Inflammatory Markers in Preeclampsia and Pregnancy Outcomes
Summary
Preeclampsia is a hypertensive disorder of pregnancy characterised by widespread endothelial dysfunction, placental malperfusion and aberrant maternal systemic inflammation. Emerging evidence has highlighted the role of innate immune activation and the release of pro-inflammatory cytokines in the pathogenesis of the condition. In affected women, leukocyte subsets show altered counts and activation states, while platelets may exhibit morphological changes reflecting systemic stress. Biomarker indices derived from routine blood counts, including ratios of neutrophils, lymphocytes and platelets, have gained traction as accessible indicators of subclinical inflammation. Concurrently, the balance between angiogenic and anti-angiogenic factors, notably soluble fms-like tyrosine kinase 1 and endoglin versus placenta growth factor, underpins the vascular complications of preeclampsia. Collectively, these inflammatory and angiogenic markers hold promise for early risk stratification, prognostic assessment and tailored monitoring of both maternal and foetal wellbeing. Application of such markers has the potential to improve global maternity care by guiding timely interventions and reducing adverse outcomes in diverse healthcare settings.
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Inflammatory Markers in Preeclampsia and Pregnancy Outcomes publication trend
The graph below shows the total number of articles in inflammatory markers in preeclampsia and pregnancy outcomes across all publications each year (not limited to Nature Index journals).
Technical terms
Systemic immune-inflammation index (SII): A composite marker calculated from neutrophil, lymphocyte and platelet counts to quantify systemic inflammatory status.
Neutrophil-to-lymphocyte ratio (NLR): The ratio of absolute neutrophil count to absolute lymphocyte count, reflecting innate versus adaptive immune balance.
Platelet-to-lymphocyte ratio (PLR): The ratio of platelet count to lymphocyte count, indicative of thrombocytic and inflammatory interplay.
Mean platelet volume (MPV): A measure of the average size of platelets, often elevated during platelet activation and inflammation.
Soluble fms-like tyrosine kinase 1 (sFlt-1): An anti-angiogenic protein that binds and neutralises vascular endothelial growth factor, contributing to endothelial dysfunction.
Soluble endoglin (sEng): A circulating form of endoglin that interferes with transforming growth factor-β signalling, promoting vascular injury in preeclampsia.
References
- Prognostic value of systemic immune-inflammation index in the diagnosis of preeclampsia. Heliyon (2024).
- First Trimester Mean Platelet Volume, Neutrophil to Lymphocyte Ratio, and Platelet to Lymphocyte Ratio Values Are Useful Markers for Predicting Preeclampsia. Ochsner Journal (2021).
- The elevation in circulating anti-angiogenic factors is independent of markers of neutrophil activation in preeclampsia. Angiogenesis (2012).
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