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Predictive Value of Inflammatory Indices for Preeclampsia and Adverse Perinatal Outcomes: A Retrospective
Hüseyin Kayaalp1, Sertaç Ayçiçek2
1Department of Obstetrics and Gynecology, Perinatology Unit, Ankara Bilkent City Hospital, University of Health Sciences, Ankara, Turkey.
Insights
Inflammation markers like SII, SIRI, and AISI can help predict preeclampsia (PE) and adverse perinatal outcomes. Third-trimester PLR and PMR are key predictors for adverse outcomes, while first-trimester NLR and PNR predict PE.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Perinatal Medicine
Background:
- Preeclampsia (PE) poses significant risks to both mother and fetus.
- Identifying reliable predictors for PE and adverse perinatal outcomes is crucial for improved management.
- Inflammation plays a key role in the pathophysiology of PE.
Purpose of the Study:
- To evaluate the predictive value of systemic inflammatory indices (SII, SIRI, AISI) for preeclampsia (PE).
- To assess the association of these inflammatory markers with composite adverse perinatal outcomes (CAPO) in patients with PE.
Main Methods:
- Retrospective case-control study involving 150 PE patients and 150 controls.
- Analysis of first- and third-trimester hematological parameters to calculate inflammatory indices.
- Receiver operating characteristic (ROC) analysis and multivariable logistic regression to determine predictive performance.
Main Results:
- PE patients exhibited higher rates of NICU admission and CAPO.
- Elevated levels of NLR, PNR, SII, SIRI, and AISI were observed in the PE group.
- Third-trimester PLR predicted NICU admission; third-trimester PLR and PMR predicted CAPO; first-trimester NLR and PNR predicted PE.
Conclusions:
- Inflammation-based indices from routine blood tests are associated with PE and adverse perinatal outcomes.
- Specific indices like third-trimester PLR, PMR, first-trimester NLR, and PNR show independent predictive value.
- These markers should complement clinical assessment rather than serve as standalone diagnostic tools.
Purpose:
The aim of this study was to evaluate the predictive value of the systemic inflammatory index (SII), the systemic inflammatory response index (SIRI), and the aggregate systemic inflammatory index (AISI) in patients diagnosed with preeclampsia (PE) for PE and composite adverse perinatal outcomes (CAPO) in patients with PE.
Patients And Methods:
This single-center, retrospective case-control study included pregnant women aged 18-45 years with PE and healthy controls. First- and third-trimester hematological parameters were recorded, and inflammatory indices were calculated. Neonatal intensive care unit (NICU) admission and CAPO were evaluated as clinical outcomes. Receiver operating characteristic (ROC) analysis assessed predictive performance, and multivariable logistic regression was used to adjust for confounding factors.
Results:
A total of 300 patients (150 with PE and 150 controls) were included. The PE group had significantly higher rates of NICU admission and CAPO (p < 0.05). Several first- and third-trimester inflammatory indices, including NLR, PNR, SII, SIRI, and AISI, were significantly higher in the PE group. ROC analysis demonstrated that multiple indices were associated with the prediction of PE, NICU admission, and CAPO. In multivariable analysis, third-trimester PLR remained an independent predictor of NICU admission, while third-trimester PLR and PMR were identified as independent predictors of CAPO (p < 0.05). For the prediction of PE, only first-trimester NLR and PNR remained independent predictors (p < 0.05).
Conclusion:
Inflammation-based indices derived from routine blood tests were associated with PE and adverse perinatal outcomes. Inflammation-based indices derived from routine blood tests were associated with PE and adverse perinatal outcomes. Certain indices demonstrated independent predictive value, particularly third-trimester PLR for NICU admission, third-trimester PLR and PMR for CAPO, and first-trimester NLR and PNR for PE. However, these indices should be interpreted in conjunction with clinical variables and considered as supportive markers rather than stand-alone predictors in clinical practice.
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