Elevated Neutrophil, Lymphocyte, and Platelet Counts as Early Biomarkers of Preeclampsia Risk: A Retrospective Cohort Study

IF 2.4 3区医学 Q3 IMMUNOLOGY

American Journal of Reproductive Immunology Pub Date : 2025-07-30 DOI:10.1111/aji.70137

Ying-Ling Yao, Zhou Xu, Rui Xiao, Er-Han Li, Yong-Jia Zhang, Li-Yang Zhou, Zhao-Hui Zhong, Li-Juan Fu, Hong-Bo Qi, Xiao-Bin Wu, Yu-Bin Ding

{"title":"Elevated Neutrophil, Lymphocyte, and Platelet Counts as Early Biomarkers of Preeclampsia Risk: A Retrospective Cohort Study","authors":"Ying-Ling Yao, Zhou Xu, Rui Xiao, Er-Han Li, Yong-Jia Zhang, Li-Yang Zhou, Zhao-Hui Zhong, Li-Juan Fu, Hong-Bo Qi, Xiao-Bin Wu, Yu-Bin Ding","doi":"10.1111/aji.70137","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>This study aimed to evaluate the association between peripheral immune markers during gestational weeks 11–28 and the risk of preeclampsia (PE), and to explore potential causal relationships using Mendelian randomization (MR).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We conducted a retrospective cohort study involving 19, 028 singleton pregnancies between January 2020 and December 2023. Peripheral immune markers, including neutrophils, lymphocytes, monocytes, and platelets, and derived indices, such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and systemic immune-inflammation index (SII), were analyzed in relation to PE incidence. Subgroup and interaction analyses were further stratified by maternal age, prepregnancy BMI, gestational age at blood test, and gestational diabetes mellitus (GDM). Causality was assessed using MR with the inverse-variance weighted multiplicative random effects (IVW MRE) method.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Elevated neutrophil (RR per SD = 1.20; 95% CI: 1.09–1.33; <i>P</i> < 0.001), lymphocyte (RR per SD = 1.16; 95% CI: 1.06–1.27; <i>P</i> = 0.002), and platelet (RR per SD = 1.19; 95% CI: 1.07–1.31; <i>P</i> = 0.001) counts were significantly associated with increased PE risk. Associations were stronger in women aged ≥35 years, with a significant interaction for platelet count (<i>P</i> = 0.004). MR analysis revealed no causal link between genetically predicted immune cell counts and PE.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Higher peripheral neutrophil, lymphocyte, and platelet levels are associated with increased PE risk, particularly among older pregnant women. While MR analysis did not support a causal effect, these immune markers may serve as accessible early indicators and offer insight into PE pathogenesis.</p>\n </section>\n </div>","PeriodicalId":7665,"journal":{"name":"American Journal of Reproductive Immunology","volume":"94 2","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Reproductive Immunology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/aji.70137","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

This study aimed to evaluate the association between peripheral immune markers during gestational weeks 11–28 and the risk of preeclampsia (PE), and to explore potential causal relationships using Mendelian randomization (MR).

Methods

We conducted a retrospective cohort study involving 19, 028 singleton pregnancies between January 2020 and December 2023. Peripheral immune markers, including neutrophils, lymphocytes, monocytes, and platelets, and derived indices, such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and systemic immune-inflammation index (SII), were analyzed in relation to PE incidence. Subgroup and interaction analyses were further stratified by maternal age, prepregnancy BMI, gestational age at blood test, and gestational diabetes mellitus (GDM). Causality was assessed using MR with the inverse-variance weighted multiplicative random effects (IVW MRE) method.

Results

Elevated neutrophil (RR per SD = 1.20; 95% CI: 1.09–1.33; P < 0.001), lymphocyte (RR per SD = 1.16; 95% CI: 1.06–1.27; P = 0.002), and platelet (RR per SD = 1.19; 95% CI: 1.07–1.31; P = 0.001) counts were significantly associated with increased PE risk. Associations were stronger in women aged ≥35 years, with a significant interaction for platelet count (P = 0.004). MR analysis revealed no causal link between genetically predicted immune cell counts and PE.

Conclusion

Higher peripheral neutrophil, lymphocyte, and platelet levels are associated with increased PE risk, particularly among older pregnant women. While MR analysis did not support a causal effect, these immune markers may serve as accessible early indicators and offer insight into PE pathogenesis.

查看原文本刊更多论文

中性粒细胞、淋巴细胞和血小板计数升高作为子痫前期风险的早期生物标志物：一项回顾性队列研究

目的本研究旨在评估妊娠11-28周外周免疫标记物与先兆子痫（PE）风险之间的关系，并利用孟德尔随机化（MR）方法探讨潜在的因果关系。方法：我们对2020年1月至2023年12月期间19028例单胎妊娠进行了回顾性队列研究。外周免疫标志物，包括中性粒细胞、淋巴细胞、单核细胞和血小板，以及衍生指标，如中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、淋巴细胞与单核细胞比值（LMR）和全身免疫炎症指数（SII），分析与PE发病率的关系。亚组和相互作用分析进一步按产妇年龄、孕前BMI、血检胎龄和妊娠期糖尿病（GDM）进行分层。因果关系评估使用磁共振与反方差加权乘法随机效应（IVW MRE）方法。结果中性粒细胞升高(RR / SD = 1.20；95% ci: 1.09-1.33；P & lt;0.001)，淋巴细胞(RR / SD = 1.16；95% ci: 1.06-1.27；P = 0.002)，血小板(RR / SD = 1.19；95% ci: 1.07-1.31；P = 0.001)计数与PE风险增加显著相关。在年龄≥35岁的女性中，相关性更强，与血小板计数有显著的相互作用（P = 0.004）。磁共振分析显示，基因预测的免疫细胞计数与PE之间没有因果关系。结论外周中性粒细胞、淋巴细胞和血小板水平升高与PE风险增加有关，尤其是在高龄孕妇中。虽然MR分析不支持因果关系，但这些免疫标记物可以作为早期指标，并为PE的发病机制提供见解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

American Journal of Reproductive Immunology 医学-免疫学

CiteScore

6.20

自引率

5.60%

发文量

314

审稿时长

2 months

期刊介绍： The American Journal of Reproductive Immunology is an international journal devoted to the presentation of current information in all areas relating to Reproductive Immunology. The journal is directed toward both the basic scientist and the clinician, covering the whole process of reproduction as affected by immunological processes. The journal covers a variety of subspecialty topics, including fertility immunology, pregnancy immunology, immunogenetics, mucosal immunology, immunocontraception, endometriosis, abortion, tumor immunology of the reproductive tract, autoantibodies, infectious disease of the reproductive tract, and technical news.