Maternal and neonatal systemic inflammatory indices and perinatal outcomes in methamphetamine-exposed pregnancies

The aim of this study is to evaluate maternal hematological inflammatory indices such as (neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), systemic immune-inflammatory index (SII), and systemic inflammatory response index (SIRI)) in pregnant women using methamphetamine and to examine the relationship between these indices and neonatal inflammatory parameters.

This retrospective case-control study included 52 pregnant individuals with methamphetamine use and 93 matched controls delivering at a university training hospital. Maternal inflammatory indices were calculated from admission blood counts, and neonatal indices were assessed in 28 exposed neonates and compared with maternal indices using the Wilcoxon signed rank test. Among the 52 methamphetamine-exposed pregnancies, neonatal complete blood count data were available for only 28 neonates. Neonatal blood sampling was performed solely when clinically indicated according to routine neonatal practice. Therefore, neonates without available hematological data were not included in the paired maternal-neonatal analysis. Neonatal outcomes were compared between groups, and multivariate logistic regression was used to identify factors associated with adverse perinatal outcomes.

The case group demonstrated higher median NLR and PLR ratios. Furthermore, neutrophil, platelet, monocyte counts along with the systemic immune-inflammation index (SII (case vs. control, 1419.2 [1086.9-2231.3] vs. 883.7 [634.2-1076]); p<0.001), and systemic inflammatory response index (SIRI (case vs. control, 3.28 [2.2-5.55] vs. 2.12 [1.51-2.98]); p<0.001) levels were significantly higher than controls (all p<0.001). Furthermore, statistically significant differences were found between maternal and neonatal paired inflammatory indices (NLR, PLR, SII, and SIRI) (all p<0.001). In logistic regression analysis, prenatal methamphetamine exposure was identified as the strongest independent risk factor for adverse perinatal outcomes (odds ratio 2.742, 95% CI: 1.182-8.330; p=0.045).

Methamphetamine use during pregnancy can lead to changes in maternal inflammatory indices, and these changes may be correlated with neonatal inflammatory parameters.