Leucocyte Differential Count and Pregnancy Induced Hypertension: Implication for Risk and Disease Assessment

Nafiu Amidu; Benedict Boateng Antuamwine; Martin Awe Akilla; William Kwame Boakye Ansah Owiredu; Otchere Addai-Mensah; Peter Paul Dapare; Eric Mishio Bawa

doi:doi:10.11648/j.ajlm.20200501.15

Leucocyte Differential Count and Pregnancy Induced Hypertension: Implication for Risk and Disease Assessment

Nafiu Amidu, Benedict Boateng Antuamwine, Martin Awe Akilla, William Kwame Boakye Ansah Owiredu, Otchere Addai-Mensah, Peter Paul Dapare, Eric Mishio Bawa

Published in American Journal of Laboratory Medicine (Volume 5, Issue 1)

Received: 8 January 2020 Accepted: 31 January 2020 Published: 14 February 2020

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Abstract

PIH accounts significantly for maternal and perinatal mortality, especially in rural communities. The sudden onset of PIH and the lack of definitive case management is worrisome. The study analysed differential leucocytes count on PIH outcomes. This is a case-control study of 40 PIH (8 GH, 16 PE and 16 EC) and 60 normotensive women who visited the Bolgatanga Regional Hospital, Ghana. Data on socio-demographics, clinical history and laboratory evaluations on blood and placental tissues were collected and analysed. Lymphocytes count was markedly increased in PIH women, while total leucocytes, neutrophils and NLR were significantly decreased. Lymphocytes count increased with severity of PIH (p=0.0037). A correlation (r=-0.9565, p<0.0001) between lymphocyte and neutrophil counts was observed among PIH subjects. Oxidative stress was more associated with PIH compared to controls. Stillbirths was associated with PIH mothers with high leucocytes count. NLR (AUC; 0.857, p<0.0001) and lymphocytes count (AUC; 0.822, p<0.0001) were optimal for prognosis of PIH. Wide variations in NLR and lymphocytes count during pregnancy necessitates urgent attention.

Published in	American Journal of Laboratory Medicine (Volume 5, Issue 1)
DOI	10.11648/j.ajlm.20200501.15
Page(s)	32-41
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Preeclampsia, Gestational Hypertension, Differential Leucocytes Count, Neutrophil-to-Lymphocyte Ratio, Risk Assessment, Stillbirth

References

[1]	Duhig, K., B. Vandermolen, and A. Shennan, Recent advances in the diagnosis and management of pre-eclampsia. F1000 Research, 2018. 7.
[2]	Organization, W. H. and Unicef, Trends in maternal mortality: 1990 to 2013: estimates by WHO, UNICEF, UNFPA, The World Bank and the United Nations Population Division. 2014.
[3]	Ananth, C. V. and O. Basso, Impact of pregnancy-induced hypertension on stillbirth and neonatal mortality in first and higher order births: a population-based study. Epidemiology (Cambridge, Mass.), 2010. 21 (1): p. 118.
[4]	Creanga, A. A., et al., Pregnancy-related mortality in the United States, 2011–2013. Obstetrics and gynecology, 2017. 130 (2): p. 366.
[5]	Adu-Bonsaffoh, K., et al., Perinatal outcomes of hypertensive disorders in pregnancy at a tertiary hospital in Ghana. BMC pregnancy and childbirth, 2017. 17 (1): p. 388.
[6]	Lee, Q. Y., et al., Maternal mortality in Ghana: a hospital-based review. Acta obstetricia et gynecologica Scandinavica, 2012. 91 (1): p. 87-92.
[7]	Adu-Bonsaffoh, K., et al., Maternal deaths attributable to hypertensive disorders in a tertiary hospital in Ghana. International Journal of Gynecology & Obstetrics, 2013. 123 (2): p. 110-113.
[8]	Harmon, A. C., et al., The role of inflammation in the pathology of preeclampsia. Clinical science, 2016. 130 (6): p. 409-419.
[9]	Serin, S., et al., Is neutrophil/lymphocyte ratio a useful marker to predict the severity of pre-eclampsia? Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health, 2016. 6 (1): p. 22-25.
[10]	Gogoi, P., et al., Neutrophil-to-lymphocyte ratio and platelet indices in pre-eclampsia. International Journal of Gynecology & Obstetrics, 2019. 144 (1): p. 16-20.
[11]	Szkandera, J., et al., External validation of the derived neutrophil to lymphocyte ratio as a prognostic marker on a large cohort of pancreatic cancer patients. PloS one, 2013. 8 (11): p. e78225.
[12]	Briggs, C., et al., ICSH Guideline for worldwide point-of-care testing in haematology with special reference to the complete blood count. International journal of laboratory hematology, 2008. 30 (2): p. 105-116.
[13]	Aouache, R., et al., Oxidative stress in preeclampsia and placental diseases. International journal of molecular sciences, 2018. 19 (5): p. 1496.
[14]	Matsubara, K., et al., Nitric oxide and reactive oxygen species in the pathogenesis of preeclampsia. International journal of molecular sciences, 2015. 16 (3): p. 4600-4614.
[15]	Obstetricians, A. C. o. and Gynecologists, Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ task force on hypertension in pregnancy. Obstetrics and gynecology, 2013. 122 (5): p. 1122.
[16]	Amidu, N., et al., Use of Selected Anthropometric Indices for Screening Hypertension in an Adult Ghanaian Population. Asian Journal of Medical Principles and Clinical Practice, 2018: p. 1-9.
[17]	Harma, M., M. Harma, and O. Erel, Measurement of the total antioxidant response in preeclampsia with a novel automated method. European Journal of Obstetrics & Gynecology and Reproductive Biology, 2005. 118 (1): p. 47-51.
[18]	Koracevic, D., et al., Method for the measurement of antioxidant activity in human fluids. Journal of clinical pathology, 2001. 54 (5): p. 356-361.
[19]	LaMarca, B., et al., Identifying immune mechanisms mediating the hypertension during preeclampsia. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 2016. 311 (1): p. R1-R9.
[20]	Canzoneri, B. J., et al., Increased neutrophil numbers account for leukocytosis in women with preeclampsia. American journal of perinatology, 2009. 26 (10): p. 729-732.
[21]	Kurtoglu, E., et al., May ratio of neutrophil to lymphocyte be useful in predicting the risk of developing preeclampsia? A pilot study. The Journal of Maternal-Fetal & Neonatal Medicine, 2015. 28 (1): p. 97-99.
[22]	Mannaerts, D., et al., Are neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and/or mean platelet volume (MPV) clinically useful as predictive parameters for preeclampsia? The Journal of Maternal-Fetal & Neonatal Medicine, 2019. 32 (9): p. 1412-1419.
[23]	Cornelius, D. C., Preeclampsia: from inflammation to immunoregulation. Clinical Medicine Insights: Blood Disorders, 2018. 11: p. 1179545X17752325.
[24]	Vargas-Rojas, M I., H. Solleiro-Villavicencio, and E. Soto-Vega, Th1, Th2, Th17 and Treg levels in umbilical cord blood in preeclampsia. The Journal of Maternal-Fetal & Neonatal Medicine, 2016. 29 (10): p. 1642-1645.
[25]	Shibata, T., et al., Management of severe pregnancy-induced hypertension after 34 weeks of gestation: A prospective study to reduce the rate of cesarean section. Hypertension in pregnancy, 2016. 35 (1): p. 82-90.
[26]	Amaral, L. M., et al., Pathophysiology and current clinical management of preeclampsia. Current hypertension reports, 2017. 19 (8): p. 61.
[27]	Owiredu, W., et al., Putative risk factors of pregnancy-induced hypertension among Ghanaian pregnant women. Journal of Medical and Biomedical Sciences, 2012. 1 (3): p. 62-76.
[28]	Somani, S., et al., To determine association of lipid profile, serum uric acid and body mass index as a marker for preeclampsia. Int J Cur Res Rev, 2015. 7 (11): p. 53.
[29]	Welsh, C., et al., Association of Total and Differential Leukocyte Counts with Cardiovascular Disease and mortality in the UK biobank. Arteriosclerosis, Thrombosis, and Vascular Biology, 2018. 38 (6): p. 1415-1423.
[30]	Yoshimura, A., et al., Association of peripheral total and differential leukocyte counts with obesity-related complications in young adults. Obesity facts, 2015. 8 (1): p. 1-16.
[31]	Torun, S., et al., Assessment of neutrophil-lymphocyte ratio in ulcerative colitis: a promising marker in predicting disease severity. Clinics and research in hepatology and gastroenterology, 2012. 36 (5): p. 491-497.
[32]	Bahig, H., et al., Neutrophil count is associated with survival in localized prostate cancer. BMC cancer, 2015. 15 (1): p. 594.
[33]	Taylor, E. B. and J. M. Sasser, Natural killer cells and T lymphocytes in pregnancy and pre-eclampsia. 2017, Portland Press Limited.
[34]	Saito, S., et al., Th1/Th2/Th17 and regulatory T-cell paradigm in pregnancy. American journal of reproductive immunology, 2010. 63 (6): p. 601-610.
[35]	Saito, S., et al., Quantitative analysis of peripheral blood Th0, Th1, Th2 and the Th1: Th2 cell ratio during normal human pregnancy and preeclampsia. Clinical and experimental immunology, 1999. 117 (3): p. 550.
[36]	Borzychowski, A. M., et al., Changes in systemic type 1 and type 2 immunity in normal pregnancy and pre-eclampsia may be mediated by natural killer cells. European journal of immunology, 2005. 35 (10): p. 3054-3063.
[37]	Wang, J., et al., Assessment efficacy of neutrophil-lymphocyte ratio and monocyte-lymphocyte ratio in preeclampsia. Journal of reproductive immunology, 2019.
[38]	Fogar, P., et al., Decreased total lymphocyte counts in pancreatic cancer: an index of adverse outcome. Pancreas, 2006. 32 (1): p. 22-28.
[39]	An, X., et al., Elevated neutrophil to lymphocyte ratio predicts survival in advanced pancreatic cancer. Biomarkers, 2010. 15 (6): p. 516-522.
[40]	Hsueh, C., et al., The prognostic value of preoperative neutrophils, platelets, lymphocytes, monocytes and calculated ratios in patients with laryngeal squamous cell cancer. Oncotarget, 2017. 8 (36): p. 60514.
[41]	Seng, J. J. B., et al., Role of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and mean platelet volume (MPV) in assessing disease control in Asian patients with axial spondyloarthritis. Biomarkers, 2018. 23 (4): p. 335-338.
[42]	Qin, B., et al., Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were useful markers in assessment of inflammatory response and disease activity in SLE patients. Modern rheumatology, 2016. 26 (3): p. 372-376.
[43]	Ghulmiyyah, L. and B. Sibai. Maternal mortality from preeclampsia/eclampsia. in Seminars in perinatology. 2012. Elsevier.
[44]	Kande, A., et al., A study of maternal and foetal outcome in severe pre-eclampsia and eclampsia. IJAR, 2016. 2 (9): p. 490-492.
[45]	Madazli, R., et al., The plasma and placental levels of malondialdehyde, glutathione and superoxide dismutase in pre-eclampsia. Journal of Obstetrics and Gynaecology, 2002. 22 (5): p. 477-480.
[46]	Can, M., et al., Oxidative stress and apoptosis in preeclampsia. Tissue and Cell, 2014. 46 (6): p. 477-481.
[47]	Kaur, G., et al., Alterations in lipid peroxidation and antioxidant status in pregnancy with preeclampsia. Molecular and cellular biochemistry, 2008. 313 (1-2): p. 37-44.
[48]	Harrison, M. S., et al., Stillbirth, Inflammatory Markers, and Obesity: Results from the Stillbirth Collaborative Research Network. American journal of perinatology, 2018. 35 (11): p. 1071-1078.
[49]	Yamauchi, A., et al., Causes of stillbirth: an analysis of 77 cases. Journal of Obstetrics and Gynaecology Research, 1999. 25 (6): p. 419-424.
[50]	Blackwell, S., et al., Maternal and fetal inflammatory responses in unexplained fetal death. The Journal of Maternal-Fetal & Neonatal Medicine, 2003. 14 (3): p. 151-157.

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APA Style

Nafiu Amidu, Benedict Boateng Antuamwine, Martin Awe Akilla, William Kwame Boakye Ansah Owiredu, Otchere Addai-Mensah, et al. (2020). Leucocyte Differential Count and Pregnancy Induced Hypertension: Implication for Risk and Disease Assessment. American Journal of Laboratory Medicine, 5(1), 32-41. https://doi.org/10.11648/j.ajlm.20200501.15

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ACS Style

Nafiu Amidu; Benedict Boateng Antuamwine; Martin Awe Akilla; William Kwame Boakye Ansah Owiredu; Otchere Addai-Mensah, et al. Leucocyte Differential Count and Pregnancy Induced Hypertension: Implication for Risk and Disease Assessment. Am. J. Lab. Med. 2020, 5(1), 32-41. doi: 10.11648/j.ajlm.20200501.15

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AMA Style

Nafiu Amidu, Benedict Boateng Antuamwine, Martin Awe Akilla, William Kwame Boakye Ansah Owiredu, Otchere Addai-Mensah, et al. Leucocyte Differential Count and Pregnancy Induced Hypertension: Implication for Risk and Disease Assessment. Am J Lab Med. 2020;5(1):32-41. doi: 10.11648/j.ajlm.20200501.15

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@article{10.11648/j.ajlm.20200501.15,
  author = {Nafiu Amidu and Benedict Boateng Antuamwine and Martin Awe Akilla and William Kwame Boakye Ansah Owiredu and Otchere Addai-Mensah and Peter Paul Dapare and Eric Mishio Bawa},
  title = {Leucocyte Differential Count and Pregnancy Induced Hypertension: Implication for Risk and Disease Assessment},
  journal = {American Journal of Laboratory Medicine},
  volume = {5},
  number = {1},
  pages = {32-41},
  doi = {10.11648/j.ajlm.20200501.15},
  url = {https://doi.org/10.11648/j.ajlm.20200501.15},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajlm.20200501.15},
  abstract = {PIH accounts significantly for maternal and perinatal mortality, especially in rural communities. The sudden onset of PIH and the lack of definitive case management is worrisome. The study analysed differential leucocytes count on PIH outcomes. This is a case-control study of 40 PIH (8 GH, 16 PE and 16 EC) and 60 normotensive women who visited the Bolgatanga Regional Hospital, Ghana. Data on socio-demographics, clinical history and laboratory evaluations on blood and placental tissues were collected and analysed. Lymphocytes count was markedly increased in PIH women, while total leucocytes, neutrophils and NLR were significantly decreased. Lymphocytes count increased with severity of PIH (p=0.0037). A correlation (r=-0.9565, p<0.0001) between lymphocyte and neutrophil counts was observed among PIH subjects. Oxidative stress was more associated with PIH compared to controls. Stillbirths was associated with PIH mothers with high leucocytes count. NLR (AUC; 0.857, p<0.0001) and lymphocytes count (AUC; 0.822, p<0.0001) were optimal for prognosis of PIH. Wide variations in NLR and lymphocytes count during pregnancy necessitates urgent attention.},
 year = {2020}
}

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TY - JOUR
T1 - Leucocyte Differential Count and Pregnancy Induced Hypertension: Implication for Risk and Disease Assessment
AU - Nafiu Amidu
AU - Benedict Boateng Antuamwine
AU - Martin Awe Akilla
AU - William Kwame Boakye Ansah Owiredu
AU - Otchere Addai-Mensah
AU - Peter Paul Dapare
AU - Eric Mishio Bawa
Y1 - 2020/02/14
PY - 2020
N1 - https://doi.org/10.11648/j.ajlm.20200501.15
DO - 10.11648/j.ajlm.20200501.15
T2 - American Journal of Laboratory Medicine
JF - American Journal of Laboratory Medicine
JO - American Journal of Laboratory Medicine
SP - 32
EP - 41
PB - Science Publishing Group
SN - 2575-386X
UR - https://doi.org/10.11648/j.ajlm.20200501.15
AB - PIH accounts significantly for maternal and perinatal mortality, especially in rural communities. The sudden onset of PIH and the lack of definitive case management is worrisome. The study analysed differential leucocytes count on PIH outcomes. This is a case-control study of 40 PIH (8 GH, 16 PE and 16 EC) and 60 normotensive women who visited the Bolgatanga Regional Hospital, Ghana. Data on socio-demographics, clinical history and laboratory evaluations on blood and placental tissues were collected and analysed. Lymphocytes count was markedly increased in PIH women, while total leucocytes, neutrophils and NLR were significantly decreased. Lymphocytes count increased with severity of PIH (p=0.0037). A correlation (r=-0.9565, p<0.0001) between lymphocyte and neutrophil counts was observed among PIH subjects. Oxidative stress was more associated with PIH compared to controls. Stillbirths was associated with PIH mothers with high leucocytes count. NLR (AUC; 0.857, p<0.0001) and lymphocytes count (AUC; 0.822, p<0.0001) were optimal for prognosis of PIH. Wide variations in NLR and lymphocytes count during pregnancy necessitates urgent attention.
VL - 5
IS - 1
ER -

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Author Information

Nafiu Amidu

Department of Biomedical Laboratory Science, University for Development Studies, Tamale, Ghana
Benedict Boateng Antuamwine

Department of Biomedical Laboratory Science, University for Development Studies, Tamale, Ghana
Martin Awe Akilla

Department of Biomedical Laboratory Science, University for Development Studies, Tamale, Ghana
William Kwame Boakye Ansah Owiredu

Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Otchere Addai-Mensah

Department of Medical Laboratory Technology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Peter Paul Dapare

Department of Biomedical Laboratory Science, University for Development Studies, Tamale, Ghana
Eric Mishio Bawa

Department of Biomedical Laboratory Science, University for Development Studies, Tamale, Ghana

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Nafiu Amidu, Benedict Boateng Antuamwine, Martin Awe Akilla, William Kwame Boakye Ansah Owiredu, Otchere Addai-Mensah, et al. (2020). Leucocyte Differential Count and Pregnancy Induced Hypertension: Implication for Risk and Disease Assessment. American Journal of Laboratory Medicine, 5(1), 32-41. https://doi.org/10.11648/j.ajlm.20200501.15

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ACS Style

Nafiu Amidu; Benedict Boateng Antuamwine; Martin Awe Akilla; William Kwame Boakye Ansah Owiredu; Otchere Addai-Mensah, et al. Leucocyte Differential Count and Pregnancy Induced Hypertension: Implication for Risk and Disease Assessment. Am. J. Lab. Med. 2020, 5(1), 32-41. doi: 10.11648/j.ajlm.20200501.15

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AMA Style

Nafiu Amidu, Benedict Boateng Antuamwine, Martin Awe Akilla, William Kwame Boakye Ansah Owiredu, Otchere Addai-Mensah, et al. Leucocyte Differential Count and Pregnancy Induced Hypertension: Implication for Risk and Disease Assessment. Am J Lab Med. 2020;5(1):32-41. doi: 10.11648/j.ajlm.20200501.15

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@article{10.11648/j.ajlm.20200501.15,
  author = {Nafiu Amidu and Benedict Boateng Antuamwine and Martin Awe Akilla and William Kwame Boakye Ansah Owiredu and Otchere Addai-Mensah and Peter Paul Dapare and Eric Mishio Bawa},
  title = {Leucocyte Differential Count and Pregnancy Induced Hypertension: Implication for Risk and Disease Assessment},
  journal = {American Journal of Laboratory Medicine},
  volume = {5},
  number = {1},
  pages = {32-41},
  doi = {10.11648/j.ajlm.20200501.15},
  url = {https://doi.org/10.11648/j.ajlm.20200501.15},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajlm.20200501.15},
  abstract = {PIH accounts significantly for maternal and perinatal mortality, especially in rural communities. The sudden onset of PIH and the lack of definitive case management is worrisome. The study analysed differential leucocytes count on PIH outcomes. This is a case-control study of 40 PIH (8 GH, 16 PE and 16 EC) and 60 normotensive women who visited the Bolgatanga Regional Hospital, Ghana. Data on socio-demographics, clinical history and laboratory evaluations on blood and placental tissues were collected and analysed. Lymphocytes count was markedly increased in PIH women, while total leucocytes, neutrophils and NLR were significantly decreased. Lymphocytes count increased with severity of PIH (p=0.0037). A correlation (r=-0.9565, p<0.0001) between lymphocyte and neutrophil counts was observed among PIH subjects. Oxidative stress was more associated with PIH compared to controls. Stillbirths was associated with PIH mothers with high leucocytes count. NLR (AUC; 0.857, p<0.0001) and lymphocytes count (AUC; 0.822, p<0.0001) were optimal for prognosis of PIH. Wide variations in NLR and lymphocytes count during pregnancy necessitates urgent attention.},
 year = {2020}
}

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