Abstract
ObjectiveSome components of the routine complete blood count (CBC) and their ratios, such as neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been found to be sensitive biomarkers of preeclampsia and other inflammatory obstetric conditions. We wanted to evaluate whether they can be associated with intrahepatic cholestasis of pregnancy (ICP).Materials and MethodsWe conducted a retrospective case-control study between May 1, 2015 and July 1, 2018. Cases were considered pregnancies with ICP and control healthy pregnancies. Cases and controls were matched for age, parity, and race.We compared the levels of white blood cells (WBC), hemoglobin, neutrophils, lymphocytes, NLR, PLR, platelets, red cell distribution width (RDW), and mean platelet volume (MPV) in the first and third trimesters between cases and controls. In addition, we compared the same components in the third trimester between patients with mild (serum total bile acid (TBA) of 10 - 40 µmols/L) and severe (TBA > 40 µmols/L) ICP. ResultsThere were 33 patients with ICP and 33 controls. There were no significant differences between the two groups in the first trimester. WBC, neutrophil count, and NLR were decreased in women with ICP in the third trimester compared to controls. MPV was significantly higher in the third trimester of patients with ICP compared to controls. RDW was lower in mild ICP compared to severe ICP in the third trimester.ConclusionDecreased WBC, neutrophil, NLR, and MPV values are associated with ICP and may be useful additions to the diagnostic algorithm for ICP. Larger studies are needed to assess the responsible underlying molecular pathogenic mechanisms.
Highlights
Intrahepatic cholestasis of pregnancy (ICP) is generally diagnosed in the late second or third trimester by localized pruritis to the abdomen and palms, elevated serum total bile acids (TBA) (> 10 μmols/L), and abnormal liver function tests, in the absence of other hepatobiliary disorders [1,2,3].ICP is the most common hepatobiliary disorder that occurs during pregnancy; the incidence of this disorder appears to vary in accordance with geographic location, time of year, and ethnicity [2, 4,5]
white blood cells (WBC), neutrophil count, and neutrophil-tolymphocyte ratio (NLR) were decreased in women with ICP in the third trimester compared to controls
mean platelet volume (MPV) was significantly higher in the third trimester of patients with ICP compared to controls
Summary
Some components of the routine complete blood count (CBC) and their ratios, such as neutrophil-tolymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been found to be sensitive biomarkers of preeclampsia and other inflammatory obstetric conditions. We wanted to evaluate whether they can be associated with intrahepatic cholestasis of pregnancy (ICP)
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