Evaluation of Neutrophil to Lymphocyte Ratio and Serum Uric Acid to Creatinine Ratio in Hypertensive Disorders of Pregnancy: A Cross-Sectional Study

Diana Powline G; Gnanapraba P; Sam Joel M

doi:10.55489/njmr.160120261219

Authors

Diana Powline G Department of Biochemistry, Madurai Medical College, Madurai, Tamil Nadu, India
Gnanapraba P Department of Biochemistry, Madurai Medical College, Madurai, Tamil Nadu, India
Sam Joel M Department of Pediatric Surgery, Apollo Women & Child Care Hospital, Madurai, Tamil Nadu, India

DOI:

https://doi.org/10.55489/njmr.160120261219

Keywords:

Hypertensive disorders of pregnancy, Preeclampsia, Uric acid-creatinine ratio, Neutrophil-lymphocyte ratio, Oxidative stress

Abstract

Background: Hypertensive disorders of pregnancy (HDP) significantly contribute to maternal and perinatal morbidity and mortality, making early identification essential. Oxidative stress and endothelial dysfunction play key roles in the pathophysiology of HDP, leading to impaired placental perfusion, systemic inflammation, hypertension, and proteinuria. Serum uric acid, an oxidative stress marker, when interpreted in relation to serum creatinine as the uric acid-creatinine ratio (UACR), may overcome limitations of isolated measurements. The Neutrophil-lymphocyte ratio (NLR) reflects systemic inflammation. Both UACR and NLR have emerged as simple, inexpensive biomarkers.

Objectives: To evaluate the utility of UACR and NLR as accessible biomarkers for early detection and risk stratification of complications in hypertensive disorders of pregnancy.

Methodology: This cross-sectional study included 82 pregnant women attending a tertiary care center between April and September 2023: 30 normotensive controls, 27 with gestational hypertension, and 25 with preeclampsia. Serum uric acid and creatinine were measured using enzymatic uricase and Jaffe’s methods, respectively. NLR was calculated from complete blood counts. Statistical analysis comprised ANOVA, correlation analysis, and receiver operating characteristic (ROC) curves.

Results: Both UACR and NLR were significantly higher in gestational hypertension and preeclampsia compared with controls (p <0.001), with the highest levels observed in preeclampsia. UACR showed strong positive correlations with systolic blood pressure (r = 0.68) and proteinuria (r = 0.59), while NLR demonstrated similar associations. ROC analysis showed good discriminatory ability for preeclampsia (AUC: 0.82 for UACR; 0.88 for NLR).

Conclusions: UACR and NLR are simple, cost-effective biomarkers reflecting oxidative stress and inflammation in HDP. Their combined use may enhance early detection, risk stratification, and timely clinical intervention.

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