| Objective To investigate the preoperative inflammatory indexes of pregnant women,such as the ratio of neutrophil to lymphocyte(NLR),the ratio of platelet to lymphocyte(PLR),the ratio of lymphocyte to monocyte(LMR)and the body mass index(BMI)in cervical cerclage(CC)to predict the clinical significance of preterm delivery.Methods From March 2009 to November 2019,156 cases of cervical incompetence diagnosed in obstetrics department of Yanbian University Affiliated Hospital and undergoing modified McDonald’s cerclage were selected.The clinical data of all the patients were collected,and the mothers who did not give birth in our hospital were followed up by telephone.128 cases of parturient with single fetus were selected according to the relevant conditions,among them,the control group(group A,n=63 cases),65 cases of parturient from 26 weeks to 36+6 weeks after operation,which were divided into intact group(group B,n=31 cases)and premature rupture group(Group C,n=34 cases).The correlation factors(height and weight)before pregnancy,preoperative ultrasound results,operation time and blood routine examination results were recorded.NLR,PLR and LMR were calculated.The gestational weeks,prolonged days and neonatal weight were recorded The clinical significance of correlation index in predicting preterm delivery after cervical cerclage was compared and analyzed under the same operation mode.Results(1)The gestational age of group B and group C was lower than that of group A,the gestational age of group C was lower than that of group B,with statistical difference(P<0.01),the neonatal weight of group B and group C was lower than that of group A,and the neonatal weight of group C was lower than that of group B,with statistical difference(P<0.01).(2)NLR and BMI of group B and C were higher than that of group A with statistical difference(P<0.05);NLR and BMI of group B and C had no statistical difference(P>0.05);PLR,LMR,NEU,LMY,PLT and MONO had no statistical significance(P>0.05)among group A,group B and group C.(3)NLR was negatively correlated with prolongation days,LMY,gestational age and LMR,positively correlated with NEU,gestational age,MONO and PLR;BMI was negatively correlated with prolongation days,neonatal weight and gestational age,positively correlated with NEU,LMY,PLT and MONO;PLR was negatively correlated with NEU,LMY and LMR,positively correlated with PLT;LMR was negatively correlated with gestational age and MONO,positively correlated with prolongation days,LMY and gestational age.(4)There were 65 cases of premature delivery and 63 cases of full-term delivery in 128 cases.There was no significant difference between the two groups(P>0.05).(5)The influencing factors of preterm delivery after cervical cerclage were BMI and NLR.Logistic regression showed that the risk of preterm delivery in patients with high NLR was 1.64 times higher than that in patients with low NLR(95%CI 1.175-2.291,P<0.01).The risk of preterm delivery after cervical cerclage in patients with high BMI was 1.209 times higher than that in patients with low BMI(95%CI,1.098-1.331,P<0.01).(6)NLR was 3.47,area under ROC was 0.654,sensitivity was 95.4%,specificity was 34.9%(P<0.05),BMI was 25.0,area under ROC was 0.714,sensitivity was 69.2%,specificity was 66.7%(P<0.05).Conclusion1.NLR and BMI before operation can be used as economic and simple reference indexes to predict preterm delivery after cervical cerclage.2.Preoperative NLR and BMI were negatively correlated with postoperative pregnancy days and gestational age,that is,the higher preoperative NLR and BMI,the lower postoperative pregnancy days and gestational age.3.PLR,LMR and operation time before operation have no significant reference value in predicting preterm delivery after cervical cerclage. |
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