Can Delta Neutrophil Index Predict The Superimposed Preeclampsia?

INTRODUCTION: We aimed to determine the utility of delta neutrophil index(DNI) in predicting superimposed preeclampsia (SPE) in chronic hypertensive pregnant women.
METHODS: The study included pregnant women diagnosed with chronic hypertension. SPE group was defined as developing acute or worsening hypertension, new-onset proteinuria, and/or significant new end-organ dysfunction after 20 weeks of gestation in a pregnant woman with chronic hypertension. Demographic variables such as maternal age, gravidity, parity, previous history of abortus, gestational age at SPE, birth week, birth weight, and Apgar scores were obtained from medical records. First-trimester laboratory parameters, including maternal aspartate transaminase (AST), alanine transaminase (ALT), platelets, and delta neutrophil index (DNI), 24-hour urine proteinuria level were assessed.
RESULTS: A total of 203 pregnant women with chronic hypertension were included in the study. Eighty-three of them were complicated by SPE. There were statistically significant differences in 24-hour proteinuria levels, the gestational week at birth, birth weight, and Apgar score at 1 minute and 5 minutes in the groups with and without SPE. In addition, the median DNI values were higher in the SPE group (p= <.001). The optimal cut-off value of DNI was 0.15 (76.1% sensitivity, 96.7% specificity, p= <.001). While DNI showed a weak positive correlation with the week patients were diagnosed with SPE (r =.223, p=.043), no significant correlation was found with the level of proteinuria (r =-.113, p=.318).
DISCUSSION AND CONCLUSION: DNI can be used in predicting superimposed preeclampsia in addition to other parameters when used in the first trimester.