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The Delta Neutrophil Index as a predictive marker of histological chorioamnionitis in patients with preterm premature rupture of membranes: A retrospective study

Authors
 Hee Young Cho  ;  Inkyung Jung  ;  Ja-Young Kwon  ;  So Jung Kim  ;  Yong Won Park  ;  Young-Han Kim 
Citation
 PLoS One, Vol.12(3) : e0173382, 2017 
Journal Title
 PLoS One 
Issue Date
2017
MeSH
Adult ; Biomarkers/blood ; Chorioamnionitis/blood ; Chorioamnionitis/diagnosis* ; Chorioamnionitis/pathology* ; Female ; Fetal Membranes, Premature Rupture/blood* ; Humans ; Mothers ; Neutrophils/cytology* ; Pregnancy ; Prognosis ; Retrospective Studies
Abstract
BACKGROUND: Histological chorioamnionitis (HCA) is related to perinatal morbidity. However, there is no definite diagnostic method for detecting chorioamnionitis before delivery. METHODS: We evaluated whether the delta neutrophil index (DNI) was an effective early marker of HCA in patients with preterm premature rupture of membranes (PPROM). We retrospectively evaluated 149 women diagnosed with PPROM (gestational age, 20+0 to 36+6 weeks) at Severance Hospital from January 2013 to December 2014. The women were categorized into the following two groups: (a) PPROM without HCA and (b) PPROM with HCA. The maternal white blood cell (WBC) count, neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP) level, and DNI were measured at admission. The DNI has been reported to reflect the fraction of circulating immature granulocytes associated with infection. RESULTS: Of the 149 patients, 87 were included in the PPROM without HCA group and 62 were included in the PPROM with HCA group. The interval between admission and delivery was significantly shorter in the PPROM with HCA group than in the PPROM without HCA group. There was no significant difference in the maternal WBC count. The serum CRP level, NLR, and DNI were significantly lower in the PPROM without HCA group than in the PPROM with HCA group, while the lymphocyte count was significantly lower in the PPROM with HCA group than in the PPROM without HCA group. A predictive equation was generated by combining the DNI, lymphocyte count, and CRP level, and the sensitivity and specificity for predicting a placental inflammatory response were 69.1% and 70.5%, respectively. CONCLUSIONS: The DNI could be a predictive marker for HCA in patients with PPROM. Our predictive equation involving the DNI, lymphocyte count, and CRP level may be helpful for predicting the placental inflammatory response in patients with PPROM.
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DOI
10.1371/journal.pone.0173382
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
Yonsei Authors
권자영(Kwon, Ja Young) ORCID logo https://orcid.org/0000-0003-3009-6325
김영한(Kim, Young Han) ORCID logo https://orcid.org/0000-0003-0645-6028
정인경(Jung, Inkyung) ORCID logo https://orcid.org/0000-0003-3780-3213
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/154696
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