The value of hematological parameters measured at first presentation in patients diagnosed with pregnancy in predicting early pregnancy loss; can NLPR be a new predictive value? A case-control study

This study investigates hematological parameters, including NLPR, for predicting early pregnancy loss (EPL), emphasizing NLPR’s novelty and clinical utility. Objective: Our study aimed to investigate the importance of hematological parameters such as neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), derived neutrophil and lymphocyte ratio (dNLR), pan-immune inflammation value (PIV), platelet distribution width (PDW), neutrophil lymphocyte to platelet ratio (NLPR), delta neutrophil index (DNI), systemic inflammation index (SII) and systemic inflammation response index (SIRI) in the prediction of early pregnancy loss (EPL) in the first trimester. Materials and methods: A total of 500 patients who presented to a tertiary hospital between 2020 and 2024 were included in our study. Of these, 250 were diagnosed with EPL in the first trimester and the other 250 patients had healthy pregnancies and delivered babies. Patient records were retrospectively reviewed, demographic data and hematological parameters (NLR, PLR, MLR, dNLR, PIV, PDW, NLPR, SII, SIRI and DNI) were calculated, and statistical comparisons were made between the two groups. Results: There were 250 patients with EPL and 250 patients with controls. EPL patients had higher age (28.59 ± 6.48 vs. 26.95 ± 5.15, p=.002), higher WBC, platelet count, lymphocyte count and lower DNI than the control groups. In addition, NLR (2.57 [1.94–3.32] vs. 2.85 [2.27–3.75], p<.001), PLR (124.78 [100–150.97] vs. 132.81 [106.58–161.64], p=.008), MLR (24.33 [20.36–30.83] vs. 27.82 [21.73–34.30], p<.001), SIRI (1. 41 [0.96–2] vs. 1.51 [1.14–2.04], p=.041), dNLR (6.56 ± 0.78 vs. 6.83 ± 0.76, p<.001) and NLPR (1.24 [0.81–1.80] vs. 1.47 [1–1.89], p=.006) values were associated with a significantly higher risk of EPL. Conclusion: NLPR is a promising, easily calculable parameter for predicting EPL. Future prospective studies are necessary to validate these findings and establish NLPR’s clinical utility.