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Published on: June 29, 2013
Second-Trimester Inflammatory Markers in Predicting Fetal Growth Restriction: A Retrospective Analysis
Gizem Aktemur1, Betül Tokgöz Çakır1, Gülşan Karabay1
1Department of Obstetrics and Gynecology, Division of Perinatology, Ankara Etlik City Hospital, Ankara, Turkey.
Insights
Systemic immune-inflammation index (SII) and neutrophil-to-lymphocyte ratio (NLR) may help predict fetal growth restriction (FGR) in the second trimester. These inflammation markers, while not linked to adverse neonatal outcomes, show potential for early FGR detection.
Area of Science:
- Obstetrics and Gynecology
- Immunology
- Perinatal Medicine
Background:
- Fetal growth restriction (FGR) is a significant pregnancy complication associated with increased perinatal risks.
- Inflammation is a key factor in FGR pathophysiology, suggesting systemic inflammation markers could be predictive.
- Numerous inflammation indices exist, but their specific utility in FGR prediction requires further investigation.
Purpose of the Study:
- To evaluate the predictive value of various inflammation indices for FGR.
- To assess the association between these indices and adverse neonatal outcomes.
- To determine potential cut-off values for predicting FGR.
Main Methods:
- Retrospective analysis of 403 pregnant women (201 FGR, 202 controls) from August 2022 to May 2024.
- Calculation of multiple inflammation indices including SII, SIRI, PIV, NLR, PLR, MLR, LMR, MPR, AISI, SCII, and IG% from second-trimester blood samples.
- Comparison of index levels between FGR and control groups, and correlation with neonatal outcomes.
Main Results:
- Systemic immune-inflammation index (SII) and neutrophil-to-lymphocyte ratio (NLR) were significantly elevated in the FGR group compared to controls (p=0.020 and p=0.028).
- No significant correlation was found between SII, NLR, and adverse neonatal outcomes.
- Established cut-off values for SII (896) and NLR (3.91) demonstrated moderate sensitivity and specificity for FGR prediction.
Conclusions:
- Second-trimester SII and NLR may serve as valuable predictors for fetal growth restriction (FGR).
- These inflammatory markers did not correlate with adverse neonatal outcomes in this study.
- Further prospective research with larger cohorts is recommended to confirm the clinical utility of SII and NLR in FGR management.
Problem:
Fetal growth restriction (FGR) is a critical pregnancy complication linked to increased perinatal morbidity and mortality. Inflammation plays a key role in FGR's pathophysiology, and systemic inflammation markers may serve as predictors. This study evaluates the role of various inflammation indices; systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), pan-immune-inflammation value (PIV), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), lymphocyte-to-platelet ratio (LMR), monocyte-to-platelet ratio (MPR), aggregate systemic inflammation index (AISI), systemic coagulation inflammation index (SCII), and immature granulocyte percentage (IG%) in predicting FGR.
Methods Of Study:
This retrospective study included 403 pregnant women treated at Ankara Etlik City Hospital between August 2022 and May 2024. The study population comprised 202 women with uncomplicated pregnancies (control group) and 201 women diagnosed with FGR per the Delphi Consensus Criteria. Second-trimester blood samples were used to calculate the inflammatory indices.
Results:
SII and NLR levels were significantly higher in the FGR group compared to controls (p = 0.020, p = 0.028, respectively). However, no significant associations were found between these indices and adverse neonatal outcomes. Cut-off values for SII and NLR were 896 and 3.91, respectively, with moderate sensitivity and specificity.
Conclusions:
SII and NLR, measured in the second trimester, may be useful in predicting FGR. Although these indices did not correlate with adverse neonatal outcomes, further prospective studies with larger populations are needed to validate their clinical utility.
