Investigation of prognostic role of NLR, MLR, and PLR in neonates with ICH admitted to AlZahra hospital and Tabriz Children's hospital during 2011-2021

Abstract

Neonates with IVH are at risk for developing significant complications, including posthemorrhagic hydrocephalus and seizures. Multiple studies have reported an association between bood biomarkers, including neutrophil to lymphocyte ratio(NLR), platelete to lymphocyte ratio(PLR), and monocyte to lymphocyte ratio (MLR) in peripheral blood and outcomes after acute intracranial hemorrhage in adults. However, the prognostic value of the NLR in neonates has not been investigated previously. Patients and methods: This retrospective, observational cohort study included premature infants with brian hemmorrhage and a neonatal reservoir placed between January 2011 and January 2021. For each patient, peripheral blood laboratory results at the day of IVH diagnosis were averaged. NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count, PLR was calculated by dividing the absolute platelet count by the absolute lymphocyte count, and MLR by dividing the absolute monocyte count by the absolute lymphocyte count. Results: Data for 41 infants were analyzed. Patients who died, had elevated levels of NLR compared to survivors (3.48±1.52 vs. 1.33 ± 0.75, P value=0.001). In addition, neonates with brain swelling had higher levels of PLR than those without brain swelling (852.53±1376.50 vs. 75.25±59.01, P=0.001). However, none of NlR, PLR MLR could predict seizures, hypoxic ischemic encephalopathy, retinopathy, and hydrocephalous.