Neutrophil-lymphocyte ratio among preeclampsia patients in India – A systematic review and meta-analysis

Preeclampsia is one of the major causes of morbidity and mortality in pregnant females in India. Early detection of preeclampsia can be of clinical utility. Neutrophil Lymphocyte Ratio (NLR) is a simple hepatological biomarker that has been used for diagnosis of preeclampsia. With this perspective in mind, the present meta-analysis was planned to evaluate NLR among preeclampsia in the Indian setting. Databases systematically searched were PubMed, MEDLINE, and Google Scholar were systematically searched till July 2023. The studies selected were all Indian published articles NLR evaluated in females of age ≥18 years and < 40 years with preeclampsia and normal health pregnant females. Data extraction was guided by a predetermined checklist. Using RevMan 5 software, the mean and standard deviation were evaluated and analyzed. The initial search yielded 103 records of which 54 articles underwent evaluation, which identified 8 articles and a total 1381 study population. Of these, 534 cases of preeclampsia and 847 normal healthy pregnant females investigated the significance of evaluation of NLR for identification of preeclampsia. The meta-analysis showed an overall significant effect in favor of the importance of NLR investigation in predicting preeclampsia (SMR = 1.04, 95% CI 0.91–1.16, p < 0.001). A significant Q statistic (p < 0.001) indicated the presence of heterogeneity (I2 = 96%). This systematic review and meta-analysis proved that NLR can be employed for detecting early preeclampsia. Further prospective studies are needed to validate the potential applicability of NLR as a diagnostic marker in clinical setup.