TY  - JOUR
T1  - Systemic Inflammatory Indices in Preterm Preeclampsia Versus Term Preeclampsia and Healthy Pregnancies: A Retrospective Case-Control Study
AU  - Özer Aslan, İlke
AU  - Erdal, Hüseyin
PY  - 2025
DA  - September
Y2  - 2025
DO  - 10.37990/medr.1730758
JF  - Medical Records
JO  - Med Records
PB  - Tıbbi Kayıtlar Derneği
WT  - DergiPark
SN  - 2687-4555
SP  - 691
EP  - 6
VL  - 7
IS  - 3
LA  - en
AB  - Aim: This study aimed to investigate whether systemic inflammatory indices derived from first-trimester complete blood counts—namely the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune-inflammation value (PIV)—differ among women with preterm preeclampsia, term preeclampsia, and healthy pregnancies.Material and Method: In this retrospective case–control study, 197 pregnant women were evaluated and categorized into three groups: preterm preeclampsia (n=39), term preeclampsia (n=59), and healthy controls (n=99). Demographic, perinatal, and hematological data were retrieved from medical records. Inflammatory indices were calculated from complete blood count parameters obtained during the first trimester. Statistical comparisons across groups were performed using one-way ANOVA or Kruskal–Wallis test, with a significance threshold of p<0.05.Results: While neutrophil counts and hemoglobin levels were significantly higher in preeclampsia groups compared to controls (p=0.001 and p<0.001, respectively), there were no statistically significant differences among groups in terms of NLR (p=0.063), PLR (p=0.750), SII (p=0.100), SIRI (p=0.110), or PIV (p=0.091). Birth weight, birth length, and Apgar scores were significantly lower in the preterm preeclampsia group (p<0.001 for all), reflecting more severe neonatal outcomes.Conclusion: Despite differences in neutrophil count and hemoglobin concentration, systemic inflammatory indices derived from first-trimester blood counts did not significantly differentiate preterm preeclampsia from term preeclampsia or healthy pregnancies. These findings suggest limited utility of these indices as standalone diagnostic markers in early pregnancy. Future prospective studies incorporating serial measurements and multimodal predictive models are warranted.
KW  - First-trimester screening
KW  - maternal biomarkers
KW  - preeclampsia
KW  - preterm preeclampsia
KW  - systemic inflammation
CR  - Rana S, Lemoine E, Granger JP, Karumanchi SA. Preeclampsia: pathophysiology, challenges, and perspectives. Circ Res. 2019;124:1094-112. Erratum in: Circ Res. 2020;126:e8.
CR  - Duley L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol. 2009;33:130-7.
CR  - Lisonkova S, Joseph KS. Incidence of preeclampsia: risk factors and outcomes associated with early- versus late-onset disease. Am J Obstet Gynecol. 2013;209:544.e1–12.
CR  - von Dadelszen P, Magee LA. Preventing deaths due to the hypertensive disorders of pregnancy. Best Pract Res Clin Obstet Gynaecol. 2016;36:83-102.
CR  - Redman CW, Sargent IL. Latest advances in understanding preeclampsia. Science. 2005;308:1592-4.
CR  - Gusella A, Martignoni G, Giacometti C. Behind the curtain of abnormal placentation in pre-eclampsia: from molecular mechanisms to histological hallmarks. Int J Mol Sci. 2024;25:7886.
CR  - Saito S, Shiozaki A, Nakashima A, et al. The role of the immune system in preeclampsia. Mol Aspects Med. 2007;28:192-209.
CR  - Laresgoiti-Servitje E. A leading role for the immune system in the pathophysiology of preeclampsia. J Leukoc Biol. 2013;94:247-57.
CR  - Cornelius DC, Lamarca B. TH17- and IL-17-mediated autoantibodies and placental oxidative stress play a role in the pathophysiology of preeclampsia. Minerva Ginecol. 2014;66:243-9.
CR  - Thombare D, Bhalerao A, Dixit P, et al. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in antenatal women with pre-eclampsia: a case-control study. Cureus. 2023;15:e40338.
CR  - Kurtoglu E, Kokcu A, Celik H, et al. May ratio of neutrophil to lymphocyte be useful in predicting the risk of developing preeclampsia? A pilot study. Matern Fetal Neonatal Med. 2015;28:97-9.
CR  - Zhai WY, Duan FF, Lin YB, et al. Pan-immune-inflammatory value in patients with non-small-cell lung cancer undergoing neoadjuvant immunochemotherapy. J Inflamm Res. 2023;16:3329-39.
CR  - Zhang K, Hua YQ, Wang D, et al. Systemic immune-inflammation index predicts prognosis of patients with advanced pancreatic cancer. J Transl Med. 2019;17:30.
CR  - Wang L, Jia J, Lin L, et al. Prognostic significance of systemic immune-inflammation index in patients with breast cancer: a meta-analysis. Cancer Cell Int. 2020;20:224.
CR  - Seyhanli Z, Bayraktar B, Baysoz OB, et al. The role of first trimester serum inflammatory indexes (NLR, PLR, MLR, SII, SIRI, and PIV) and the β-hCG to PAPP-A ratio in predicting preeclampsia. J Reprod Immunol. 2024;162:104190.
CR  - Genç ŞO, Erdal H. Are pan-immune-inflammation value, systemic inflammatory response index and other hematologic inflammatory indexes clinically useful to predict first-trimester pregnancy loss?. Ann Clin Anal Med. 2023;14:473-7.
CR  - Ives CW, Sinkey R, Rajapreyar I, et al. Preeclampsia – pathophysiology and clinical presentations: JACC state-of-the-art review. J Am Coll Cardiol. 2020;76:1690-702.
CR  - Magee LA, Pels A, Helewa M, et al. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy: executive summary. J Obstet Gynaecol Can. 2014;36:416-41.
UR  - https://doi.org/10.37990/medr.1730758
L1  - https://dergipark.org.tr/en/download/article-file/5006336
ER  -