Neutrophil count is a useful marker to predict the severity of preeclampsia

ABSTRACT

Background

At present, pre-eclampsia is a growing concern and still a diagnostic challenge for obstetricians.

Aims

This study aimed to evaluate whether the relationship of second trimester of pregnancy neutrophil count differed among pregnancies with mild preeclampsia, severe preeclampsia, and healthy status and explore whether or not neutrophil count in the second trimester of pregnancy would be useful as new predictors of subsequent preeclampsia.

Patients and methods

This study involved 933 pregnancies from 1 January 2018 to 30 January 2021, comprising 396 healthy pregnancies, 222 pregnancies with mild preeclampsia, and 315 pregnancies with severe preeclampsia. The relationship between preeclampsia and neutrophil count was analyzed by multiple logistic regression. In addition, maternal placental tissues of three groups were immunohistochemically stained for myeloperoxidase (MPO).

Results

Neutrophil count was significantly higher in pregnancies with preeclampsia (including pregnancies with mild and severe preeclampsia) than that in healthy pregnancies. The neutrophil count level was prominently higher in patients with severe preeclampsia compared with those with mild preeclampsia (p < .001). The neutrophil count level was significantly positively associated with preeclampsia after adjusting for gestational week at time of blood sampling, BMI, and age (β:1.23; 95%CI:1.09–1.36; p < .0001). In addition, MPO expressions of placental tissues in preeclamptic groups were significantly increased than these in healthy pregnant controls (p < .05).

Conclusions

Increased neutrophil count in the second trimester of pregnancy was significantly positively associated with preeclampsia. Hence, neutrophil count plays a role in predicting the severity of preeclampsia. At the same time, it may be an independent predictor of subsequent preeclampsia.

Abbreviations: BMI: body mass index; MPO: myeloperoxidase.

KEYWORDS:

• Preeclampsia
• neutrophil count
• second trimester of pregnancy
• severity
• prediction

Acknowledgments

Thanks to all the peer reviewers and editors for their opinions and suggestions. Funding support from the Key Research and Development Program of Jining Science (No.2020YXNS007) and the Research Fund for Academician Lin He New Medicine, China (No. JYHL2019FMS14).

Author contributions

M.L., F.G.W. and D.M.M. conceived and designed the study. M.L., P.L., C.L., H.R.L. and D.M.M. participated in the design. M.L. drafted the manuscript. M.L., R.X.Z., M.M.Q., L.H.Z. and L.J.Z. performed the statistical analysis. L.H.Z., H.S., X.Q.F., C.L.S. and T.T.Y. participated in the design of the study and revised the manuscript. All authors have read and approved the final manuscript.

Availability of data and materials

The datasets used and/or analyzed in the current study are available from the corresponding author on reasonable request.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics approval and consent to participate

This study was were obtained with the informed consent of all participants. The institutional review board of the Human Ethics Committee of the Affiliated Hospital of Jining Medical University (Shandong, China) approved This study, code 2019-zr-016. All procedures performed in the study were following the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors. Informed written consent was obtained from all participants before enrollment in the study.

Additional information

Funding

The Key Research and Development Program of Jining Science (No.2020YXNS007) and the Research Fund for Academician Lin He New Medicine, China (No. JYHL2019FMS14).