Maternal Neutrophil-to-Lymphocyte Ratio Predicts Preterm Birth after Cerclage in Women with Cervical Insufficiency

Objective: To define factors associated with spontaneous preterm delivery at < 34 weeks of gestation after cerclage in women with cervical insufficiency.

Materials and methods: We performed a retrospective study of women with known pregnancy outcomes who underwent emer-gency or urgent cerclage between March 2016 and April 2017. Pregnancy outcomes were analyzed using logistic regression analyses to identify risk factors predictive of spontaneous preterm delivery (< 34 weeks of gestation).

Results: A total of 68 women receiving cerclage were included in this study, of which 19 (27.9%) experienced preterm birth (< 34 weeks). Logistic regression analyses identified a high maternal neutrophil-to-lymphocyte ratio (NLR) in serum, preoperative short-ening of the cervix, and early gestational age at cerclage as risk factors for spontaneous preterm delivery following cerclage.

Conclusion: High preoperative NLR was associated with increased risk for preterm delivery. NLR may serve as a noninvasive, cost-effective predictor of spontaneous preterm delivery after cerclage.