Association between platelet to lymphocyte ratio and plateletcrit with the presence of hyperemesis gravidarum: A case-control study

Authors

  • Naela Faraj Massious Department of Obstetrics and Gynecology, Maternity Teaching Hospital, Erbil, Iraq.
  • Aryiana Khalis Jawad Department of Obstetrics and Gynecology, Maternity Teaching Hospital, Erbil, Iraq.

DOI:

https://doi.org/10.15218/zjms.2020.031

Keywords:

Hyperemesis gravidarum, Platelet to lymphocyte ratio, Plateletcrit, Pregnancy, Nausea and vomiting

Abstract

Background and objective: Hyperemesis gravidarum can be defined as intractable nausea and vomiting, leading to electrolyte imbalance, ketonuria, nutrition deficiency, and weight loss during pregnancy. This study aimed to investigate the association of the platelet to lymphocyte ratio and plateletcrit with the presence of hyperemesis gravidarum.

Methods: A case-control study was conducted at Maternity Teaching Hospital in Erbil city, Kurdistan region of Iraq, between January 1st, 2017 and January 1st, 2018. A convenience sample of 120 pregnant women, of which 60 of them with a diagnosis of hyperemesis gravidarum admitted to the emergency department, were regarded as cases. The other 60 visited the outpatient department with mild discomfort, but not having hyperemesis gravidarum were regarded as controls. Age, gestational age, gravida, parity, height, and weight and laboratory parameters, including complete blood count from which we had platelet to lymphocyte ratio and plateletcrit %, were recorded on a specially designed questionnaire. Chi-square test, Fisher’s exact test, Student's t-test, Youden’s index were used to determine the associations.

Results: The platelet to lymphocyte ratio and plateletcrit were higher in the hyperemesis gravidarum groups than controls (P <0.001). The area under the curve for platelet to lymphocyte ratio and plateletcrit were 0.887 and 0.936, respectively, with P <0.001. Platelet to lymphocyte ratio >145.07 and plateletcrit >0.205% were significantly related to an increased risk of hyperemesis gravidarum.

Conclusion: The platelet to lymphocyte ratio and plateletcrit are higher in hyperemesis gravidarum cases and may have a predictive value of the development of hyperemesis gravidarum as further studies needed in the future to confirm.

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References

Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Gilstrap III L, Wenstrom KD. Prenatal care. In: Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Gilstrap III L, Wenstrom KD (eds) William’s obstetrics. New York, NY:McGraw-Hill Medical Publishing Division; 2005. P. 201–29.

Lacroix R, Eason E, Melzack R. Nausea and vomiting during pregnancy: a prospective study of its frequency, intensity, and patterns of change. Am J Obstet Gynecol 2000; 182:931–7.

Bailit JL. Hyperemesis gravidarium: epidemiologic findings from a large cohort. Am J Obstet Gynecol 2005; 193:811–4.

Niebyl JR. Clinical practice. Nausea and vomiting in pregnancy. N Engl J Med 2010; 363:1544–50.

Källen B, Lundberg G, Aberg A. Relationship between vitamin use, smoking, and nausea and vomiting of pregnancy. Acta Obstet Gynecol Scand 2003; 82:916–20.

Fell DB, Dodds L, Joseph KS, Allen VM, Butler B. Risk factors for hyperemesis gravidarum requiring hospital admission during pregnancy. Obstet Gynecol 2006; 107:277–84.

Basso O, Olsen J. Sex ratio and twinning in women with hyperemesis or pre-eclampsia. Epidemiology 2001; 12:747–9.

Schiff MA, Reed SD, Daling JR. The sex ratio of pregnancies complicated by hospitalization for hyperemesis gravidarum. BJOG 2004; 111:27–30.

Trogstad LI, Stoltenberg C, Magnus P, Skjaerven R, Irgens LM. Recurrence risk in hyperemesis gravidarum. Br J Obstet Gynaecol 2005; 112:1641–5.

Verberg MF, Gillott DJ, Al-Fardan N, Grudzinskas JG. Hyperemesis gravidarum, a literature review. Hum Reprod Update 2005; 11:527–39.

Akpinar I, Sayin MR, Gursoy YC, Karabag T, Kucuk E, Buyukuysal MC, et al. Plateletcrit: A platelet marker associated with saphenous vein graft disease. Herz 2014; 39:142–8.

Nording HM, Seizer P, Langer HF. Platelets in inflammation and atherogenesis. Front Immunol 2015; 6:98.

Kim CH, Kim SJ, Lee MJ, Kwon YE, Kim YL, Park KS, et al. An increase in mean platelet volume from baseline is associated with mortality in patients with severe sepsis or septic shock. PLoS One 2015; 10:e0119437.

Tang J, Gao X, Zhi M, Zhang M, Chen HW, Yang QF, et al. Plateletcrit: A sensitive biomarker for evaluating disease activity in Crohn's disease with low hs-CRP. J Dig Dis 2015; 16:118–24.

Akbas EM, Demirtas L, Ozcicek A, Timuroglu A, Bakirci EM, Hamur H, et al. Association of epicardial adipose tissue, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with diabetic nephropathy. Int J Clin Exp Med 2014; 7:1794–801.

Balta S, Ozturk C. The platelet-lymphocyte ratio: A simple, inexpensive and rapid prognostic marker for cardiovascular events. Platelets 2014; 30:1–2.

Terzi S, Dursun E, Özgür A, Yiğit E, Özergin-Coşkun Z, Çelebi-Erdivanl O, et al. Status of Neutrophils, Lymphocytes and Platelets in Patients with Recurrent Aphthous Stomatitis: A Retrospective Study. Iran J Otorhinolaryngol 2016; 28(89):421–4.

Tayfur C, Burcu DC, Gulten O, Betul D, Tugberk G, Onur O, et al. Association between platelet to lymphocyte ratio, plateletcrit and the presence and severity of hyperemesis gravidarum. J Obstet Gynaecol Res 2017; 43(3):498–504.

Bewick V, Cheek L, Ball J. Receiver operating characteristic curve. Critical care 2004; 8(6):508–12.

Netravathi M, Sinha S, Taly AB, Bindu PS, Bharath RD. Hyperemesis-gravidarum- induced Wernicke’s encephalopathy: Serial clinical, electrophysiological and MR imaging observations. J Neurol Sci 2009; 284:214–6.

Engin-Ustun Y, Tonguç E, Var T, Deveer R, Yilmaz N, Danisman N, et al. Vaspin and C-reactive protein levels in hyperemesis gravidarum. Eur Rev Med Pharmacol Sci 2013; 17:138–40.

Verit FF, Erel O, Celik H. Paraoxonase-1 activity in patients with hyperemesis gravidarum. Redox Rep 2008; 13:134–8.

Yoneyama Y, Suzuki S, Sawa R, Yoneyama K, Doi D, Otsubo Y, et al. The T-helper 1/T-helper 2 balance in peripheral blood of women with hyperemesis gravidarum. Am J Obstet Gynecol 2002; 187:1631–5.

Jarvis S, Nelson-Piercy C. Management of nausea and vomiting in pregnancy. BMJ 2011; 342:d3606.

Brew O, Sullivan MH. The links between maternal histamine levels and complications of humanpregnancy. J Reprod Immunol 2006; 72:94–107.

Kuscu NK, Yildirim Y, Koyuncu F. Interleukin-6 levels in hyperemesis gravidarum. Arch Gynecol Obstet 2003; 269:13–5.

Kaplan PB, Gucer F, Sayin NC, Yüksel M, YüceMA, Yardim T. Maternal serum cytokine levels in women with hyperemesis gravidarum in the first trimester of pregnancy. Fertil Steril 2003; 79:498–502.

Leylek OA, Toyaksi M, Erselcan T, Dokmetas S. Immunologic and biochemical factors in hyperemesis gravidarum with or without hyperthyroxinemia. Gynecol Obstet Invest 1999; 47:229–34.

Minagawa M, Narita J, Tada T, Maruyama S, Shimizu T, Bannai M, et al. Mechanisms underlying immunologic states during pregnancy: Possible association of the sympathetic nervous system. Cell Immunol 1999; 196:1–13.

Desdicioglu R, Yildirim M, Kocaoglu G, Cendek BD, Avcioglu G, Tas EE, et al. Soluble urokinase-type plasminogen activator receptor (suPAR) and interleukin-6 levels in hyperemesis gravidarum J Chin Med Assoc 2018; 81(9):825–9.

Yoneyama Y, Sawa R, Suzuki S, Otsubo Y, Araki T. Serum adenosine deaminase activity in women with hyperemesis gravidarum. Clin Chim Acta 2002; 324:141–5.

Keskin KR, Guler A, BenkSilfeler D, Ozcil MD, Karateke A, Hakverdi AU. Relation of inflammatory markers with both presence and severity of hyperemesis gravidarum. Ginekol Pol 2014; 85:589–93.

Wang D, Yang JX, Cao DY, Wan XR, Feng FZ, Huang HF, et al. Preoperative neutrophil-lymphocyte and platelet-lymphocyte ratios as independent predictors of cervical stromal involvement in surgically treated endometrioid adenocarcinoma. Onco Targets Ther 2013; 6:211–6.

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Published

2020-08-30

How to Cite

Massious, N. F., & Jawad, A. K. (2020). Association between platelet to lymphocyte ratio and plateletcrit with the presence of hyperemesis gravidarum: A case-control study. Zanco Journal of Medical Sciences (Zanco J Med Sci), 24(2), 274–282. https://doi.org/10.15218/zjms.2020.031

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Original Articles