ArticleInternational journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics2026
Neutrophil-to-lymphocyte ratio at admission helps to predict the need for blood transfusion after vaginal delivery.
Article in International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Abstract
objectiveThis study assesses the association between complete blood count (CBC) parameters, including the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) and predicts the need for postpartum packed red blood cell transfusion (pRBCT).
methodsThis retrospective cohort study was conducted at a tertiary, university-affiliated medical center with approximately 12 500 annual deliveries (2012-2023). Women requiring postpartum pRBCT were identified based on criteria including severe hemorrhage, symptomatic anemia with hemoglobin (Hb) levels of 7-8 g/dL, or severe anemia (Hb <7 g/dL). Maternal demographics, admission complete blood count (CBC), and delivery outcomes were analyzed. Multivariable logistic regression identified independent predictors of pRBCT, and a risk score was developed and evaluated using receiver operating characteristic (ROC) analysis.
resultsAdmission CBC data were available for 37 631 vaginal deliveries, of which 957 (2.5%) required pRBCT. Risk factors for pRBCT included nulliparity, previous cesarean, assisted reproductive technology conception and intrapartum fever. Protective factors included spontaneous labor onset, body mass index >30, and admission hematocrit >40%. Key CBC independent predictors included Hb <11 g/dL (adjusted odds ratio [aOR] 5.70, 95% confidence interval [CI] 4.79-6.79), and NLR >5 (aOR 1.28, 95% CI 1.02-1.60). The scoring model, with a clinical cutoff of 5, predicted pRBCT with an area under the curve of 0.77 (95% CI 0.75-0.79, P < 0.001).
conclusionAdmission CBC parameters, particularly NLR and Hb, alongside maternal factors, might help predict pRBCT in vaginal deliveries.
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