First-Trimester Maternal CALLY Index Is Associated With Fetal Growth Restriction

Area of Science:

• Reproductive Medicine and Perinatal Health
• Maternal-Fetal Medicine
• Inflammatory and Immune Markers in Pregnancy

Background:

• Fetal growth restriction (FGR) is a significant contributor to perinatal morbidity, often linked to placental malperfusion.
• Inflammatory and immune dysregulation are implicated in the pathophysiology of FGR.
• The C-reactive protein-albumin-lymphocyte (CALLY) index is a composite marker assessing systemic inflammation, nutritional status, and immune competence.

Purpose of the Study:

• To evaluate the association between the first-trimester maternal CALLY index and the subsequent development of FGR.
• To assess the CALLY index's diagnostic performance in identifying FGR and placental malperfusion.

Main Methods:

• Retrospective case-control study of 105 singleton pregnancies (69 FGR cases, 36 controls).
• First-trimester CALLY index calculated as (albumin × lymphocyte count) / CRP.
• Placental histopathology evaluated; diagnostic performance assessed via ROC analysis.

Main Results:

• The CALLY index was significantly lower in the FGR group (0.065 vs. 0.170, p < 0.001).
• FGR cases exhibited lower birthweight and placental weight, with increased maternal vascular malperfusion (MVM).
• The CALLY index showed modest discriminatory ability for FGR (AUC = 0.739) but limited ability for placental malperfusion.

Conclusions:

• A low first-trimester CALLY index is significantly associated with subsequent FGR.
• The CALLY index may serve as a complementary tool for FGR risk assessment when combined with other clinical data.
• The CALLY index is not a reliable standalone predictor for placental malperfusion.