The accuracy of selected hematology and inflammatory indices for predicting preterm labor; a cross-sectional study

Abstract

Introduction: The role of inflammatory indices has been suggested in preterm labor. Objectives: The possible relationship of some inflammatory and hematological markers were investigated as predictors of preterm labor. Patients and Methods: Around 110 full-term and 109 preterm women were randomly enrolled. According to the gestational age at delivery, they were divided into two groups including <37 weeks and ≥37 weeks pregnancies. The patients’ age, body mass index (BMI), history of smoking were recorded. Selected hematological parameters, erythrocyte sedimentation rate (ESR) and high-sensitive C-reactive protein (hsCRP) were measured. Comparison of groups, the odd’s ratio and accuracy of each index were evaluated and assessed statistically. Results: Overall, 110 full-term and 109 preterm mothers were evaluated. Mothers with preterm labor had higher WBC, hemoglobin, neutrophil proportion, neutrophil/lymphocyte ratio (NLR), platelet count, platelet/lymphocyte ratio (PLR), and ESR and also hs-CRP values. However, they had lower lymphocyte proportion than mothers with full-term delivery. Hs-CRP higher than 10.9 mg/L showed moderate sensitivity (50.46%) instead of high specificity (90.91%), while ESR >30 mm revealed 85.32% sensitivity and 93.64% specificity for predicting preterm labor. Lymphocyte ratio ≤22% and NLR >3.21 represented high sensitivity and plausible specificity. Hemoglobin >10.8 g/dL, platelet count >178000 cells/μL, PLR> 8.53 and WBC >7800 cells/μL showed adequate sensitivities with low to moderate specificities to predict preterm labor. Conclusion: Most of the investigated variables were associated with preterm delivery. The cut-off values obtained here may help obstetricians to predict preterm delivery, and therefore to manage its complications, costs, hazards and care problems.