Neutrophil-to-lymphocyte ratio is associated with early cervical shortening after cerclage: a single-center cohort study integrating C-reactive protein

The study examined the relationship between pre-operative inflammatory markers (neutrophil-to-lymphocyte ratio and C-reactive protein) and cervical shortening after cerclage in 84 pregnant women. Results showed a linear correlation between the neutrophil ratio and cervical shortening (r = 0.61). Each one-unit increase in the neutrophil ratio was associated with an additional 0.09 mm per week of cervical shortening. Among women with high neutrophil ratio without atosiban treatment, preterm birth before 32 weeks occurred in 60% of cases, compared to 14.3% in those receiving atosiban. In women with low neutrophil ratio, no preterm birth occurred. The combination of both markers predicted significant cervical shortening with an accuracy of 0.81. The authors emphasize that these are preliminary observations requiring further prospective studies.