CC BY 4.0 · Journal of Child Science 2020; 10(01): e207-e211
DOI: 10.1055/s-0040-1720958
Original Article

Value of Neutrophil to Lymphocyte Ratio in Early Prediction of Meconium Aspiration Syndrome

Suzan Gad
1  Department of Pediatrics, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
Abeer Alkhalafawi
2  Department of Pediatrics, Ras Elkheima Hospital, Ras Elkheima, UAE
Syed Raza
3  Department of Pediatrics, Sheikh Khalifa Medical City, Ajman, UAE
Mervat Hesham
4  Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
Mohamed Sheta
5  Department of Pediatrics, Mansoura General Hospital, Mansoura, Egypt
› Author Affiliations
Funding None.


Meconium aspiration syndrome (MAS) is a serious neonatal condition. Prediction of MAS is challenging particularly in low-resource setting. Neutrophil to lymphocyte ratio (NLR) is a new simple index used for diagnosis of many inflammatory conditions. The present study was an attempt to determine whether NLR can predict the occurrence of MAS. The present study included 101 children with meconium-stained amniotic fluid. They comprised 22 patients who developed MAS and 79 neonates who didn't have the condition. All neonates were subjected to careful analysis of maternal and perinatal history in addition to thorough clinical assessment and radiological and laboratory evaluation. Blood samples from the umbilical cord were collected at birth and were used to obtain complete blood counts and C-reactive protein (CRP) assay. Univariate analysis revealed that elevated CRP levels, increased NLR, and 5-minute Apgar score of <7 were significant risk factors for the occurrence of MAS. Multivariate analysis revealed that low 5-minute Apgar score and increased NLR remained as significant risk factors of MAS. Receiver operating characteristic curve analysis showed good performance of NLR in prediction of MAS. NLR is useful in prediction of MAS in term neonates with meconium-stained amniotic fluid.

Publication History

Received: 13 July 2020

Accepted: 28 September 2020

Publication Date:
19 November 2020 (online)

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (

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