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Neuroprotective magnesium sulfate administration increases maternal Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio and Systemic Immune-Inflammation Index

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

We aimed to analyze the linear changes of Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR) and Systemic Immune-Inflammation Index (SII) levels in pregnant women who administrated magnesium sulfate for fetal neuroprotection.

Methods

This retrospective study included 63 pregnant women who underwent neuroprotective magnesium sulfate administration during January 2015 and July 2020. Women with co-existing diseases or obstetric complications such as preeclampsia, gestational diabetes mellitus, suspicion of chorioamnionitis etc. excluded. The laboratory test results were obtained for each participant. Three results were compared; (1) Before magnesium sulfate-0th hour, (2) 6 h and (3) 12 h after starting loading dose.

Results

The mean NLR was 7.18 ± 5.14 in patients before treatment. The mean NLR increased to 10.09 ± 4.77 and 10.04 ± 4.35 at 6th and 12th hour of magnesium sulfate treatment. The mean PLR was also increased after starting neuroprotective magnesium sulfate (170.35 ± 89.09 at the beginning; 209.85 ± 88.77 at 6th hour and 209.24 ± 76.66 at 12th hour). The mean SII was found to be increased from 1783.33 ± 1367.29 to 2517.15 ± 1325.77 with magnesium sulfate treatment. However, no statistically significant difference was observed in terms of SII between 6 and 12th hours of treatment (p = 0.752). Maternal serum magnesium levels at 6th and 12th hour were found to be not correlated with NLR, PLR and SII.

Conclusion

We demonstrated that values of NLR, PLR and SII at 6th hour were all increased after starting magnesium sulfate. Levels of these systemic inflammatory indices were similar at 6th and 12th hour of therapy.

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References

  1. Fawke J (2007) Neurological outcomes following preterm birth. Publisher.

  2. Costantine MM, Weiner SJ (2009) Effects of antenatal exposure to magnesium sulfate on neuroprotection and mortality in preterm infants: a meta-analysis. Obstet Gynecol 114:354

    Article  Google Scholar 

  3. Chollat C, Sentilhes L, Marret S (2018) Fetal neuroprotection by magnesium sulfate: from translational research to clinical application. Front Neurol 9:247

    Article  Google Scholar 

  4. Obstetricians ACo, Gynecologists, Medicine SfM-F. Obstetric Care consensus No. 6: Periviable Birth. Obstetr Gynecol. 2017;130:e187.

  5. Organization WH (2015) WHO recommendations on interventions to improve preterm birth outcomes.

  6. Women's NCCf, Health Cs (2015) Preterm labour and birth

  7. Zheng W-F, Zhan J, Chen A, Ma H, Yang H, Maharjan R. Diagnostic value of neutrophil-lymphocyte ratio in preeclampsia: a PRISMA-compliant systematic review and meta-analysis. Medicine. 2019;98.

  8. Yazar FM, Bakacak M, Emre A, Urfalıoglu A, Serin S, Cengiz E, Bülbüloglu E (2015) Predictive role of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios for diagnosis of acute appendicitis during pregnancy. Kaohsiung J Med Sci 31:591–596

    Article  Google Scholar 

  9. Stojkovic Lalosevic M, Pavlovic Markovic A, Stankovic S, Stojkovic M, Dimitrijevic I, Radoman Vujacic I, Lalic D, Milovanovic T, Dumic I, Krivokapic Z (2019) Combined diagnostic efficacy of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV) as biomarkers of systemic inflammation in the diagnosis of colorectal cancer. Disease Mark 2019.

  10. Tanacan A, Uyanik E, Unal C, Beksac MS (2020) A cut‐off value for systemic immune‐inflammation index in the prediction of adverse neonatal outcomes in preterm premature rupture of the membranes. J Obstetr Gynaecol Res.

  11. Zhong J-H, Huang D-H, Chen Z-Y (2017) Prognostic role of systemic immune-inflammation index in solid tumors: a systematic review and meta-analysis. Oncotarget 8:75381

    Article  Google Scholar 

  12. Jayaram PM, Mohan MK, Farid I, Lindow S (2019) Antenatal magnesium sulfate for fetal neuroprotection: a critical appraisal and systematic review of clinical practice guidelines. J Perinat Med 47:262–269

    Article  Google Scholar 

  13. Galinsky R, Dean JM, Lingam I, Robertson NJ, Mallard C, Bennet L, Gunn AJ. A Systematic Review of Magnesium Sulfate for Perinatal Neuroprotection: what Have We Learnt From the Past Decade?. Front Neurol. 2020;11.

  14. Keepanasseril A, Maurya DK, Manikandan K, Suriya JY, Habeebullah S, Raghavan SS (2018) Prophylactic magnesium sulphate in prevention of eclampsia in women with severe preeclampsia: randomised controlled trial (PIPES trial). J Obstet Gynaecol 38:305–309

    Article  CAS  Google Scholar 

  15. Group TMTC (2002) Do women with pre-eclampsia, and their babies, benefit from magnesium sulphate? The Magpie Trial: a randomised placebo-controlled trial. Lancet 359:1877–1890

    Article  Google Scholar 

  16. Sugimoto J, Romani AM, Valentintorres AM, Luciano AA, Kitchen CMR, Funderburg N, Mesiano N, Bernstein HB (2012) Magnesium decreases inflammatory cytokine production: a novel innate immunomodulatory mechanism. J Immunol. 188:6338–6346

    Article  CAS  Google Scholar 

  17. da Silva LF, da Rocha Romero AB, Hastreiter A, Nogueira-Pedro A, Makiyama E, Colli C, Fock RA (2018) An insight into the role of magnesium in the immunomodulatory properties of mesenchymal stem cells. J Nutrit Biochem 55:200–208

    Article  Google Scholar 

  18. Suzuki-Kakisaka H, Sugimoto J, Tetarbe M, Romani AM, Ramirez Kitchen CM, Bernstein HB (2013) Magnesium sulfate increases intracellular magnesium reducing inflammatory cytokine release in neonates. Am J Reprod Immunol 70:213–220

    Article  CAS  Google Scholar 

  19. Beloosesky R, Khatib N, Ginsberg Y, Anabosy S, Shalom-Paz E, Dahis M, Ross MG, Weiner Z (2016) Maternal magnesium sulfate fetal neuroprotective effects to the fetus: inhibition of neuronal nitric oxide synthase and nuclear factor kappa-light-chain-enhancer of activated B cells activation in a rodent model. Am J Obstetr Gynecol 215:382

    Article  Google Scholar 

  20. Ginsberg Y, Khatib N, Weiss B, Arison S, Ross MG, Weiner Z, Beloosesky R (2017) Magnesium sulfate (MG) prevents maternal inflammation induced offspring cerebral injury evident on MRI but not via IL-1β. Neuroscience 353:98–105

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Perinatology, Etlik Zubeyde Hanim Women’s Health Care, Training and Research Hospital, University of Health Sciences, 06050, Yenimahalle, Ankara, Turkey

    Gokcen Orgul, Tugba Agbal, Sevki Celen & Ali Turhan Caglar

Authors
  1. Gokcen Orgul
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  2. Tugba Agbal
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  3. Sevki Celen
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  4. Ali Turhan Caglar
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Contributions

GO; Data analysis, Manuscript writing. TA; Data collection, SC; Manuscript editing, AT Caglar; Manuscript editing.

Corresponding author

Correspondence to Gokcen Orgul.

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The authors declare that there is no conflict of interest.

Ethical approval

Local Committee of Ethics of Etlik Zubeyde Hanim Women's Health Care, Training and Research Hospital, University of Health Sciences approved the study with the number of 09/18.

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Informed consent is not applicable for this study (retrospective study).

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Orgul, G., Agbal, T., Celen, S. et al. Neuroprotective magnesium sulfate administration increases maternal Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio and Systemic Immune-Inflammation Index. Arch Gynecol Obstet 303, 1433–1437 (2021). https://doi.org/10.1007/s00404-020-05866-y

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  • DOI: https://doi.org/10.1007/s00404-020-05866-y

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