The Neutrophil-to-lymphocyte Ratio in Anaemic Pregnant Women and Association with Traditional Marker of Inflammation.

Abstract

Anaemia is the most common nutritional deficiency in pregnant women which is more prevalent in developing than developed countries of the world. Pregnancy is considered as a pro-inflammatory condition and anaemia may modulate leukocytosis and inflammation during gestation. The objective of this study was to investigate changes in neutrophil-to-lymphocyte ratio (NLR) in anaemic pregnant women compare with nonanaemic pregnant women and to correlate such changes with a sensitive traditional marker of inflammation. Full blood count and high sensitive C-reactive protein (hsCRP) were determined in 522 anaemic pregnant women and 600 non-anaemic pregnant women on their first ante-natal visits to three hospitals in Ogun State, Nigeria. The full blood count was analyzed using Coulter counter cell dye auto-analyzer by Abott diagnostics (Wiesbaden, Germany) while hsCRP was assayed using reagents supplied by Abbot Diagnostics BV (Hoofddorp, Netherlands). The means total white blood count (p=0.044), neutrophil (p=0.031), lymphocyte (p=0.042), eosinophil (p=0.008),NLR (p<0.001) and hsCRP(p<0.001) were significantly higher in anaemic pregnant women than non-anaemic pregnant women. The mean levels of NLR and hsCRP significantly increased from mild anaemia, moderate anaemia to severe anaemia compared with levels in non-anaemic pregnant women. NLR correlated positively (r=0.128;p=0.005) with hsCRP in anaemic pregnant women. The NLR may be used in clinical setting in the assessment of inflammation in pregnant women.

Key words: Anaemia, inflammation, neutrophil-to-lymphocyte ratio, pregnancy