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Published on: June 8, 2022
Derived inflammatory indicators for identifying preeclampsia in pregnant patients with systemic lupus erythematosus:
Jiaxin Huo1, Minyi Zhang1, Haoyue Hu2
1Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China.
Background:
Pregnant women with systemic lupus erythematosus (SLE) are at high risk of preeclampsia (PE). However, overlapping clinical features between the two conditions make it challenging to detect superimposed PE. Failure to promptly recognize PE significantly increases the risk of adverse pregnancy outcomes. In recent years, complete blood count-derived inflammatory indicators (e.g., platelet-to-lymphocyte ratio) have emerged as readily available, low-cost biomarkers with clinical utility. This study aimed to assess the discriminative capacity of these derived inflammatory indicators, measured within one week before delivery, for identifying superimposed PE in pregnant patients with SLE.
Methods:
This retrospective single-center study included 157 pregnant women with SLE treated at Nanfang Hospital of Southern Medical University from April 2010 to October 2024. Clinical and laboratory data, including complete blood count, liver function tests, and coagulation parameters, were collected. Univariate and multivariate logistic regression were performed to identify risk factors for PE and construct combined models. Model performance was assessed using receiver operating characteristic (ROC) curves, Hosmer-Lemeshow test, calibration plots, and the integrated discrimination improvement (IDI) and net reclassification improvement (NRI) indices. Internal validation used the bootstrap method, and sensitivity analysis used E-values.
Results:
Among the study patients, 35 developed PE. Univariate logistic regression analysis showed significant differences in monocyte-to-lymphocyte ratio (MLR) and platelet-to-lymphocyte ratio (PLR) between groups (P < 0.05). Multivariable logistic regression identified that lower MLR (OR = 0.223, 95% CI: 0.071-0.699) and PLR (OR = 0.344, 95% CI: 0.175-0.675) levels may be associated with an increased risk of superimposed PE in SLE pregnancies. The models based on MLR (AUC = 0.859, 95% CI: 0.782-0.936) and PLR (AUC = 0.860, 95% CI: 0.786-0.934) each showed discriminative capacity for identifying PE in pregnant patients with SLE.
Conclusion:
MLR and PLR may serve as cost-effective and readily available markers for identifying superimposed preeclampsia in pregnant patients with SLE. These preliminary findings warrant validation in larger prospective cohorts, given the small sample size.
