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Complete Blood Count-Derived Inflammatory Indices and Perinatal Outcomes in Pregnancies With Preterm Premature
Orhan Altinboga1, Atakan Tanacan1, Fahri Burcin Firatligil1
1Division of Perinatology, Department of Obstetrics and Gynecology, Ankara Bilkent City Hospital, Ankara, Turkey.
Introduction:
Preterm premature rupture of membranes (PPROM) is associated with significant maternal and neonatal morbidity, and reliable prognostic biomarkers remain limited. This study aimed to evaluate the prognostic value of complete blood count-derived inflammatory indices in pregnancies complicated by PPROM.
Methods:
This retrospective cohort study included 256 singleton PPROM pregnancies managed at a tertiary perinatology center between January 2022 and January 2025. Neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), systemic immune response index (SIRI), and pan-immune inflammation value (PIV) were calculated from admission blood samples. Previable PPROM cases were analyzed for prediction of birth weight <1000 g, whereas viable PPROM cases were evaluated for prediction of latency period <4 weeks. Receiver operating characteristic (ROC) and multivariable logistic regression analyses were performed.
Results:
In previable PPROM, NLR and SII were significantly higher in cases with birth weight <1000 g. ROC analysis demonstrated moderate predictive performance for NLR (AUC 0.76) and SII (AUC 0.75). In viable PPROM cases, higher NLR, SIRI, and PIV were associated with latency <4 weeks, although predictive accuracy was modest (AUC range 0.60-0.63). SII showed potential predictive value for chorioamnionitis (AUC 0.79). However, inflammatory indices did not remain significant predictors in multivariable regression analyses.
Conclusion:
Complete blood count-derived inflammatory indices may provide additional information for risk stratification in PPROM; however, their independent prognostic value appears limited and should be interpreted together with clinical findings.
