{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T14:45:05Z","timestamp":1780325105531,"version":"3.54.1"},"reference-count":74,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2021,6,17]],"date-time":"2021-06-17T00:00:00Z","timestamp":1623888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Seoul National University","award":["800-20160056"],"award-info":[{"award-number":["800-20160056"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>There is no information about whether maternal neutrophil to lymphocyte ratios (NLRs) progressively increase with respect to the progression of acute histologic chorioamnionitis (acute-HCA) and increased maternal NLR is a risk factor for amnionitis, known as advanced acute-HCA, in pregnant women at risk for spontaneous preterm birth (PTB). The objective of the current study is to examine this issue. The study population included 132 singleton PTB (&lt;34 weeks) due to either preterm labor or preterm-PROM with both placental pathology and maternal CBC results within 48 h before delivery. We examined maternal NLRs according to the progression of acute-HCA in extra-placental membranes (EPM) (i.e., group-0, inflammation-free EPM; group-1, inflammation restricted to decidua; group-2, inflammation restricted to the membranous trophoblast of chorion and the decidua; group-3, inflammation in the connective tissue of chorion but not amnion; group-4, amnionitis). Maternal NLRs significantly and progressively increased with the progression of acute-HCA (Spearman\u2019s rank correlation test, \u03b3 = 0.363, p = 0.000019). Moreover, the increased maternal NLR (\u22657.75) (Odds-ratio 5.56, 95% confidence-interval 1.26-24.62, p &lt; 0.05) was a significant independent risk factor for amnionitis even after the correction for potential confounders. In conclusion, maternal NLRs significantly and progressively increased according to the progression of acute-HCA and the increased maternal NLR (\u22657.75) was an independent risk factor for amnionitis in spontaneous PTB. The evaluation of the performance of NLR should clearly require a prospective description of this parameter in a cohort of patients with either threatened PTL or preterm-PROM.<\/jats:p>","DOI":"10.3390\/jcm10122673","type":"journal-article","created":{"date-parts":[[2021,6,17]],"date-time":"2021-06-17T11:20:26Z","timestamp":1623928826000},"page":"2673","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Neutrophil to Lymphocyte Ratio in Maternal Blood: A Clue to Suspect Amnionitis"],"prefix":"10.3390","volume":"10","author":[{"given":"Joon-Hyung","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul 03080, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1290-6438","authenticated-orcid":false,"given":"Chan-Wook","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul 03080, Korea"},{"name":"Institute of Reproductive Medicine and Population, Seoul National University Medical Research Center, Seoul 03080, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung-Chul","family":"Moon","sequence":"additional","affiliation":[{"name":"Department of Pathology, Seoul National University College of Medicine, Seoul 03080, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5246-0477","authenticated-orcid":false,"given":"Joong-Shin","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul 03080, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong-Kwan","family":"Jun","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul 03080, Korea"},{"name":"Institute of Reproductive Medicine and Population, Seoul National University Medical Research Center, Seoul 03080, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1056\/NEJM200005183422007","article-title":"Intrauterine Infection and Preterm Delivery","volume":"342","author":"Goldenberg","year":"2000","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1097\/00003081-198809000-00006","article-title":"Infection and Preterm Labor","volume":"31","author":"Romero","year":"1988","journal-title":"Clin. Obstet. Gynecol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/S0002-9378(98)70272-8","article-title":"The fetal inflammatory response syndrome","volume":"179","author":"Gomez","year":"1998","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"S29","DOI":"10.1016\/j.ajog.2015.08.040","article-title":"Acute chorioamnionitis and funisitis: Definition, pathologic features, and clinical significance","volume":"213","author":"Kim","year":"2015","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1007\/s10024-003-7070-y","article-title":"Amniotic Infection Syndrome: Nosology and Reproducibility of Placental Reaction Patterns","volume":"6","author":"Redline","year":"2003","journal-title":"Pediatr. Dev. Pathol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"698","DOI":"10.5858\/arpa.2015-0225-CC","article-title":"Sampling and Definitions of Placental Lesions: Amsterdam Placental Workshop Group Consensus Statement","volume":"140","author":"Khong","year":"2016","journal-title":"Arch. Pathol. Lab. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1016\/S0029-7844(96)00339-0","article-title":"Serum C-reactive protein, white blood cell count, and amniotic fluid white blood cell count in women with preterm premature rupture of membranes","volume":"88","author":"Hyunyoon","year":"1996","journal-title":"Obstet. Gynecol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/0029-7844(95)00380-0","article-title":"Maternal blood C-reactive protein, white blood cell count, and temperature in preterm labor: A comparison with amniotic fluid white blood cell count","volume":"87","author":"Yoon","year":"1996","journal-title":"Obstet. Gynecol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1067\/mob.2001.117680","article-title":"Clinical significance of intra-amniotic inflammation in patients with preterm labor and intact membranes","volume":"185","author":"Yoon","year":"2001","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1016\/j.ajog.2004.06.085","article-title":"Clinical significance of intra-amniotic inflammation in patients with preterm premature rupture of membranes","volume":"191","author":"Shim","year":"2004","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.placenta.2017.07.324","article-title":"Inflammation in the connective-tissue of chorion, but not inflammation restricted to the trophoblast-layer of chorion and the decidua, is associated with the development of amnionitis and more intense acute-histologic chorioamnionitis in the context of choriodeciduitis","volume":"57","author":"Oh","year":"2017","journal-title":"Placenta"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.placenta.2008.09.017","article-title":"The Involvement of Human Amnion in Histologic Chorioamnionitis is an Indicator that a Fetal and an Intra-Amniotic Inflammatory Response is more Likely and Severe: Clinical Implications","volume":"30","author":"Park","year":"2009","journal-title":"Placenta"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1080\/01443610600604432","article-title":"Amniotic fluid neutrophil elastase and lactate dehydrogenase: Association with histologic chorioamnionitis","volume":"85","author":"Kidokoro","year":"2006","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/j.pedneo.2013.03.012","article-title":"Histological Chorioamnionitis: Effects on Premature Delivery and Neonatal Prognosis","volume":"54","author":"Erdemir","year":"2013","journal-title":"Pediatr. Neonatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"847","DOI":"10.3109\/14767058.2013.783806","article-title":"An elevated maternal serum C-reactive protein in the context of intra-amniotic inflammation is an indicator that the development of amnionitis, an intense fetal and AF inflammatory response are likely in patients with preterm labor: Clinical implications","volume":"26","author":"Park","year":"2013","journal-title":"J. Matern. Neonatal Med."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Kim, M.-A., Lee, Y.S., and Seo, K. (2014). Assessment of Predictive Markers for Placental Inflammatory Response in Preterm Births. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0107880"},{"key":"ref_17","first-page":"168","article-title":"Maternal Serum Interleukin-6: A Non-Invasive Predictor of Histological Chorioamnionitis in Women with Preterm-Prelabor Rupture of Membranes","volume":"45","year":"2018","journal-title":"Fetal Diagn. Ther."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Howman, R.A., Charles, A., Jacques, A., Doherty, D.A., Simmer, K., Strunk, T., Richmond, P., Cole, C.H., and Burgner, D.P. (2012). Inflammatory and Haematological Markers in the Maternal, Umbilical Cord and Infant Circulation in Histological Chorioamnionitis. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0051836"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"390","DOI":"10.12659\/MSM.891203","article-title":"Related Factors and Adverse Neonatal Outcomes in Women with Preterm Premature Rupture of Membranes Complicated by Histologic Chorioamnionitis","volume":"21","author":"Zhu","year":"2015","journal-title":"Med. Sci. Monit."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"461","DOI":"10.3349\/ymj.2016.57.2.461","article-title":"Non-Invasive Prediction of Histologic Chorioamnionitis in Women with Preterm Premature Rupture of Membranes","volume":"57","author":"Kim","year":"2016","journal-title":"Yonsei Med. J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1007\/s00404-019-05061-8","article-title":"Immune biomarkers in maternal plasma to identify histologic chorioamnionitis in women with preterm labor","volume":"299","author":"Park","year":"2019","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1055\/s-2008-1078759","article-title":"First-trimester maternal plasma concentrations of C-reactive protein in low-risk patients and the subsequent development of chorioamnionitis","volume":"25","author":"Hackney","year":"2008","journal-title":"Am. J. Perinatol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/S1875-9572(09)60066-8","article-title":"Subclinical Histologic Chorioamnionitis and Related Clinical and Laboratory Parameters in Preterm Deliveries","volume":"50","author":"Wu","year":"2009","journal-title":"Pediatr. Neonatol."},{"key":"ref_24","first-page":"818","article-title":"Relation between viability of vaginal polymorphonuclear leukocytes and presence of listologic chorioamnionitis","volume":"79","author":"Yamada","year":"2000","journal-title":"Acta Obstet. et Gynecol. Scand."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.placenta.2019.03.007","article-title":"The combination of maternal blood and amniotic fluid biomarkers improves the predictive accuracy of histologic chorioamnionitis","volume":"80","author":"Kurakazu","year":"2019","journal-title":"Placenta"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1159\/000291862","article-title":"Value of the Maternal Interleukin 6 Level for Determination of Histologic Chorioamnionitis in Preterm Delivery","volume":"43","author":"Maeda","year":"1997","journal-title":"Gynecol. Obstet. Investig."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1515\/jpm-2014-0142","article-title":"Usefulness of maternal serum C-reactive protein with vaginal Ureaplasma urealyticum as a marker for prediction of imminent preterm delivery and chorioamnionitis in patients with preterm labor or preterm premature rupture of membranes","volume":"43","author":"Kwak","year":"2015","journal-title":"J. P\u00e9rinat. Med."},{"key":"ref_28","first-page":"671","article-title":"Serum intercellular adhesion molecule-1 levels and histologic chorioamnionitis","volume":"95","author":"Steinborn","year":"2000","journal-title":"Obstet. Gynecol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1016\/j.placenta.2011.07.080","article-title":"Predictive value of intra-amniotic and serum markers for inflammatory lesions of preterm placenta","volume":"32","author":"Oh","year":"2011","journal-title":"Placenta"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1016\/S0006-291X(02)03059-0","article-title":"Decreased mature adrenomedullin levels in feto-maternal tissues of pregnant women with histologic chorioamnionitis","volume":"301","author":"Makino","year":"2003","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Cho, H.Y., Jung, I., Kwon, J.-Y., Kim, S.J., Park, Y.W., and Kim, Y.-H. (2017). The Delta Neutrophil Index as a predictive marker of histological chorioamnionitis in patients with preterm premature rupture of membranes: A retrospective study. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0173382"},{"key":"ref_32","first-page":"50","article-title":"Predictive values of maternal serum levels of procalcitonin, ESR, CRP, and WBC in the diagnosis of chorioamnionitis in mothers with preterm premature rupture of membrane","volume":"9","author":"Broumand","year":"2018","journal-title":"Iranian J. Neonatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/S0020-7292(97)02891-9","article-title":"Interleukin-8 level in maternal serum as a marker for screening of histological chorioamnionitis at term","volume":"57","author":"Shimoya","year":"1997","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"3162","DOI":"10.3109\/14767058.2015.1118036","article-title":"Maternal serum interleukin-6 in the management of patients with preterm premature rupture of membranes","volume":"29","author":"Ahmed","year":"2015","journal-title":"J. Matern. Neonatal Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1111\/aji.12360","article-title":"Accurate Prediction of the Stage of Histological Chorioamnionitis before Delivery by Amniotic Fluid IL-8 Level","volume":"73","author":"Yoneda","year":"2015","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1111\/j.1600-0897.2011.01084.x","article-title":"Interleukin-6 as a Predictor of Subclinical Chorioamnionitis in Preterm Premature Rupture of Membranes","volume":"67","author":"Gulati","year":"2012","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.ejogrb.2016.08.022","article-title":"Accuracy of several maternal seric markers for predicting histological chorioamnionitis after preterm premature rupture of membranes: A prospective and multicentric study","volume":"205","author":"Caloone","year":"2016","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1995","DOI":"10.3109\/14767058.2012.666592","article-title":"A prediction model of histological chorioamnionitis and funisitis in preterm prelabor rupture of membranes: Analyses of multiple proteins in the amniotic fluid","volume":"25","author":"Cobo","year":"2012","journal-title":"J. Matern. Neonatal Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.3109\/14767058.2011.638952","article-title":"Maternal serum interleukin-6 and its association with clinicopathological infectious morbidity in preterm premature rupture of membranes: A prospective cohort study","volume":"25","author":"Gulati","year":"2012","journal-title":"J. Matern. Neonatal Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1080\/14767050701227877","article-title":"Maternal plasma interleukin-6, interleukin-1\u03b2 and C-reactive protein as indicators of tocolysis failure and neonatal outcome after preterm delivery","volume":"20","author":"Kralik","year":"2007","journal-title":"J. Matern. Neonatal Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1053\/hupa.2002.31291","article-title":"Re-evaluation of chorioamnionitis and funisitis with a special reference to subacute chorioamnionitis","volume":"33","author":"Ohyama","year":"2002","journal-title":"Hum. Pathol."},{"key":"ref_42","first-page":"154","article-title":"The value of the soluable intercellular adhesion molecule-1 levels in matermal serum for determination of occult chorioamnionitis in premature rupture of membranes","volume":"24","author":"Li","year":"2004","journal-title":"Acta Acad. Med. Wuhan"},{"key":"ref_43","first-page":"67","article-title":"Pathology of the placenta, membranes, and umbilical cord in bacterial, fungal, and viral infections in man","volume":"22","author":"Blanc","year":"1981","journal-title":"Monogr. Pathol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"960","DOI":"10.1016\/0002-9378(95)90028-4","article-title":"Amniotic fluid interleukin-6: A sensitive test for antenatal diagnosis of acute inflammatory lesions of preterm placenta and prediction of perinatal morbidity","volume":"172","author":"Yoon","year":"1995","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1097\/00003081-195902030-00010","article-title":"Amniotic infection syndrome; pathogenesis, morphology, and significance in circumnatal mortality","volume":"2","author":"Blanc","year":"1959","journal-title":"Clin. Obstet. Gynecol."},{"key":"ref_46","first-page":"383","article-title":"The prevalence and distribution of acute placental inflammation in uncomplicated term pregnancies","volume":"73","author":"Salafia","year":"1989","journal-title":"Obstet. Gynecol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.ejr.2017.11.004","article-title":"Neutrophil-lymphocyte and platelet-lymphocyte ratios in rheumatoid arthritis patients: Relation to disease activity","volume":"40","author":"Mohamed","year":"2018","journal-title":"Egypt. Rheumatol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"269","DOI":"10.7754\/Clin.Lab.2014.140927","article-title":"Neutrophil- and Platelet-to-Lymphocyte Ratios are Correlated with Disease Activity in Rheumatoid Arthritis","volume":"61","author":"Fu","year":"2015","journal-title":"Clin. Lab."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.intimp.2016.04.006","article-title":"Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were associated with disease activity in patients with systemic lupus erythematosus","volume":"36","author":"Wu","year":"2016","journal-title":"Int. Immunopharmacol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.cca.2016.12.007","article-title":"Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio are 2 new inflammatory markers associated with pulmonary involvement and disease activity in patients with dermatomyositis","volume":"465","author":"Yang","year":"2017","journal-title":"Clin. Chim. Acta"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"372","DOI":"10.3109\/14397595.2015.1091136","article-title":"Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were useful markers in assessment of inflammatory response and disease activity in SLE patients","volume":"26","author":"Qin","year":"2016","journal-title":"Mod. Rheumatol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1002\/jcla.21908","article-title":"The Association between Neutrophil\/Lymphocyte Ratio and Disease Activity in Rheumatoid Arthritis and Ankylosing Spondylitis","volume":"30","author":"Mercan","year":"2016","journal-title":"J. Clin. Lab. Anal."},{"key":"ref_53","first-page":"3045","article-title":"Neutrophil\/lymphocyte ratio and mean platelet volume in Beh\u00e7et\u2019s disease","volume":"20","author":"Balkarli","year":"2016","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1016\/j.ajem.2019.10.023","article-title":"Prognostic value of neutrophil-to-lymphocyte ratio in sepsis: A meta-analysis","volume":"38","author":"Huang","year":"2020","journal-title":"Am. J. Emerg. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.ajem.2016.10.055","article-title":"Neutrophil-to-lymphocyte ratio as a prognostic marker in critically-ill septic patients","volume":"35","author":"Hwang","year":"2017","journal-title":"Am. J. Emerg. Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2016\/7432845","article-title":"Prognostic Significance of Neutrophil-to-Lymphocyte Ratio in Patients with Sepsis: A Prospective Observational Study","volume":"2016","author":"Liu","year":"2016","journal-title":"Mediat. Inflamm."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"e18029","DOI":"10.1097\/MD.0000000000018029","article-title":"Neutrophil to lymphocyte ratio (NLR) as a prognostic marker for in-hospital mortality of patients with sepsis: A secondary analysis based on a single-center, retrospective, cohort study","volume":"98","author":"Ni","year":"2019","journal-title":"Medicine"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"S16","DOI":"10.21037\/jtd.2019.12.63","article-title":"The complete blood count to diagnose septic shock","volume":"12","author":"Farkas","year":"2020","journal-title":"J. Thorac. Dis."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"e229","DOI":"10.1097\/MPH.0000000000001059","article-title":"The Value of Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio for Detecting Early-onset Neonatal Sepsis","volume":"40","author":"Can","year":"2018","journal-title":"J. Pediatr. Hematol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"512","DOI":"10.5455\/annalsmedres.2018.07.134","article-title":"Predictive value of serum neutrophil-to-lymphocyte ratio in bronchopulmonary dysplasia: A retrospective observational study","volume":"25","author":"Ozdemir","year":"2018","journal-title":"Ann. Med. Res."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.pedneo.2016.01.005","article-title":"Maternal and Placental Risk Factors for Developing Necrotizing Enterocolitis in Very Preterm Infants","volume":"58","author":"Lee","year":"2017","journal-title":"Pediatr. Neonatol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"431","DOI":"10.5603\/GP.2016.0021","article-title":"High first-trimester neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios are indicators for early diagnosis of preeclampsia","volume":"87","author":"Gezer","year":"2016","journal-title":"Ginekol. Polska"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"97","DOI":"10.3109\/14767058.2014.905910","article-title":"May ratio of neutrophil to lymphocyte be useful in predicting the risk of developing preeclampsia? A pilot study","volume":"28","author":"Kurtoglu","year":"2015","journal-title":"J. Matern. Neonatal Med."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.preghy.2016.01.005","article-title":"Is neutrophil\/lymphocyte ratio a useful marker to predict the severity of pre-eclampsia?","volume":"6","author":"Serin","year":"2016","journal-title":"Pregnancy Hypertens."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1016\/S0002-9378(99)70239-5","article-title":"Preeclampsia: An excessive maternal inflammatory response to pregnancy","volume":"180","author":"Redman","year":"1999","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1055\/s-0029-1223285","article-title":"Increased Neutrophil Numbers Account for Leukocytosis in Women with Preeclampsia","volume":"26","author":"Canzoneri","year":"2009","journal-title":"Am. J. Perinatol."},{"key":"ref_67","first-page":"86","article-title":"Platelets and leucocyte counts in pregnancy","volume":"42","author":"Karim","year":"1992","journal-title":"J. Pak. Med. Assoc."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1111\/j.1365-2257.1993.tb00116.x","article-title":"Reference ranges for haematology parameters in pregnancy derived from patient populations","volume":"15","author":"Balloch","year":"2008","journal-title":"Int. J. Lab. Hematol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.ejogrb.2005.02.022","article-title":"Fluctuations in C-reactive protein concentration and neutrophil activation during normal human pregnancy","volume":"123","author":"Belo","year":"2005","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_70","unstructured":"Lockitch, G. (1993). Handbook of Diagnostic Biochemistry and Hematology in Normal Pregnancy, CRC Press."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1080\/01443615.2016.1268575","article-title":"Reference values for maternal total and differential leukocyte counts in different trimesters of pregnancy and the initial postpartum period in western Turkey","volume":"37","author":"Sanci","year":"2017","journal-title":"J. Obstet. Gynaecol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"98306","DOI":"10.1172\/jci.insight.98306","article-title":"IL-1 signaling mediates intrauterine inflammation and chorio-decidua neutrophil recruitment and activation","volume":"3","author":"Presicce","year":"2018","journal-title":"JCI Insight"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"2008","DOI":"10.1172\/JCI114111","article-title":"Cooperative interactions of LFA-1 and Mac-1 with intercellular adhesion molecule-1 in facilitating adherence and transendothelial migration of human neutrophils in vitro","volume":"83","author":"Smith","year":"1989","journal-title":"J. Clin. Investig."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.1084\/jem.20040965","article-title":"Coordinated Redistribution of Leukocyte LFA-1 and Endothelial Cell ICAM-1 Accompany Neutrophil Transmigration","volume":"200","author":"Shaw","year":"2004","journal-title":"J. Exp. Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/12\/2673\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:17:45Z","timestamp":1760163465000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/12\/2673"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,17]]},"references-count":74,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2021,6]]}},"alternative-id":["jcm10122673"],"URL":"https:\/\/doi.org\/10.3390\/jcm10122673","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,17]]}}}