DOI QR코드

DOI QR Code

Efficacy of Serum Neutrophil-to-Lymphocyte Ratio for Meconium Aspiration Syndrome

  • Jo, Chae-Ku (Department of Pediatrics, Dong-A University College of Medicine) ;
  • Kang, Sung-Min (Department of Pediatrics, Dong-A University College of Medicine) ;
  • Lee, Sun-Young (Department of Pediatrics, Dong-A University College of Medicine) ;
  • Kim, Myo-Jing (Department of Pediatrics, Dong-A University College of Medicine)
  • Received : 2017.06.13
  • Accepted : 2018.08.26
  • Published : 2018.12.31

Abstract

Objective: To evaluate the relationship between serum neutrophil-to-lymphocyte ratio (NLR) and severity of meconium aspiration syndrome (MAS). Methods: We retrospectively analyzed 197 neonates who admitted for MAS between 2008 and 2016 at the neonatal intensive care unit of Dong-A University Hospital. The serial changes of NLR were analyzed from 1st to 3rd day of life. The NLR was compared by disease severities (non-invasive respiratory care group vs. invasive respiratory care group and MAS with or without persistent pulmonary hypertension of the newborn [PPHN]). Results: The NLR values from 1st to 3rd day of life significantly increased and then decreased (P=0.031). The NLR of invasive respiratory care group was significantly higher than non-invasive respiratory care group at 2nd, 3rd, and average of 1 to 3 days of life. The NLR of PPHN group was significantly higher than without PPHN group at 3rd, and average of 1 to 3 days of life. Conclusion: The NLR was significantly increased and then decreased in early stage of MAS and associated with the severity of MAS.

Keywords

References

  1. Lindenskov PH, Castellheim A, Saugstad OD, Mollnes TE. Meconium aspiration syndrome: possible pathophysiological mechanisms and future potential therapies. Neonatology 2015;107:225-30. https://doi.org/10.1159/000369373
  2. Lee EC, Choi MG, Shim GH, Song YH, Chey MJ. Comorbid risk factors of persistent pulmonary hypertension of the newborn in infants with meconium aspiration syndrome. Neonatal Med 2014;21:166-71. https://doi.org/10.5385/nm.2014.21.3.166
  3. Singh SN, Srivastava R, Singh A, Tahazzul M, Kumar M, Kanta C, et al. Respiratory distress including meconium aspiration syndrome in vigorous neonates born through meconium stained amniotic fluid: incidence, onset, severity and predictors at birth. Indian J Pediatr 2013;80: 583-43.
  4. Louis D, Sundaram V, Mukhopadhyay K, Dutta S, Kumar P. Predictors of mortality in neonates with meconium aspiration syndrome. Indian Pediatr 2014;51:637-40. https://doi.org/10.1007/s13312-014-0466-0
  5. Wiswell TE. Handling the meconium-stained infant. Semin Neonatol 2001;6:225-31. https://doi.org/10.1053/siny.2001.0051
  6. Vidyasagar D, Lukkarinen H, Kaapa P, Zagariya A. Inflammatory response and apoptosis in newborn lungs after meconium aspiration. Biotechnol Prog 2005;21:192-7.
  7. de Beaufort AJ, Bakker AC, van Tol MJ, Poorthuis BJ, Schrama AJ, Berger HM. Meconium is a source of pro-inflammatory substances and can induce cytokine production in cultured A549 epithelial cells. Pediatr Res 2003;54:491-5. https://doi.org/10.1203/01.PDR.0000082017.97479.39
  8. Mokra D, Mokry J. Glucocorticoids in the treatment of neonatal meconium aspiration syndrome. Eur J Pediatr 2011;170:1495-505. https://doi.org/10.1007/s00431-011-1453-2
  9. Hofer N, Jank K, Strenger V, Pansy J, Resch B. Inflammatory indices in meconium aspiration syndrome. Pediatric Pulmonology 2016;51:601-6. https://doi.org/10.1002/ppul.23349
  10. Dargaville PA. Respiratory support in meconium aspiration syndrome: a practical guide. Int J Pediatr 2012;23:965159.
  11. Castellheim A, Lindenskov PH, Pharo A, Aamodt G, Saugstad OD, Mollnes TE. Meconium aspiration syndrome induces complement-associated systemic inflammatory response in newborn piglets. Scand J Immunol 2005;61:217-25. https://doi.org/10.1111/j.1365-3083.2005.01532.x
  12. Gupta GK, Cole CH, Abbasi S, Demissie S, Njinimbam C, Nielsen HC, et al. Effects of early inhaled beclomethsone therapy on tracheal aspirate inflammatory mediators IL-8 and IL-1ra in ventilated preterm infants at risk for bronchopulmonary dysplasia. Pediatr Pulmonol 2000;30:275-81. https://doi.org/10.1002/1099-0496(200010)30:4<275::AID-PPUL1>3.0.CO;2-G
  13. Hofer N, Zacharias E, MullerW, Resch B. An update on the use of C- reactive protein in early-onset neonatal sepsis: current insights and new tasks. Neonatology 2012;102:25-36. https://doi.org/10.1159/000336629
  14. Bhandari V. Effective biomarkers for diagnosis of neonatal sepsis. J Pediatric Infect Dis Soc 2014;3:234-45. https://doi.org/10.1093/jpids/piu063
  15. Wu Y, Chen Y, Yang X, Chen L, Yang Y. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were associated with disease activity in patients with systemic lupus erythematosus. Int Immunopharmacol 2016;36:94-9. https://doi.org/10.1016/j.intimp.2016.04.006
  16. Guthrie GJ, Charles KA, Roxburgh CS, Horgan PG, McMillan DC, Clarke SJ. The systemic inflammation-based neutrophil-lymphocyte ratio: experience in patients with cancer. Crit Rev Oncol Hematol 2013;88:218-30. https://doi.org/10.1016/j.critrevonc.2013.03.010
  17. Walsh SR, Cook EJ, Goulder F, Justin TA, Keeling NJ. Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol 2005;91:181-4. https://doi.org/10.1002/jso.20329
  18. Tamhane UU, Aneja S, Montgomery D, Rogers EK, Eagle KA, Gurm HS. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol 2008;102:653-7. https://doi.org/10.1016/j.amjcard.2008.05.006
  19. Templeton AJ, Ace O, McNamara MG, Al-Mubarak M, Vera-Badillo FE, Hermanns T, et al. Prognostic role of platelet to lymphocyte ratio in solid tumors: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev 2014;23:1204-12. https://doi.org/10.1158/1055-9965.EPI-14-0146
  20. Lee JY, Park KH, Kim A, Yang HR, Jung EY, Cho SH. Maternal and placental risk factors for developing necrotizing enterocolitis in very preterm infants. Pediatr Neonatol 2017;58:57-62. https://doi.org/10.1016/j.pedneo.2016.01.005
  21. Akgun N, Namli Kalem M, Yuce E, Kalem Z, Aktas H. Correlations of maternal neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) with birth weight. J Matern Fetal Neonatal Med 2017; 30:2086-91. https://doi.org/10.1080/14767058.2016.1237497
  22. Kurtul BE, Kabatas EU, Zenciroglu A, Ozer PA, Ertugrul GT, Beken S, et al. Serum neutrophil-to-lymphocyte ratio in retinopathy of prematurity. J AAPOS 2015;19:327-31. https://doi.org/10.1016/j.jaapos.2015.04.008
  23. Lee J, Dammann O. Perinatal infection, inflammation, and retinopathy of prematurity. Semin Fetal Neonatal Med 2012;17:26-9. https://doi.org/10.1016/j.siny.2011.08.007