{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T17:56:43Z","timestamp":1786471003413,"version":"build-2736575974"},"reference-count":38,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp;amp; Obste"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study assesses the association between complete blood count (CBC) parameters, including the neutrophil\u2010to\u2010lymphocyte ratio (NLR) and the platelet\u2010to\u2010lymphocyte ratio (PLR) and predicts the need for postpartum packed red blood cell transfusion (pRBCT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study was conducted at a tertiary, university\u2010affiliated medical center with approximately 12\u2009500 annual deliveries (2012\u20132023). Women requiring postpartum pRBCT were identified based on criteria including severe hemorrhage, symptomatic anemia with hemoglobin (Hb) levels of 7\u20138\u2009g\/dL, or severe anemia (Hb &lt;7\u2009g\/dL). Maternal demographics, admission complete blood count (CBC), and delivery outcomes were analyzed. Multivariable logistic regression identified independent predictors of pRBCT, and a risk score was developed and evaluated using receiver operating characteristic (ROC) analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Admission CBC data were available for 37\u2009631 vaginal deliveries, of which 957 (2.5%) required pRBCT. Risk factors for pRBCT included nulliparity, previous cesarean, assisted reproductive technology conception and intrapartum fever. Protective factors included spontaneous labor onset, body mass index &gt;30, and admission hematocrit &gt;40%. Key CBC independent predictors included Hb &lt;11\u2009g\/dL (adjusted odds ratio [aOR] 5.70, 95% confidence interval [CI] 4.79\u20136.79), and NLR &gt;5 (aOR 1.28, 95% CI 1.02\u20131.60). The scoring model, with a clinical cutoff of 5, predicted pRBCT with an area under the curve of 0.77 (95% CI 0.75\u20130.79,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Admission CBC parameters, particularly NLR and Hb, alongside maternal factors, might help predict pRBCT in vaginal deliveries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70765","type":"journal-article","created":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T07:58:46Z","timestamp":1766217526000},"page":"1489-1495","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Neutrophil\u2010to\u2010lymphocyte ratio at admission helps to predict the need for blood transfusion after vaginal delivery"],"prefix":"10.1002","volume":"173","author":[{"given":"Daniel","family":"Gabbai","sequence":"first","affiliation":[{"name":"Lis Hospital for Women's Health, Tel Aviv Sourasky Medical Center Tel Aviv University  Tel Aviv Israel"},{"name":"Affiliated to Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itamar","family":"Gilboa","sequence":"additional","affiliation":[{"name":"Lis Hospital for Women's Health, Tel Aviv Sourasky Medical Center Tel Aviv University  Tel Aviv Israel"},{"name":"Affiliated to Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anat","family":"Lavie","sequence":"additional","affiliation":[{"name":"Lis Hospital for Women's Health, Tel Aviv Sourasky Medical Center Tel Aviv University  Tel Aviv Israel"},{"name":"Affiliated to Faculty of Medicine Tel Aviv University  Tel Aviv 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