Complete blood count parameters, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio in hydatidiform mole versus missed abortion

Objective : Molar pregnancy is the most common type of gestational trophoblastic disease. Gestational trophoblastic disease is characterized by lower absolute and relative lymphocyte levels and a lower white blood cell (WBC) count relative to normal pregnancy. However, no studies have examined the WBC count relative to missed abortion. The aim of this study was to investigate whether blood parameters, such as neutrophil and lymphocyte counts, the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), WBC count and platelets can distinguish gestational trophoblastic disease from missed abortion. Methods : This retrospective study included 104 women diagnosed with molar pregnancy and 110 women with missed abortions during 2010–2020 at one institution. Sixty-nine women had partial moles (PM) and 35 had complete moles (CM). We extracted and compared maternal and pregnancy characteristics, and laboratory parameters of all the women with molar pregnancy, and separately for those with PM and CM, compared to women with missed abortion. Results : The mean neutrophil level was higher in the molar pregnancy than the missed abortion group (5.67 ± 1.92 vs. 5.02 ± 1.65, p = 0.013); the patients with PM largely drove this difference. In multivariable linear models, women with molar pregnancy were more likely to have higher neutrophil values than women with missed abortion ( p = 0.023). Platelet, WBC, NLR and PLR values did not differ significantly between women with gestational trophoblastic disease and women with missed abortion. Conclusions : A higher neutrophil level was observed among women with molar pregnancies than among women with missed abortion. This suggests that molar pregnancies may cause a higher inflammatory response due to continued trophoblastic growth. However, the magnitude of the difference was small and not useful for establishing a diagnosis.