Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Sep;132(10):1454-1459.
doi: 10.1111/1471-0528.18208. Epub 2025 May 8.

Neutrophil-To-Lymphocyte Ratio and Delivery Within 24 h in Preterm Premature Rupture of Membranes: A Retrospective Cohort Study

Daniel Gabbai  1 , Itamar Gilboa  1 , Anat Lavie  1 , Yariv Yogev  1 , Emmanuel Attali  1
Affiliations

Neutrophil-To-Lymphocyte Ratio and Delivery Within 24 h in Preterm Premature Rupture of Membranes: A Retrospective Cohort Study

Daniel Gabbai et al. BJOG. 2025 Sep.

Abstract

Objective: To evaluate the association between maternal neutrophil-to-lymphocyte ratio (NLR) and delivery within 24 h in women with preterm premature rupture of membranes (PPROM).

Study design and setting: Retrospective cohort study in a single university-affiliated tertiary medical centre.

Population: Women with PPROM at ≤ 36 + 6 weeks' gestation planning vaginal delivery. Exclusions included women who lacked complete blood count (CBC) data within the first 24 h from PPROM caesarean delivery.

Methods: Maternal demographic and clinical data, including age, gestational age, body mass index, parity and mode of conception, were collected. Women who delivered within 24 h of membrane rupture were compared to those who did not via univariate and multivariate Cox analyses.

Main outcome measure: Women who delivered within 24 h from rupture of membrane.

Results: Among 145 833 deliveries during the study period, 1498 women (0.9%) presented with PPROM. After exclusions, 371 women were included, with 173 (46.6%) delivering spontaneously within 24 h. Cox regression analysis identified NLR > 10 (HR = 1.60; 95% CI, 1.06-2.40; p = 0.025) as an independent risk factor for spontaneous delivery within 24 h.

Conclusion: Elevated maternal NLR is associated with delivery within 24 h in PPROM and may support clinical assessment for anticipating imminent preterm delivery, aiding in management decisions for this population.

Keywords: NLR; PPROM; delivery; risk factors.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Study population.
FIGURE 2
FIGURE 2
Cox proportional hazards model.
See this image and copyright information in PMC

References

    1. ACOG Practice Bulletin No. 188 Summary: Prelabor Rupture of Membranes,” Obstetrics & Gynecology 131, no. 1 (2018): 187–189. - PubMed
    1. Practice Bulletin No. 160 Summary: Premature Rupture of Membranes,” Obstetrics and Gynecology 127, no. 1 (2016): 192–194. - PubMed
    1. Helmer H., “Continuing Challenges in Treating Preterm Labour: Preterm Prelabour Rupture of the Membranes,” BJOG: An International Journal of Obstetrics and Gynaecology 113, no. Suppl 3 (2006): 111–112. - PubMed
    1. Linehan L. A., Walsh J., Morris A., et al., “Neonatal and Maternal Outcomes Following Midtrimester Preterm Premature Rupture of the Membranes: A Retrospective Cohort Study,” BMC Pregnancy and Childbirth 16 (2016): 25. - PMC - PubMed
    1. Practice Bulletin No. 159 Summary: Management of Preterm Labour,” Obstetrics and Gynecology 127, no. 1 (2016): 190–191. - PubMed

LinkOut - more resources