Diagnostic value of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio to predict recurrent pregnancy loss and abortion; a systematic review and meta-analysis

ObjectiveThis systematic review and meta-analysis aimed to evaluate the diagnostic value of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in women with a history of abortion (missed and threatened) and recurrent pregnancy loss (RPL) in comparison with healthy pregnancies.MethodsElectronic databases including MEDLINE, Scopus, Web of Science, Embase, and Cochrane Library were searched for NLR and PLR in women who experienced early pregnancy loss up to January 1, 2023 with a combination of proper keywords. Meta-analysis was done for comparison with three or more studies and summary estimates were measured.ResultsA total of 390 citations were retrieved initially, and after screening, 16 articles were deemed eligible for the final review. Among these, 14 studies underwent meta-analysis. The meta-analysis revealed that the standard mean of the NLR was significantly higher in abortion cases compared to the control group. However, there was no significant difference in the PLR between the pregnancy loss group and the control group.ConclusionNLR was significantly higher among RPL patients compared to the control group, according to these data, NLR may be capable of being used in the diagnosis of RPL as an easy, cheap, and accessible modality. Further studies, which take these variables into account, will need to be undertaken to determine the diagnostic value of NLR and PLR in early pregnancy loss. In a review of 16 eligible articles, meta-analysis showed that the standard mean of the neutrophil-to-lymphocyte ratio (NLR) was significantly higher in cases of abortion compared to the control group. However, there was no significant difference in the platelet-to-lymphocyte ratio (PLR) between the pregnancy loss group and the control group. These findings suggest that NLR may have potential as an accessible and cost-effective diagnostic tool for recurrent pregnancy loss (RPL), but further studies considering additional variables are needed to determine the diagnostic value of NLR and PLR in early pregnancy loss. image