Pre-op neutrophil-to-lymphocyte ratio and risk of headache after spinal anesthesia

Preoperative Neutrophil-to-Lymphocyte Ratio as a Predictor of Post-Dural Puncture Headache Following Cesarean Section Under Spinal Anesthesia

Observational Istinye University · NCT07075874

This project will test whether a simple blood-count ratio taken before cesarean with spinal anesthesia can help predict which women will get a post-dural puncture headache.

Quick facts

Study typeObservational
Enrollment821 (estimated)
Ages18 Years and up
SexFemale
SponsorIstinye University Academic / other
Locations1 site (Istanbul, Merkez Mahallesi)
Trial IDNCT07075874 on ClinicalTrials.gov

What this trial studies

This is an observational analysis of obstetric patients who had cesarean delivery under spinal anesthesia, using preoperative complete blood counts to calculate the neutrophil-to-lymphocyte ratio (NLR). Researchers will compare NLR values between patients who did and did not develop post-dural puncture headache (PDPH) using medical record follow-up. Patients with hematologic or active inflammatory conditions, abnormal coagulation, or missing pre-op CBC data are excluded. Statistical models will control for key factors such as age, elective versus emergency procedure, and intraoperative events to see if higher NLR is associated with increased PDPH risk.

Who should consider this trial

Good fit: Women aged 18 or older who undergo elective or emergency cesarean section under spinal anesthesia and have a complete preoperative CBC available, with no hematologic or active inflammatory disease, are ideal candidates.

Not a fit: Patients without preoperative CBC data, with hematologic malignancy or active infection/autoimmune disease, with abnormal coagulation, or who do not receive spinal anesthesia are unlikely to benefit from the study findings.

Why it matters

Potential benefit: If successful, the finding could give clinicians a low-cost preoperative marker to identify women at higher risk of PDPH so they can offer targeted counseling or preventive measures.

How similar studies have performed: Some prior research has linked systemic inflammatory markers to various postoperative outcomes, but using preoperative NLR specifically to predict PDPH is relatively novel and not yet well established.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Women aged 18 years or older
* Underwent elective or emergency cesarean section under spinal anesthesia
* Had complete preoperative complete blood count (CBC) data available
* No known hematological or inflammatory disease
* No intraoperative complications recorded
* Medical records accessible for postoperative follow-up regarding PDPH symptoms

Exclusion Criteria:

* Age under 18
* Absence of preoperative complete blood count data
* Presence of hematologic malignancy, active infection, autoimmune disease, or immunosuppressive therapy
* Platelet count \<150,000/mm³ or INR \>1.5
* Incomplete or missing medical records

Where this trial is running

Istanbul, Merkez Mahallesi

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Preoperative Neutrophil-to-Lymphocyte RatioPostdural Puncture Headache
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.