SavedAdd your journal

Journals / Journal of Experimental and Clinical Medicine / 2026 / Volume: 41 Issue: 3

Evaluation of the efficacy of maternal hemogram parameters in predicting meconium presence at birth in healthy pregnancies

Sebati Sinan Ürkmez(ONDOKUZ MAYIS ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0002-8821-1835
Özge Deniz Ünyeli(Samsun Training and Research Hospital)0000-0001-8507-2756
Yeşim Civil(Samsun Training and Research Hospital)0000-0002-9662-244X
Semra Eroglu(SAMSUN UNIVERSITY, SCHOOL OF MEDICINE)0000-0002-9959-9433
Sakine Merve Aydın(SAMSUN UNIVERSITY, SCHOOL OF MEDICINE)0000-0003-1187-6262
Canan Soyer Çalışkan(SAMSUN UNIVERSITY, SCHOOL OF MEDICINE)0000-0002-9889-5249
Zehra Yılmaz(Private Practice)0000-0003-1162-8648
Ceren Mert Soruklu(Samsun Training and Research Hospital)0000-0001-6041-238X
Samettin Çelik(SAMSUN UNIVERSITY, SCHOOL OF MEDICINE)0009-0009-3804-3851
Pages
—
Publication Date
2024-09-30
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Results showed that NLR, MLR, SIRI, AISI, and procalcitonin levels were significantly higher in the MSAF group.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:The presence of meconium-stained amniotic fluid (MSAF) is a critical indicator of fetal distress, associated with increased neonatal morbidity and mortality.
📊
Key Findings & Data:Data were retrospectively analyzed from healthy pregnant women who presented to Samsun Education and Research Hospital between 2014 and 2023 and delivered either by normal spontaneous delivery or cesarean section.
💡
Conclusion & Impact:Results showed that NLR, MLR, SIRI, AISI, and procalcitonin levels were significantly higher in the MSAF group.
🔬Design:Research Article
📍Scope:2014 Verileri
⚙️Variables:meconium · amniotic fluid · inflammation mediators

Abstract

The presence of meconium-stained amniotic fluid (MSAF) is a critical indicator of fetal distress, associated with increased neonatal morbidity and mortality. The aim of this study was to evaluate the potential of maternal blood parameters to predict the presence of meconium-stained amniotic fluid (MSAF) in term pregnancies. Data were retrospectively analyzed from healthy pregnant women who presented to Samsun Education and Research Hospital between 2014 and 2023 and delivered either by normal spontaneous delivery or cesarean section. The study included healthy pregnant women aged 18 and over who gave birth between 37 and 42 weeks of gestation. The non-invasive laboratory parameters investigated were neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SIRI), aggregate index of systemic inflammation (AISI), and procalcitonin levels. Results showed that NLR, MLR, SIRI, AISI, and procalcitonin levels were significantly higher in the MSAF group. The ROC curve analysis demonstrated that SIRI (cutoff: 3.55) had an AUC of 0.826 (sensitivity: 89.2%, specificity: 71.8%). AISI (cutoff: 1340.39) had an AUC of 0.749 (sensitivity: 75.8%, specificity: 70.9%). NLR (cutoff: 3.58) showed an AUC of 0.757 (sensitivity: 87.5%, specificity: 56.3%). MLR (cutoff: 0.55) presented an AUC of 0.822 (sensitivity: 87.5%, specificity: 74.8%). However, SII demonstrated negligible and statistically non-significant diagnostic value. PLR and procalcitonin exhibited lower diagnostic efficacy. This study demonstrates that NLR, MLR, SIRI, AISI, and procalcitonin are effective non-invasive biomarkers for predicting the presence of MSAF in term pregnancies. These parameters can assist clinicians in anticipating fetal distress and the risk of meconium aspiration syndrome (MAS), thereby improving perinatal outcomes through timely intervention.

🔖

Cite This Article

Ürkmez, S. S., Ünyeli, Ö. D., Civil, Y., Eroglu, S., Aydın, S. M., Çalışkan, C. S., Yılmaz, Z., Soruklu, C. M., Çelik, S. (2024). Evaluation of the efficacy of maternal hemogram parameters in predicting meconium presence at birth in healthy pregnancies. Journal of Experimental and Clinical Medicine, Volume: 41 Issue: 3. https://ajindex.com/articles/1422660

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (31)

  1. Sadaf R, Mehrunnisa K, Khanum F, Zahid M, Khan S. Fetal outcome in deliveries of patients with meconium stained liquor. J Med Sci. 2012;20:165-7.
  2. Mundhra R, Agarwal M. Fetal outcome in meconium stained deliveries. J Clin Diagn Res. 2013;7:2874-6.
  3. Osava RH, Silva FM, Vasconcellos de Oliveira SM, Tuesta EF, Amaral MC. Fatores maternos e neonatais associados ao mecônio no líquido amniótico em um centro de parto normal [Meconium-stained amniotic fluid and maternal and neonatal factors associated]. Rev Saude Publica. 2012;46(6):1023-9. Portuguese.
  4. Rathoria R, Rathoria E, Bansal U, Mishra M, Jalote I, Shukla NK, et al. Study of risk factors and perinatal outcome in meconium stained deliveries from a district of Uttar Pradesh, India. Int J Reprod Contracept Obstet Gynecol. 2018;7:3605-9.
  5. Wang J, Zhu QW, Cheng XY, Liu JY, Zhang LL, Tao YM, et al. Assessment efficacy of neutrophil-lymphocyte ratio and monocyte-lymphocyte ratio in preeclampsia. J Reprod Immunol. 2019;132:29-34.
  6. Lee J, Romero R, Lee KA, Kim EN, Korzeniewski SJ, Chaemsaithong P, et al. Meconium aspiration syndrome: a role for fetal systemic inflammation. Am J Obstet Gynecol. 2016;214:366.e1-9.
  7. Monen L, Hasaart TH, Kuppens SM. The aetiology of meconium-stained amniotic fluid: pathologic hypoxia or physiologic foetal ripening? Early Hum Dev. 2014;90:325-8.
  8. Davis PJ, Shekerdemian LS. Meconium aspiration syndrome and extracorporeal membrane oxygenation. Arch Dis Child Fetal Neonatal Ed. 2001;84.
  9. Gavhane B, Thakare S, Wankhede S. The study of meconium staining of amniotic fluid and foetal outcome. Int J Reprod Contracept Obstet Gynecol. 2018;7:4042-7.
  10. Aksakal SE, Erdoğan K, Ustun Y. Ortalama Platelet Hacmi (MPV), Platelet Dağılım Genişliği (PDW), Nötrofil/Lenfosit Oranı (NLR), Red Cell Dağılım Genişliği (RDW), ve Platelet/Lenfosit Oranının (PLR) Fetal Distresi Öngörmedeki Yeri. Turk Kadın Sağlığı ve Neonatoloji Dergisi. 3(4), 81-86.
  11. Paliogiannis P, Satta R, Deligia G, Farina G, Bassu S, Mangoni AA, et al. Associations between the neutrophil-to-lymphocyte and the platelet-to-lymphocyte ratios and the presence and severity of psoriasis: A systematic review and meta-analysis. Clin Exp Med. 2018;19:37-45.
  12. Erre GL, Paliogiannis P, Castagna F, Mangoni AA, Carru C, Passiu G, et al. Meta-analysis of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio in rheumatoid arthritis. Eur J Clin Invest. 2019;49.
  13. Pinna A, Porcu T, Ricci GD, Dore S, Boscia F, Paliogiannis P, et al. Complete blood cell count-derived inflammation biomarkers in men with age-related macular degeneration. Ocul Immunol Inflamm. 2018;27:932-6.
  14. Putzu C, Cortinovis D, Colonese F, Canova S, Carru C, Zinellu A, et al. Blood cell count indexes as predictors of outcomes in advanced non-small-cell lung cancer patients treated with nivolumab. Cancer Immunol Immunother. 2018;67:1349-53.
  15. Paliogiannis P, Fois AG, Sotgia S, Mangoni AA, Zinellu E, Pirina P, et al. The neutrophil-to-lymphocyte ratio as a marker of chronic obstructive pulmonary disease and its exacerbations: A systematic review and meta-analysis. Eur J Clin Invest. 2018;48.
  16. Mochimaru T, Ueda S, Suzuki Y, Asano K, Fukunaga K. Neutrophil-to-lymphocyte ratio as a novel independent predictor of severe exacerbation in patients with asthma. Ann Allergy Asthma Immunol. 2019;122:337-9.
  17. Ruta V, Man A, Alexescu T, Motoc N, Tarmure S, Ungur R, et al. Neutrophil-to-lymphocyte ratio and systemic immune-inflammation index—biomarkers in interstitial lung disease. Medicina (Kaunas). 2020;56:381.
  18. Hashemipour S, Panahi H, Kelishomi SE, Ghasemi A, Chopani SM, Kolaji S, et al. Superiority of neutrophil count over other inflammatory markers in predicting gestational diabetes: A prospective cohort study.
  19. Cakir U, Tayman C. Evaluation of systemic inflammatory indices in the diagnosis of early onset neonatal sepsis in very low birth weight infants.
  20. İpek G, Tanaçan A, Peker A, Ağaoğlu Z, Kara Ö, Şahin D. Systemic inflammation response index as a diagnostic and prognostic predictor of intrahepatic cholestasis of pregnancy: A case-control study from a tertiary center. Int J Gynaecol Obstet. 2024;165:717-22.
  21. Consonni S, Salmoiraghi E, Vaglio Tessitore I, Pintucci A, Vitale V, Calzi P, et al. Intra-Amniotic Inflammation or Infection: Suspected and Confirmed Diagnosis of “Triple I” at Term. Children (Basel). 2023;10(7):1110.
  22. Gomez-Lopez N, Romero R, Xu Y, Leng Y, Garcia-Flores V, Miller D, et al. Are amniotic fluid neutrophils in women with intraamniotic infection and/or inflammation of fetal or maternal origin?. Am J Obstet Gynecol. 2017;217(6):693.e1-693.e19.
  23. Esercan A, Demir I. Neutrophil/lymphocyte and platelet/lymphocyte ratio in preterm premature rupture of membranes. Cureus. 2023. doi:10.7759/cureus.38664.
  24. Taşkın A, Can E, Hamilçıkan Ş. Suspected or proven early-onset sepsis and NLR, PLR, and MPV parameters in neonates with born through MSAF. Am J Perinatol. 2022;39(6):609-15.
  25. Schuetz P, Chiappa V, Briel M, Greenwald JL. Procalcitonin algorithms for antibiotic therapy decisions: a systematic review of randomized controlled trials and recommendations for clinical algorithms. Arch Intern Med. 2011;171(15):1322-31.
  26. Joyce CM, Deasy S, Abu H, Lim YY, O’Shea PM, O’Donoghue K. Reference values for C-reactive protein and procalcitonin at term pregnancy and in the early postnatal period. Ann Clin Biochem. 2021;58(5):452-60.
  27. Agarwal R, Priyadarshini P, Mehndiratta M. Serum procalcitonin in pregnancy-associated sepsis: a case control study. S Afr J Og. 2019;25:15-9.
  28. Naveen S, Kumar SV, Ritu S, Kushia P. Predictors of meconium stained amniotic fluid: a possible strategy to reduce neonatal morbidity and mortality. J Obstet Gynecol India. 2006;56(6):514-7.
  29. Wong SF, Chow KM, Ho LC. The relative risk of 'fetal distress' in pregnancy associated with meconium-stained liquor at different gestation. J Obstet Gynaecol. 2002;22(6):594-9.
  30. Mundhra R, Agarwal M. Fetal outcome in meconium stained deliveries. J Clin Diagn Res. 2013;7(12):2874-6.
  31. Levin G, Tsur A, Shai D, Cahan T, Shapira M, Meyer R. Prediction of adverse neonatal outcome among newborns born through meconium-stained amniotic fluid. Int J Gynaecol Obstet. 2021;154(3):515-20.