readily applicable model provides a valuable alternative to cost-intensive screening methods, particularly in resource-constrained settings. Its implementation could enhance first-trimester risk stratification and guide timely interventions, ultimately contributing to improved maternal and perinatal outcomes.