The Role of the Delta Neutrophil Index in Determining the Severity of Intrahepatic Cholestasis of Pregnancy.

OBJECTIVE

This study aimed to investigate the clinical utility of the delta neutrophil index (DNI) in distinguishing patients with intrahepatic cholestasis of pregnancy (ICP) from healthy pregnant women, and to assess its potential role in evaluating disease severity.

METHODS

This retrospective analysis included data from 249 pregnant women. Among them, 131 were identified with ICP, based on clinical symptoms and total bile acid levels ≥10 μmol/L. The remaining 118 participants served as healthy controls. The ICP cases were categorized into mild (TBA 10-39 μmol/L; n = 90) and severe (TBA ≥ 40 μmol/L; n = 41) subgroups. Demographic data, routine blood parameters, and DNI values were evaluated across the groups.

RESULTS

The ICP group demonstrated significantly elevated white blood cell (WBC) counts, neutrophil counts, immature granulocyte (IG) levels, DNI values, and neutrophil-to-lymphocyte ratio (NLR) compared to controls (p < 0.05 for all). Both mild and severe ICP subgroups exhibited higher IG, DNI, and NLR than controls. Furthermore, DNI and IG values significantly differed between mild and severe ICP cases. Receiver operating characteristic (ROC) analysis revealed high diagnostic performance for both DNI (cut-off: 0.65; sensitivity: 82.4%; specificity: 78%) and IG (cut-off: 0.06; sensitivity: 77.1%; specificity: 82.2%).

CONCLUSION

The DNI levels were markedly elevated in ICP and varied with disease severity, suggesting its potential as a noninvasive marker for both diagnosis and risk stratification.