Burak KENAR, Metin KABA, Hasan Ali INAL, Gulsah INAL
Medical Science and Discovery - 2026;13(9):293-300
Objective: This prospective study investigates the frequency of histological chorioamnionitis (HCA) and evaluates the predictive value of maternal peripheral inflammatory markers-specifically the neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP)-in 123 women who presented with preterm labour (<37 weeks of gestation). Materials and methods: One hundred twenty-three women with gestational ages of <37 weeks who underwent vaginal or caesarean delivery between January 1, 2019, and December 31, 2021, in our hospital obstetrics clinic (Group 1, negative histological chorioamnionitis, n=41 and Group 2, positive histological chorioamnionitis, n=82) were included in this retrospective-prospective study. A pathologist examined the placentas to diagnose HCA. The underlying hypothesis - that non-invasive, cost-effective maternal serum inflammatory markers (NLR and CRP) can reliably predict HCA in patients experiencing preterm labour- is clinically relevant. Results: While haemoglobin levels, mean platelet volume, mean corpuscular volume, and lymphocyte, monocyte, and platelet counts on admission and after delivery were comparable between the HCA-negative and HCA-positive groups (p>0.05), leukocyte (11168.29+2757.66, respectively, vs 13022.80+4795.97, p=0.008) and neutrophil (8202.44+2459.82 vs 10220.73+4608.84, p=0.002) counts, the neutrophil-lymphocyte ratio(NLR) (4.31+2.39 vs 6.15+4.64, p=0.004), and C-reactive protein (CRP) (9.35+3.29 vs 19.11+10.46 mg/dL, p=0.022) values differed significantly between the groups. The recommended threshold for the neutrophil-lymphocyte ratio was 3.34 (AUC=0.670, 95% CI 0.538-0.802, sensitivity 78.1%, specificity 61.0%). The ROC analysis cut-off for CRP was 6.5 mg/dL (AUC = 0.601, 95% CI 0.490-0.710, sensitivity 58.1%, specificity 47.2%) Conclusions: Given that subclinical chorioamnionitis often progresses without overt maternal clinical signs (e.g., fever, purulent discharge), identifying reliable haematological indices is of value in obstetric care. The study found HCA in 66.6% of this cohort and suggests that NLR has higher sensitivity and specificity than CRP for identifying HCA.
