Trombosit Lenfosit Oranı ile Koryoamniyonit ve Yenidoğan Morbiditeleri Arasındaki İlişki

Amaç: Lenfopeni, nötropeniler ve trombositopeniler yeni doğan yoğun bakım ünitelerinde sık karşılaşılan problemlerdendir. Trombosit ve lenfositlerin inflamatuar durumlarda üretim, tüketim ve yaşam döngüleri değişmektedir. Bu çalışmada trombosit lenfosit oranları (TLO) ile yeni doğan morbiditeleri arasında ilişkinin incelenmesi amaçlanmıştır. Gereç ve Yöntemler: Geriye dönük son 2 yılda yeni doğan yoğun bakım ünitesine yatışı yapılan 201 hastanın verileri incelendi. Demografik özellikleri morbidite ve mortalite verileri kaydedildi. Hastaların ilk yatışındaki trombosit lenfosit oranları hesaplandı. Trombosit lenfosit oranları ile koryoamniyonit ve yeni doğan morbiditleri arasındaki ilişki incelendi. Bulgular: Vakaların ortalama gebelik haftası ve ağırlıkları sırasıyla 30,9±3,6 hafta ve 1492±660 gram idi. Vakaların %43,3’ünü 28-32 gebelik haftasında doğan bebekler oluşturmaktaydı. TLO klinik koryoaniyonitli annelerin bebeklerinde anlamlı derecede yüksek bulunurken (p=0,006), intrauterin büyüme kısıtlılığı olan bebeklerde de anlamlı derecede düşük bulundu (p=0,020). ROC eğrisi klinik koryoamniyoniti tahmin etme gücü yönünden Max c-reaktif protein (Crp) 1. hafta ve max Crp 2. hafta ile karşılaştırıldığında TLO’nun belirgin üstün olduğu gözlemlenmiştir (Area under the curve (AUC):0,696, p=0,032). Anne TLO ve bebek TLO oranları arasında da anlamlı bir korelasyon bulunmuştur (r=0,202 p=0,020). Antenatal steroidler, doğum şekli, çoğul gebelikler, annede hipertansiyon varlığı ve erken dönem yeni doğan morbiditeleriyle TLO arasında ilişki bulunmazken, premature retinopatisi açısından gruplar arasında anlamlı fark bulundu (p<0,001). Sonuç: TLO kolay ulaşılabilir ve ucuz bir gösterge olarak klinik koryoamniyonitli anne bebeklerinin karşılaşabileceği yeni doğan morbiditeleri için yeni doğan hekimlerine yol gösterebilir.

Anahtar Kelimeler:

Trombosit lenfosit oranı, koryoamniyonit, perinatal morbidite

The Relationship Between Platelet Lymphocyte Ratio and Neonatal Morbidities, Chorioamnionitis

Aim: Lymphopenia, neutropenia, and thrombocytopenia are common problems in neonatal intensive care units. Production, consumption, and life cycles of platelets and lymphocytes in inflammatory conditions change. In this study, it was aimed to examine the relationship between Platelet lymphocyte ratio (PLR) and neonatal morbidity. Material and Methods: The data of 201 patients who were admitted to the neonatal intensive care unit in the last 2 years were analyzed retrospectively. Demographic characteristics, morbidity, and mortality data were recorded. PLRs at the first hospitalization of the patients were calculated. The relationship between PLR and chorioamnionitis, neonatal morbidities was examined. Results: Mean gestational age and birth weight of the cases were 30.9 ± 3.6 weeks and 1492 ± 660 grams, respectively. 43.3% of the cases were babies born between 28-32 weeks of gestation. PLR was found significantly higher in babies of mothers with clinical chorioamnionitis (p = 0.006), while it was significantly lower in babies with intrauterine growth restriction (p = 0.020). There was a significant correlation between maternal PLR and infant PLR (r = 0.202 p = 0.020). While no relationship was found between PLR and antenatal steroids, delivery type, multiple pregnancies, presence of maternal hypertension, and early neonatal morbidity, a significant difference was found between the groups in terms of especially in babies born from mothers with clinical chorioamnionitis.

Keywords:

Platelet lymphocyte ratio, chorioamnionitis, perinatal morbidities,

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