Comparison of inflammatory markers in women experiencing both missed abortion and healthy pregnancy: A...

Missed abortion (MA) is a form of spontaneous abortion in which the embryo has died, but the body fails to recognize the pregnancy loss and continues hormone production, accounting for approximately 15% of clinically diagnosed pregnancies. The aim of this study was to compare inflammatory markers measured between 6 and 18 weeks of gestation in the same women during 2 different pregnancies: one that resulted in MA and another that resulted in a healthy birth.

In this retrospective cohort study, medical records from 2016 to 2024 were reviewed. From 350 women with documented MA history, 300 were excluded (280 due to unavailable data from healthy pregnancies, 5 with thyroid disease, 3 with multiple gestations, 5 with coagulation disorders, 5 with chronic conditions, and 2 with fetal chromosomal abnormalities), resulting in 50 eligible participants. The study compared several inflammatory markers (neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, eosinophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, and systemic immune-inflammation index) between women with miscarriage and those with healthy pregnancies during the first and early second trimesters (6-18 weeks of gestation).

In the 50 women included in the study, hemoglobin levels were significantly higher in healthy pregnancies (12.6 g/dL in healthy pregnancy vs 12.05 g/dL in MA; P = .003). Platelet distribution width was also significantly higher in healthy pregnancy (15.60% vs 12%; P = .001). Similarly, eosinophil percentage was significantly higher in healthy pregnancy compared to MA (1.7% vs 1.15%; P = .047). However, inflammatory indices such as neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, eosinophil-to-lymphocyte ratio, and systemic immune-inflammation index did not show statistically significant differences between both pregnancy states (P > .05). The ROC curve analysis showed that hemoglobin had the highest diagnostic performance (area under the curve = 0.72) with a sensitivity of 68%, specificity of 62%, positive predictive value of 64%, and negative predictive value of 66% at the optimal cutoff value of 12.3 g/dL.

This study reveals that many inflammatory markers do not differ significantly between MA and healthy pregnancy in the same women. These findings suggest that inflammatory markers may be of limited value in predicting MA when individual variability is taken into account.