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Relationship between combined systemic inflammatory indices with presence and severity of hyperemesis gravidarum
S B Yıldırım1, K I Ayaydın Yılmaz, N B Altuntaş
1Department of Obstetrics and Gynecology, Faculty of Medicine, Giresun University, Giresun, Turkey. iclal_itf@hotmail.com.
Insights
Systemic inflammation indices like the Systemic Inflammation Response Index (SIRI) are elevated in hyperemesis gravidarum (HG) and correlate with disease severity. SIRI demonstrates strong diagnostic potential for HG presence and severity.
Area of Science:
- Obstetrics and Gynecology
- Immunology
- Clinical Diagnostics
Background:
- Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting in pregnancy.
- Understanding the underlying inflammatory processes in HG is crucial for diagnosis and management.
Purpose of the Study:
- To determine systemic inflammation marker levels in HG patients.
- To investigate the association between these markers and HG severity.
- To evaluate their diagnostic potential for HG.
Main Methods:
- Compared 83 HG patients with 100 healthy pregnant controls.
- Calculated neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), Systemic immune-inflammation index (SII), Systemic Inflammation Response Index (SIRI), and Aggregate Systemic Inflammation Index (AISI).
- Grouped HG patients by severity using the Modified Pregnancy Unique Quantification of Emesis/Nausea (PUQE) score.
Main Results:
- NLR, PLR, SII, SIRI, and AISI were significantly higher in HG patients.
- These indices increased with HG severity.
- SIRI showed the highest diagnostic performance for HG presence (AUC: 0.695) and severity (AUC: 0.785).
Conclusions:
- Combined systemic inflammatory indices are associated with HG presence and severity.
- These indices serve as independent risk factors for HG.
- SIRI is the most powerful diagnostic tool for HG and its severity.
Objective:
Our study aims to determine the levels of systemic inflammation markers and the combined systemic inflammation indices in hyperemesis gravidarum (HG) patients and to investigate the association between the severity of the disease.
Patients And Methods:
The study population consisted of 83 pregnant women with HG and 100 healthy pregnant women matched for gestational age as a control group. We grouped the HG patients according to the Modified Pregnancy Unique Quantification of Emesis/Nausea (PUQE) scoring system as mild, moderate, and severe. We calculated the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), MPV-to-lymphocyte ratio (MPVLR), RDW-to-platelet ratio (RPR), Systemic immune-inflammation index (SII), Systemic Inflammation Response Index (SIRI), and Aggregate Systemic Inflammation Index (AISI).
Results:
NLR, PLR, SII, SIRI, and AISI levels were significantly higher in the HG group. These indices tended to increase as the severity of the disease increased. We found NLR, PLR, SII, SIRI, and AISI indices as the independent risk factors for the presence and severity of HG. The SIRI index, which has the highest area under the curve (AUC), sensitivity, and specificity values, was determined as the most powerful diagnostic tool in the diagnostic evaluation of the presence (AUC: 0.695; p < 0.001; sensitivity: 54%; specificity: 75%; cut-off: 3.14) and severity (AUC: 0.785; p < 0.001, sensitivity: 82%; specificity: 68%; cut-off: 2.74) of HG.
Conclusions:
Our study results showed that combined systemic inflammatory indices (NLR, PLR, SII, SIRI, and AISI) are associated and correlated with the presence and severity of HG. These indices are independent risk factors for the presence and severity of HG. Combined systemic inflammatory indices are diagnostic in determining the severity of HG. The SIRI index has the best diagnostic power for both the diagnosis of HG and the determination of the severity of HG.
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