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SYSTEMATIC REVIEW article

Front. Med.

Sec. Obstetrics and Gynecology

Volume 12 - 2025 | doi: 10.3389/fmed.2025.1565979

The predictive value of neutrophil to lymphocyte ratio for abortion:A systematic review and meta-analysis

Provisionally accepted
Mi  WangMi Wang1Rui  YueRui Yue1Jun  XiJun Xi2Fang  YanFang Yan1*
  • 1Department of Blood Transfusion,Xi’an No.3 Hospital,the Affiliated Hospital of Northwest University, Xi'an, China
  • 2Medical laboratory, XD Group Hospital, Xi'an, China

The final, formatted version of the article will be published soon.

Background: Abortion usually refers to the loss of pregnancy before viability. Despite a potential link between neutrophil-lymphocyte ratio(NLR) levels and abortion, inconclusive findings remain. This review aimed to comprehensively appraise the predictive utility of NLR levels in abortion, offering a new approach to clarify its potential role as a biomarker. Methods: PubMed and Cochrane Library were searched for relevant cohort and case-control studies until September 2024. Odds ratio (OR) or weighted mean difference(WMD) with 95% CI of abortion were computed. Subgroup analyses were implemented to clarify potential sources of heterogeneity. Results: Higher NLR levels were linked to an enhanced risk of abortion as a continuous (WMD, 0.58; 95% CI: 0.29, 0.88) and dichotomous variable (OR, 1.33; 95% CI: 1.03, 1.72). In subgroup analyses, pooled results from studies with NLR cut-off>3, Asia populations, missed abortion, spontaneous abortion, and mean age>30 demonstrated an increased risk of abortion. In continuous NLR for predicting abortion, retrospective study, Europe populations, threatened abortion, recurrent pregnancy loss, and abortion had an enhanced risk of abortion for higher NLR levels as a dichotomous variable. Conclusion: Pooled analyses demonstrated that higher NLR levels may predict abortion. Further investigations need to determine whether these findings can be generalized to all populations.

Keywords: Neutrophil to lymphocyte ratio, Abortion, Pregnancy, prognosis, NLR

Received: 05 Jun 2025; Accepted: 04 Sep 2025.

Copyright: © 2025 Wang, Yue, Xi and Yan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Fang Yan, Department of Blood Transfusion,Xi’an No.3 Hospital,the Affiliated Hospital of Northwest University, Xi'an, China

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