Relationship between aggregate index of systemic inflammation with miscarriage and pregnancy complications

This study aimed to investigate the association between the aggregate index of systemic inflammation (AISI), a novel indicator of inflammation, miscarriage, and other pregnancy complications in patients with threatened miscarriage.

This retrospective observational study analyzed 166 singleton pregnant women who experienced threatened miscarriage. Demographic data, complete blood count parameters, complications, gestational age, birth weight, Apgar scores, and neonatal intensive care admission were examined. The participants were divided into two groups: miscarriage (n = 55) or ongoing pregnancy (n = 111). Ongoing pregnancies were further categorized as complicated (n = 59) or uncomplicated (n = 52). AISI was calculated using the following formula: neutrophil × platelet × monocyte / lymphocyte.

In the miscarriage group, white blood cell count, monocyte, and platelet levels were significantly higher, whereas neutrophil and lymphocyte counts did not differ significantly. AISI was significantly higher in women who experienced miscarriage. Threatened miscarriage was diagnosed at earlier gestational ages in women who subsequently experienced miscarriage. AISI predicted miscarriage, with an optimal cut-off value of 414.63, 72.7% sensitivity and 57.3% specificity. Complications were common in ongoing pregnancies. The AISI values measured at the time of first hospital admission did not differ significantly between complicated and uncomplicated pregnancies; however, gestational age at delivery, birth weight, and APGAR scores were significantly lower in complicated pregnancies.

The AISI calculated from the hemogram parameters, is a simple, inexpensive, repeatable, and easily accessible index that may serve as a supportive tool in clinical decision-making and risk stratification for miscarriage.