Comparison of serum ınflammatory parameters between spontaneous abortion and threatened abortion

Early pregnancy loss is a frequent reproductive health problem. Systemic inflammatory markers derived from complete blood count-neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic inflammatory index-may reflect the inflammatory status present at clinical presentation. The aim of this study was to compare these indices between spontaneous abortion and threatened abortion.

This retrospective cross-sectional study included 146 women evaluated between January 2022 and April 2025. Patients were classified as spontaneous abortion (n=67) or threatened abortion (n=79) based on clinical and ultrasonographic findings. neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic inflammatory index were calculated from complete blood counts. Group comparisons were performed using the Student's t-test or the Mann-Whitney U test. Blood samples were obtained at presentation, when the diagnosis of spontaneous abortion or threatened abortion had already been established; therefore, markers reflected concurrent inflammatory status rather than pre-diagnostic levels.

The groups were similar regarding age, body mass index, gravida, parity, and gestational age (all p>0.05). Compared with threatened abortion, spontaneous abortion patients had significantly higher white blood cell and neutrophil counts, neutrophil-to-lymphocyte ratio, C-reactive protein, and systemic inflammatory index (all p<0.05). Although platelet-to-lymphocyte ratio values were numerically higher in the spontaneous abortion group, the difference was borderline and not statistically significant (p=0.058).

Spontaneous abortion is associated with a stronger systemic inflammatory profile at presentation. Elevated systemic inflammatory index, neutrophil-to-lymphocyte ratio, and C-reactive protein levels reflect concurrent inflammation rather than definitive predictive or causal relationships.