Are NLR, PLR, and Elevated Uric Acid Levels Predictive of Preeclampsia?

Background: It is estimated that 2 to 8% of pregnancies are complicated by gestational hypertension and preeclampsia, the latter being considered a major cardiovascular emergency due to its possible progression to severe eclampsia and HELLP syndrome. New inflammatory biomarkers, such as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), may predict the progression of gestational hypertension. Aim of the study: The aim of this study was to assess whether NLR, PLR, and uric acid play a role in predicting preeclampsia and its severe forms. Methods: This prospective, single-center cohort study, conducted between January 1, 2020 and December 31, 2022, included 107 pregnant women with gestational hypertension, preeclampsia and its severe forms, HELLP syndrome and eclampsia. Patients were divided into two groups: the first group included 88 patients with gestational hypertension (GH group), and the second group included 19 patients with preeclampsia and its severe forms (PE group). We compared demographic, clinical and biochemistry data between the two groups. Results: PLR was significantly lower in women with preeclampsia (85.47 +/- 7.91 vs. 115.90 +/- 4.63, p = 0.005). The mean serum uric acid level in the PE group was significantly higher than in the GH group (6.71 +/- 0.44 mg/dL vs. 4.59 +/- 0.12 mg/dL, p <0.0001). Conclusion: In this study, low-cost biomarkers PLR and serum uric acid were associated with a higher risk of PE and its severe forms and may be used to predict the progression of gestational hypertension.