Evaluation of the Neutrophil Percentage Albumin Ratio (NPAR) Index in Predicting the Severity of Hyperemesis Gravidarum

Authors : Burcu Bozkurt Özdal, Dilek Sahin
Pages : 449-454
Doi:10.38136/jgon.1820089
View : 32 | Download : 88
Publication Date : 2026-01-03
Article Type : Research Paper
Abstract :Abstract Aim The aim of this study is to investigate the effect of the neutrophil percentage to albumin ratio (NPAR) index in determining the severity of hyperemesis gravidarum in patients diagnosed with this condition. Material and Methods In a retrospective, single-center study, pregnant women diagnosed with HEG between January 2024 and November 2025 at the Perinatology Department of Ankara City Hospital were included. NPAR was calculated by dividing the neutrophil percentage by the albumin value. HEG severity was classified as mild, moderate, or severe using the modified PUQE-24 scoring system. The Kolmogorov-Smirnov and Shapiro-Wilk tests were used to assess the normality of data distribution. Group comparisons were performed using the Kruskal-Wallis test. ROC analysis was performed for NPAR to predict HEG severity; p<0.05 was considered significant. Results A total of 160 HEG patients were included in the study: mild n=80, moderate n=40, severe n=40. No differences were found between groups in BMI, gestational age, and other parameters; however, hospital stay, and PUQE-24 scores were significantly higher in the severe HEG group. Both the neutrophil percentage and NPAR were significantly higher in the severe HEG group (p=0.01 and p=0.009). In the ROC analysis, the best cutoff value for NPAR was found to be 1.77; sensitivity was 70%, specificity was 68%, and AUC was 0.675 (p=0.005). Conclusion NPAR showed a statistically significant correlation in predicting HEG severity and partially distinguished between mild and severe HEG; however, its limited performance, with an AUC of 0.675, indicates that NPAR alone is not sufficient for clinical decision-making. These findings suggest that NPAR may provide additional information when used with PUQE-24 and necessitate validation through prospective/multicenter studies.
Keywords : Hiperemezis gravidarum, NPAR, Şiddet

ORIGINAL ARTICLE URL