title: Prediction of Preeclampsia by First Trimester Combined Test and Simple Complete Blood Count Parameters.
abstract: BACKGROUND
  Preeclampsia is a serious disease which may result in maternal and neonatal mortality and morbidity. Improving the outcome for preeclampsia necessitates early prediction of the disease to identify women at high risk. Measuring blood cell subtype ratios, such as the neutrophil to lymphocyte (NLR) and platelet to lymphocyte (PLR) ratios, might provide prognostic and diagnostic clues to diseases.
  
  
  OBJECTIVE
  To investigate hematological changes in early pregnancy, using simple complete blood count (CBC) and blood concentrations of beta-human chorionic gonadotropin (β-hCG) and pregnancy-associated plasma protein-A (PAPP-A) to determine whether these measures are of any value in the prediction and early diagnosis of preeclampsia.
  
  
  METHODS
  Six hundred fourteen consecutive pregnant women with preeclampsia (288 with mild disease and 326 with severe disease) and 320 uncomplicated pregnant women were included in the study. Blood samples for routine CBC and first trimester screen, which combines PAPP-A and free β-hCG blood concentrations, were analyzed.
  
  
  RESULTS
  The NLR values were significantly higher in the severe preeclampsia group compared with the control group (p<0.001). We also confirmed that levels of PAPP-A were lower in patients who developed preeclampsia.
  
  
  CONCLUSIONS
  Because measuring CBC parameters, particularly NLR, is fast and easily applicable, they may be used to predict preeclampsia.
authors.affiliation: Faculty, Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara, Turkey .
authors.forename: Ayse
authors.initials: A
authors.lastname: Kirbas
authors.affiliation: Faculty, Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara, Turkey .
authors.forename: Ali Ozgur
authors.initials: AO
authors.lastname: Ersoy
authors.affiliation: Faculty, Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara, Turkey .
authors.forename: Korkut
authors.initials: K
authors.lastname: Daglar
authors.affiliation: Faculty, Deparment of Obstetric and Gynecology, Hilal Hospital , Kirikkale, Turkey .
authors.forename: Turkan
authors.initials: T
authors.lastname: Dikici
authors.affiliation: Faculty, Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara, Turkey .
authors.forename: Ebru Hacer
authors.initials: EH
authors.lastname: Biberoglu
authors.affiliation: Faculty, Department of Cardiology, Yuksek Ihtisas Education and Research Hospital , Ankara, Turkey .
authors.forename: Ozgur
authors.initials: O
authors.lastname: Kirbas
authors.affiliation: Assistant Professor, Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara, Turkey .
authors.forename: Nuri
authors.initials: N
authors.lastname: Danisman
keywords: Inflammation; Mean platelet volume; Neutrophil-to-lymphocyte ratio; PAPP-A; Platelet distribution width; β-human chorionic gonadotropin