Publication:

Serum β-hCG and neutrophil lymphocyte ratio in early second trimester of pregnancy and prediction of pre-eclampsia

Background Hypertensive disorders, especially preeclampsia (PE), continues to challenge obstetric care, contributing substantially to maternal and perinatal morbidity and mortality. Reliable biomarkers for early prediction are needed. Biomarkers such as serum beta-human chorionic gonadotropin (β-hCG) and neutrophil-to-lymphocyte ratio (NLR) are emerging as potential tools for early risk stratification.

Methods This prospective observational study included 86 pregnant women attending antenatal care at a tertiary care hospital. Serum β-hCG and NLR were measured between 13-20 weeks of gestation, and participants were followed until delivery. The development of PE was recorded, and associations with biochemical and clinical parameters were analysed using t tests, chi-square tests, and ROC curves.

Results Of the 86 participants, 17.4% developed PE. Mean serum β-hCG was significantly higher in the PE group (60719 mIU/ml) vs. normotensive group (24952 mIU/ml, p=0.002)). MeanNLR was also elevated in PE (4.409) compared to normotensive women (3.010, p=0.002). A β-hCG cut-off of 57213 mIU/ml had a specificity of 93% for predicting PE. Higher BMI and multigravidity were significantly associated with PE (p=0.049 and p=0.029, respectively). PE was linked with earlier gestational age at delivery (35.13 vs. 37.56 weeks, p=0.013) and lower birth weight (2.53 kg vs. 2.93 kg, p=0.019).

Conclusions Elevated second-trimester β-hCG and NLR, are significantly associated with an increased risk of PE. These accessible and cost-effective markers can aid in the early identification of high-risk pregnancies, allowing for timely interventions to improve maternal and foetal outcomes.