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New Emirates Medical Journal

ISSN (Online): 0250-6882

Research Article

Are Monocyte, %M and WBC Biomarkers in the First Trimester Screening Test?

Author(s): Ozlem Oz* and Ataman Gonel

Volume 3, Issue 2, 2022

Published on: 06 October, 2022

Article ID: e061022209626 Pages: 6

DOI: 10.2174/03666221006083724

open access plus


Background: Differences in free beta HCG and PAPP-A values, which are among the biochemical parameters in the double screening test, are frequently used for pregnancy follow-up, allowing aneuploidy and triploidy risk to be determined. In recent studies, it is suggested that the modified hemogram indices have gained importance as a marker in the prognosis of diseases.

Objective: In this study, we aimed to determine the hematological parameters, which are routinely applied in the first trimester of pregnancy, have any value in predicting the risk increase in the double screening test and in early diagnosis.

Methods: Pregnant women who conceived spontaneously and had double screening tests were included in the study. CBC results that were studied together with the first trimester screening test were reported. The patients were divided into two groups according to the results of the screening test as the combined risk ratio.

Results: The mean age was found to be significantly higher in the high-risk group than in the low-risk group. Monocyte, % M and WBC values were significantly lower in the high-risk group (0,483±0,140, 5,58±1,44 and 8,75±2,12, respectively). There was no significant difference in NLR and PLR values compared between the groups. MPV values were lower and PAPP-A, PAPP-A MoM values were significantly lower in high-risk group compared to the low-risk group.

Conclusion: The findings support low Monocyte, % M and WBC values as a potential marker for the identification of high risk pregnancy in otherwise healthy pregnant women. The results indicate that CBC parameters commonly used in pregnancy can be used to predict the prognosis.

Keywords: Pregnancy, Double screening test, Beta HCG, PAPP-A, Hemogram, Monocyte, WBC, MPV.

Akbari MR, Malekzadeh R, Nasrollahzadeh D, et al. Germline BRCA2 mutations and the risk of esophageal squamous cell carcinoma. Oncogene 2008; 27(9): 1290-6.
[] [PMID: 17724471]
Driscoll DA, Gross SJ. Screening for fetal aneuploidy and neural tube defects. Genet Med 2009; 11(11): 818-21.
[] [PMID: 19915395]
Ong CYT, Liao AW, Spencer K, Munim S, Nicolaides KH. First trimester maternal serum free β human chorionic gonadotrophin and pregnancy associated plasma protein A as predictors of pregnancy complications. BJOG 2000; 107(10): 1265-70.
[] [PMID: 11028579]
Buyukkaya E, Karakaş MF, Karakaş E, et al. Correlation of neutrophil to lymphocyte ratio with the presence and severity of metabolic syndrome. Clin Appl Thromb Hemost 2014; 20(2): 159-63.
[] [PMID: 22992349]
Imtiaz F, Shafique K, Mirza S, Ayoob Z, Vart P, Rao S. Neutrophil lymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in Asian population. Int Arch Med 2012; 5(1): 2.
[] [PMID: 22281066]
Hamminga EA, van der Lely AJ, Neumann HAM, Thio HB. Chronic inflammation in psoriasis and obesity: Implications for therapy. Med Hypotheses 2006; 67(4): 768-73.
[] [PMID: 16781085]
Turkmen K, Erdur FM, Ozcicek F, et al. Platelet-to-lymphocyte ratio better predicts inflammation than neutrophil-to-lymphocyte ratio in end-stage renal disease patients. Hemodial Int 2013; 17(3): 391-6.
[] [PMID: 23522328]
Wagner DD, Burger PC. Platelets in inflammation and thrombosis. Arterioscler Thromb Vasc Biol 2003; 23(12): 2131-7.
[] [PMID: 14500287]
Spencer K, Bindra R, Nicolaides KH. Maternal weight correction of maternal serum PAPP-A and free? -hCG MoM when screening for trisomy 21 in the first trimester of pregnancy. Prenat Diagn 2003; 23(10): 851-5.
[] [PMID: 14558032]
Wenstrom KD. Prenatal screening: Incorporating the first trimester screening. Semin Perinatol 2005; 29(4): 189-280.
Dugoff L, Hobbins JC, Malone FD, et al. First-trimester maternal serum PAPP-A and free-beta subunit human chorionic gonadotropin concentrations and nuchal translucency are associated with obstetric complications: A population-based screening study (The FASTER Trial). Am J Obstet Gynecol 2004; 191(4): 1446-51.
[] [PMID: 15507981]
Yaron Y, Heifetz S, Ochshorn Y, Lehavi O, Orr-Urtreger A. Decreased first trimester PAPP-A is a predictor of adverse pregnancy outcome. Prenat Diagn 2002; 22(9): 778-82.
[] [PMID: 12224070]
Smith GCS, Stenhouse EJ, Crossley JA, Aitken DA, Cameron AD, Connor JM. Early pregnancy levels of pregnancy-associated plasma protein a and the risk of intrauterine growth restriction, premature birth, preeclampsia, and stillbirth. J Clin Endocrinol Metab 2002; 87(4): 1762-7.
[] [PMID: 11932314]
Rosen T, D’Alton ME. Seminars in perinatology 2005; 29: 367-75.
Kagan KO, Avgidou K, Molina FS, Gajewska K, Nicolaides KH. Relation between increased fetal nuchal translucency thickness and chromosomal defects. Obstet Gynecol 2006; 107(1): 6-10.
[] [PMID: 16394033]
OʼMAHONY JB, Palder SB, Wood JJ, et al. Depression of cellular immunity after multiple trauma in the absence of sepsis. J Trauma 1984; 24(10): 869-75.
[] [PMID: 6238173]
Zahorec R. Ratio of neutrophil to lymphocyte counts--rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy 2001; 102(1): 5-14.
[PMID: 11723675]
Jaillon S, Galdiero MR, Del Prete D, Cassatella MA, Garlanda C, Mantovani A. Seminars in immunopathology 2013; 35: 377-94.
Feng JF, Huang Y, Chen QX. Preoperative platelet lymphocyte ratio (PLR) is superior to neutrophil lymphocyte ratio (NLR) as a predictive factor in patients with esophageal squamous cell carcinoma. World J Surg Oncol 2014; 12(1): 58.
[] [PMID: 24641770]
Núñez J, Núñez E, Bodí V, et al. Usefulness of the neutrophil to lymphocyte ratio in predicting long-term mortality in ST segment elevation myocardial infarction. Am J Cardiol 2008; 101(6): 747-52.
[] [PMID: 18328833]
Gibson PH, Croal BL, Cuthbertson BH, et al. Preoperative neutrophil-lymphocyte ratio and outcome from coronary artery bypass grafting. Am Heart J 2007; 154(5): 995-1002.
[] [PMID: 17967611]
Tamhane UU, Aneja S, Montgomery D, Rogers EK, Eagle KA, Gurm HS. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol 2008; 102(6): 653-7.
[] [PMID: 18773982]
Celikbilek M, Dogan S, Ozbakır O, et al. Neutrophil-lymphocyte ratio as a predictor of disease severity in ulcerative colitis. J Clin Lab Anal 2013; 27(1): 72-6.
[] [PMID: 23292894]
Öztürk ZA, Kuyumcu ME, Yesil Y, et al. Is there a link between neutrophil-lymphocyte ratio and microvascular complications in geriatric diabetic patients? J Endocrinol Invest 2013; 36(8): 593-9.
[PMID: 23511196]
Qin B, Ma N, Tang Q, et al. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were useful markers in assessment of inflammatory response and disease activity in SLE patients. Mod Rheumatol 2016; 26(3): 372-6.
[] [PMID: 26403379]
Yilmaz H, Celik H, Namuslu M, et al. Benefits of the neutrophil-to-lymphocyte ratio for the prediction of gestational diabetes mellitus in pregnant women. Exp Clin Endocrinol Diabetes 2014; 122(1): 39-43.
[] [PMID: 24464596]
Christoforaki V, Zafeiriou Z, Daskalakis G, Katasos T, Siristatidis C. First trimester neutrophil to lymphocyte ratio (NLR) and pregnancy outcome. J Obstet Gynaecol 2020; 40(1): 59-64.
[] [PMID: 31609136]
Cerit L. Assessment of indirect inflammatory markers in patients with myocardial bridging. Cardiovasc J Afr 2017; 28(3): 182-5.
[] [PMID: 27805707]
Choi DH, Kang SH, Song H. Mean platelet volume: A potential biomarker of the risk and prognosis of heart disease. Korean J Intern Med (Korean Assoc Intern Med) 2016; 31(6): 1009-17.
[] [PMID: 27776204]
Harrison P, Goodall AH. Studies on mean platelet volume (MPV)-new editorial policy. Platelets 2016; 27(7): 605-.
Oh GH, Chung SP, Park YS, et al. Mean platelet volume to platelet count ratio as a promising predictor of early mortality in severe sepsis. Shock: Injury, Inflammation, and Sepsis. Shock 2017; 47(3): 323-30.
[] [PMID: 27504801]
Mannaerts D, Heyvaert S, De Cordt C, Macken C, Loos C, Jacquemyn Y. Are neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and/or mean platelet volume (MPV) clinically useful as predictive parameters for preeclampsia? J Matern Fetal Neonatal Med 2019; 32(9): 1412-9.
[] [PMID: 29179639]
Chavhan PS, Patil BU, Gangane NM. Tubal ectopic pregnancy and variation in platelet parameters: A six years study in rural population of Central India. J Med Sci Clin Res 2017; 5(1): 15562-66.
Yilmaz M, Delibas IB, Isaoglu U, Ingec M, Borekci B, Ulug P. Relationship between mean platelet volume and recurrent miscarriage: A preliminary study. Arch Med Sci 2015; 11(5): 989-93.
[PMID: 26528341]
Abdelfttah AH, Amin SMF, Elkafrawy MA-S, El-Dawy DM. Relationship between Mean platelet volume and recurrent miscarriage. Al-Azhar Assiut Med J 2020; 18(4): 421.
Han L, Liu X, Li H, et al. Blood coagulation parameters and platelet indices: Changes in normal and preeclamptic pregnancies and predictive values for preeclampsia. PLoS One 2014; 9(12): e114488.
[] [PMID: 25464515]
Turgut A, Sak M, Ozier A, Soydinç H, Karaçor T, Gül T. Alteration of peripheral blood cells in tubal ectopic pregnancy. Ginekol Pol 2013; 84(3): 193-6.
[] [PMID: 23700846]
Horasanli JE, Görkemli H, Özkaya EB, Işikalan MM, Akinci D, Kiliç F. Evaluation of hemogram parameters in the diagnosis of ectopic pregnancy and threat of miscarriage. Cukurova Med J 46(1): 63-9.

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