Hubungan Nilai Rasio Neutrofil Limfosit dengan Kejadian Ketuban Pecah Dini Preterm

https://doi.org/10.22146/jkr.95144

Aldila Geri Istantina(1*), Ahsanudin Attamimi(2), Diah Rumekti Hadiati(3)

(1) PPDS 1 Obstetri dan Ginekologi FKKMK UGM
(2) Departemen Obstetri dan Ginekologi FKKMK UGM
(3) Departemen Obstetri dan Ginekologi FKKMK UGM
(*) Corresponding Author

Abstract


Latar Belakang: Di Indonesia, insidensi ketuban pecah dini, juga dikenal sebagai PPROM (preterm premature membranes rupture), mencapai 4,5% dari seluruh komplikasi kehamilan. Kondisi ini meningkatkan risiko infeksi intraamniotik sebesar lima belas hingga tiga puluh lima persen dan infeksi pascapersalinan sebesar lima belas hingga dua puluh lima persen. Sekitar 60% kasus ketuban pecah dini preterm disebabkan oleh infeksi bakteri ascending, yang meningkatkan mortalitas dan morbiditas ibu dan bayi. Dalam kasus ketuban pecah dini preterm, respons inflamasi pada chorion dan amnion menyebabkan pelepasan sitokin yang lebih besar, yang ditandai dengan peningkatan jumlah neutrofil. Rasio neutrofil-limfosit merupakan ukuran penting dari status inflamasi.

Tujuan: Tujuan penelitian ini adalah untuk melihat bagaimana rasio neutrofil-limfosit dan insidensi ketuban pecah dini preterm berhubungan satu sama lain.

Metode: Studi cross-sectional ini melibatkan ibu hamil 37 minggu atau lebih yang memenuhi kriteria inklusi dan eksklusi di RSUP Dr. Sardjito Yogyakarta antara 1 Januari 2018 dan 31 Desember 2021.

Hasil: Menurut hasil penelitian terhadap delapan puluh pasien, nilai AUC (area di bawah kurva) sebesar 0,902 menunjukkan bahwa kemampuan untuk memprediksi rasio neutrofil-limfosit (RNL) terhadap kejadian ketuban pecah dini (KPD) preterm mencapai 90,2%. Nilai titik cut-off RNL lebih dari 3,55 menunjukkan nilai sensitivitas, spesifisitas, NPP, NPN, akurasi, dan indeks Youden optimal. Nilai RNL = 3,55 ditetapkan Dengan nilai p = 0,001 dan risiko relatif (RP, 95% CI) = 12,667 (3,285–48,847), hasil penelitian menunjukkan hubungan yang signifikan secara statistik maupun klinis antara RNL dan kejadian KPD preterm.

Kesimpulan: Hasil penelitian menunjukkan bahwa pada usia kehamilan yang setara, pasien dengan KPD preterm memiliki nilai RNL 12,6 kali lebih tinggi daripada pasien tanpa KPD.


Keywords


RNL, Rasio Neutrofil Limpfosit, KPD preterm, Ketuban Pecah Dini preterm

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References

  1. Cunningham FG, Leveno KJ, Dashe JS, Hoffman BL, Spong CY, Casey BM, editors. Williams obstetrics. 26th edition. New York: McGraw Hill Medical; 2022.
  2. Zhan F, Zhu S, Liu H, Wang Q, Zhao G. Blood routine test is a good indicator for predicting premature rupture of membranes. Clinical Laboratory Analysis. 2019 Feb;33(2):e22673.
  3. Sakriawati M, Rahmawati R. Faktor risiko usia dan paritas ibu hamil terhadap kejadian ketuban pecah dini. Nurs Arts. 2021 Jan 28;14(2):90–7.
  4. Practice Bulletin No. 172: Premature Rupture of Membranes. Obstetrics & Gynecology. 2016 Oct;128(4):e165–77.
  5. Tsakiridis I, Mamopoulos A, Chalkia-Prapa EM, Athanasiadis A, Dagklis T. Preterm Premature Rupture of Membranes: A Review of 3 National Guidelines. Obstetrical & Gynecological Survey. 2018 Jun;73(6):368–75.
  6. Ozel A, Alici Davutoglu E, Yurtkal A, Madazli R. How do platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio change in women with preterm premature rupture of membranes, and threaten preterm labour? Journal of Obstetrics and Gynaecology. 2020 Feb 17;40(2):195–9.
  7. Swiatkowska-Freund M, Traczyk-Łos A, Partyka A, Obara K, Damdinsuren A, Preis K. Perinatal outcome in preterm premature rupture of membranes before 37 weeks of gestation. Ginekol Pol. 2019 Nov 28;90(11):645–50.
  8. Lakshmi MPAS, Sravani VL. Role of neutrophil-lymphocyte ratio in determining the outcomes of preterm premature rupture of membranes. Int J Reprod Contracept Obstet Gynecol. 2021 Mar 24;10(4):1617.
  9. Balciuniene G, Kvederaite-Budre G, Gulbiniene V, Dumalakiene I, Viliene R, Pilypiene I, et al. Neutrophil–lymphocyte ratio for the prediction of histological chorioamnionitis in cases of preterm premature rupture of membranes: a case-control study. BMC Pregnancy Childbirth. 2021 Dec;21(1):656.
  10. Kumar N, Nandula P, Menden H, Jarzembowski J, Sampath V. Placental TLR/NLR expression signatures are altered with gestational age and inflammation. The Journal of Maternal-Fetal & Neonatal Medicine. 2017 Jul 3;30(13):1588–95.
  11. Vakili S, Torabinavid P, Tabrizi R, Shojazadeh A, Asadi N, Hessami K. The Association of Inflammatory Biomarker of Neutrophil-to-Lymphocyte Ratio with Spontaneous Preterm Delivery: A Systematic Review and Meta-analysis. Andrukhov O, editor. Mediators of Inflammation. 2021 Feb 1;2021:1–7.
  12. Balta S, Ozturk C, Balta I, Demirkol S, Demir M, Celik T, et al. The Neutrophil–Lymphocyte Ratio and Inflammation. Angiology. 2016 Mar;67(3):298–9.
  13. Russell CD, Parajuli A, Gale HJ, Bulteel NS, Schuetz P, De Jager CPC, et al. The utility of peripheral blood leucocyte ratios as biomarkers in infectious diseases: A systematic review and meta-analysis. Journal of Infection. 2019 May;78(5):339–48.
  14. Huang Z, Fu Z, Huang W, Huang K. Prognostic value of neutrophil-to-lymphocyte ratio in sepsis: A meta-analysis. The American Journal of Emergency Medicine. 2020 Mar;38(3):641–7.
  15. Forget P, Khalifa C, Defour JP, Latinne D, Van Pel MC, De Kock M. What is the normal value of the neutrophil-to-lymphocyte ratio? BMC Res Notes. 2017 Dec;10(1):12.
  16. Kurtul BE, Ozer PA. The Relationship between Neutrophil-to-lymphocyte Ratio and Age-related Macular Degeneration. Korean J Ophthalmol. 2016;30(5):377.
  17. Karakaya S, Altay M, Kaplan Efe F, Karadağ İb, Ünsal O, Bulur O, et al. The Neutrophil-Lymphocyte Ratio and its Relationship with Insulin Resistance in Obesity. Turk J Med Sci [Internet]. 2019 Jan 17 [cited 2024 Mar 21]; Available from: https://journals.tubitak.gov.tr/medical/vol49/iss1/36
  18. Furuncuoğlu Y, Tulgar S, Dogan AN, Cakar S, Tulgar YK, Cakiroglu B. How obesity affects the neutrophil/lymphocyte and platelet/lymphocyte ratio, systemic immune-inflammatory index and platelet indices: a retrospective study. Eur Rev Med Pharmacol Sci. 2016 Apr;20(7):1300–6.
  19. Bahadir A, Baltaci D, Turker Y, Turker Y, Iliev D, Ozturk S, et al. Is the neutrophil-to-lymphocyte ratio indicative of inflammatory state in patients with obesity and metabolic syndrome? Anatol J Cardiol. 2015 Oct 14;15(10):816–22.
  20. Niehues T. C-reactive protein and other biomarkers—the sense and non-sense of using inflammation biomarkers for the diagnosis of severe bacterial infection. LymphoSign Journal. 2018 Jun 1;5(2):35–47.
  21. Thorsted A, Nielsen EI, Friberg LE. Pharmacodynamics of immune response biomarkers of interest for evaluation of treatment effects in bacterial infections. International Journal of Antimicrobial Agents. 2020 Sep;56(3):106059.
  22. Abebe Diriba T, Geda B, Jabessa Wayessa Z. Premature rupture of membrane and associated factors among pregnant women admitted to maternity wards of public hospitals in West Guji Zone, Ethiopia, 2021. International Journal of Africa Nursing Sciences. 2022;17:100440.
  23. Jang IY, Jung HJ, Sung JH, Choi SJ, Oh SY, Kim JS, et al. Do the Causes of Spontaneous Preterm Delivery Affect Placental Inflammatory Pathology and Neonatal Outcomes? Diagnostics. 2022 Sep 1;12(9):2126.
  24. Lee JH, Park CW, Moon KC, Park JS, Jun JK. Neutrophil to Lymphocyte Ratio in Maternal Blood: A Clue to Suspect Amnionitis. JCM. 2021 Jun 17;10(12):2673.



DOI: https://doi.org/10.22146/jkr.95144

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