Research Article
BibTex RIS Cite

Predictive value of systemic immune-inflammation index in patients with preterm labor

Year 2022, Volume: 47 Issue: 2, 697 - 703, 30.06.2022
https://doi.org/10.17826/cumj.1089119

Abstract

Purpose: The aim of this study was to investigate whether the systemic immune-inflammatory index (SII) could predict the development of preterm labor in pregnant women.
Materials and Methods: Pregnant women aged 18 years and over who presented to our clinic with spontaneous labor between January 1, 2018, and December 31, 2021, had intact membranes, and had a single living fetus were retrospectively evaluated. The women were divided into two groups, preterm and term delivery, according to the week of delivery. The clinical and laboratory characteristics of the women were assessed. The patients’ platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and SII (neutrophil count x platelet count/lymphocyte count) were calculated.
Results: The study included 171 women with preterm labor and 173 women with healthy term labor. The PLR, NLR, and SII values were statistically significantly higher in the preterm group than in the term group. The multivariate logistic regression analysis showed that SII (odds ratio [OR]: 3.65, 95% confidence interval [CI]: 2.21–10.07) was an independent predictor of the development of preterm labor. We found that the power of SII to predict preterm labor (area under the curve [AUC]: 0.792) was higher than that of NLR (AUC: 0.725) or PLR (AUC: 0.716) alone. SII values higher than 789.3 predicted preterm labor with 68.4% sensitivity and 81.5% specificity.
Conclusion: We found that SII was more valuable than NLR and PLR in the early detection of preterm labor. SII can help identify pregnant women at risk of developing preterm labor in the early stages of pregnancy.

References

  • 1. Georgiou HM, Di Quinzio MK, Permezel M, Brennecke SP. Predicting Preterm Labour: Current Status and Future Prospects. Dis Markers 2015; 2015:435014.
  • 2. World Health Organisation (WHO). Preterm Birth. February 2018 (cited 2019 December3). Availablefrom: URL: https://www.who. int/news-room/fact-sheets/detail/preterm-birth.
  • 3. Cappelletti M, Presicce P, Lawson MJ, Chaturvedi V, Stankiewicz TE, Vanoni S, et al. Type I interferons regulate susceptibility to inflammation-induced preterm birth. JCI Insight 2017;2(5): e91288.
  • 4. Buhimschi CS, Turan OM, Funai EF, Azpurua H, Bahtiyar MO, Turan S, et al. Fetal adrenal gland volume and cortisol/dehydroepiandrosterone sulfate ratio in inflammation-associated preterm birth. Obstet Gynecol 2008;111(3):715-22.
  • 5. Kurban Y, Alan Y, Uyar İ, Atak Z, Aydemir Ö, Öktem A. Investigation of Neutrophil/Lymphocyte Ratio and Mean Platelet Volume in Patients Diagnosed with Preterm Labor. Paediatr Respir Rev 2021; 40:39-43.
  • 6. Dundar O, Yoruk P, Tutuncu L, Erikci AA, Muhcu M, Ergur AR, et al. Longitudinal study of platelet size changes in gestation and predictive power of elevated MPV in development of pre‐eclampsia. Prenat Diagn 2008;28(11):1052-6.
  • 7. Bozoklu Akkar O, Sancakdar E, Karakus S, Yildiz C, Akkar I, Arslan M, et al. Evaluation of maternal serum 25-hydroxyvitamin d, paraoxonase 1 levels, and neutrophil-to-lymphocyte ratio in spontaneous preterm birth. Med Sci Monit 2016; 22:1238-43.
  • 8. Kokulu K, Günaydın YK, Akıllı NB, Köylü R, Sert ET, Köylü Ö, et al. The Relationship between the neutrophil-to-lymphocyte ratio in acute pancreatitis and the severity and systemic complications of the disease. Turk J Gastroenterol 2018; 29: 684-91.
  • 9. Kim DS, Shin D, Lee MS, Kim HJ, Kim DY, Kim SM, et al. Assessments of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in Korean patients with psoriasis vulgaris and psoriatic arthritis. J Dermatol 2016;43(3):305-10.
  • 10. Daglar H, Kirbas A, Kaya B, Kilincoglu F. The value of complete blood count parameters in predicting preterm delivery. Eur Rev Med Pharmacol Sci 2016;20(5):801-5.
  • 11. Kim M-A, Lee YS, Seo K. Assessment of predictive markers for placental inflammatory response in preterm births. PLoS One 2014;9(10): e107880.
  • 12. Tanacan A, Uyanik E, Unal C, Beksac MS. A cut-off value for systemic immune-inflammation index in the prediction of adverse neonatal outcomes in preterm premature rupture of the membranes. J Obstet Gynaecol Res 2020;46(8):1333-1341.
  • 13. Farzaneh F, Ghobadi S, Absalan A. The accuracy of selected hematology and inflammatory indices for predicting preterm labor; a cross-sectional study. Immunopathol Persa 2019;5(1): e05.
  • 14. Teune MJ, Bakhuizen S, Gyamfi Bannerman C, Opmeer BC, van Kaam AH, van Wassenaer AG, et al. A systematic review of severe morbidity in infants born late preterm. Am J Obstet Gynecol 2011;205(4): 374.e1-9.
  • 15. Aktepe T, Büyükkayacı Duman N. Preterm Doğum Riski Olan Gebeliklerin Yönetiminde Kanıta Dayalı Yaklaşımlar. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi 2020;17(1):309-314.
  • 16. Nadeau-Vallée M, Obari D, Quiniou C, Lubell WD, Olson DM, Girard S, et al. A critical role of interleukin-1 in preterm labor. Cytokine Growth Factor Rev 2016; 28:37-51.
  • 17. Dixon CL, Richardson L, Sheller‐Miller S, Saade G, Menon R. A distinct mechanism of senescence activation in amnion epithelial cells by infection, inflammation, and oxidative stress. Am J Reprod Immunol 2018;79(3):10.1111/aji.12790.
  • 18. Ma M, Zhu M, Zhuo B, Li L, Chen H, Xu L, et al. Use of complete blood count for predicting preterm birth in asymptomatic pregnant women: A propensity score‐matched analysis. J Clin Lab Anal 2020;34(8): e23313.
  • 19. Toprak E, Bozkurt M, Dinçgez Çakmak B, Özçimen EE, Silahlı M, Ender Yumru A, et al. Platelet-to-lymphocyte ratio: A new inflammatory marker for the diagnosis of preterm premature rupture of membranes. J Turk Ger Gynecol Assoc 2017;18(3):122-126.
  • 20. Hu B, Yang XR, Xu Y, Sun YF, Sun C, Guo W, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res 2014;20(23):6212-22.
  • 21. Ustundag Y, Huysal K, Gecgel SK, Unal D. Relationship between C-reactive protein, systemic immune-inflammation index, and routine hemogram-related inflammatory markers in low-grade inflammation. Int J Med Biochem 2018;1(1):24-28.
  • 22. Yang YL, Wu CH, Hsu PF, Chen SC, Huang SS, Chan WL, et al. Systemic immune-inflammation index (SII) predicted clinical outcome in patients with coronary artery disease. Eur J Clin Invest 2020;50(5): e13230.
  • 23. Hou D, Wang C, Luo Y, Ye X, Han X, Feng Y, et al. Systemic immune-inflammation index (SII) but not platelet-albumin-bilirubin (PALBI) grade is associated with severity of acute ischemic stroke (AIS). Int J Neurosci 2021;131(12):1203-1208.

Erken doğum yapan kadınlarda sistemik immün-inflamasyon indeksinin prediktif değeri

Year 2022, Volume: 47 Issue: 2, 697 - 703, 30.06.2022
https://doi.org/10.17826/cumj.1089119

Abstract

Amaç: Bu çalışmada sistemik immün-inflamatuar indeksin (SII) hamile kadınlarda erken doğum gelişimini tahmin edip edemeyeceği araştırılmıştır.
Gereç ve Yöntem: 1 Ocak 2018-31 Aralık 2021 tarihleri arasında kliniğimize spontan doğum eylemi ile başvuran, membranları intakt olan ve tek canlı fetüsü olan 18 yaş ve üstü gebeler retrospektif olarak değerlendirildi. Kadınlar doğum haftasına göre preterm ve term doğum olmak üzere iki gruba ayrıldı. Kadınların klinik ve laboratuvar özellikleri değerlendirildi. Hastaların trombosit-lenfosit oranı (PLR), nötrofil-lenfosit oranı (NLR) ve SII (nötrofil sayısı x trombosit sayısı/lenfosit sayısı) hesaplandı.
Bulgular: Çalışmaya erken doğum yapan 171 kadın ve sağlıklı term doğum yapan 173 kadın dahil edildi. PLR, NLR ve SII değerleri preterm grupta term grubuna göre istatistiksel olarak anlamlı derecede yüksekti. Çok değişkenli lojistik regresyon analizi, SII'nin (olasılık oranı [OR]: 3.65, %95 güven aralığı [GA]: 2.21–10.07) erken doğum gelişiminin bağımsız bir prediktör olduğunu gösterdi. SII'nin erken doğumu (eğrinin altındaki alan [AUC]: 0.792) tahmin etme gücünün, tek başına NLR (AUC: 0.725) veya PLR'den (AUC: 0.716) daha yüksek olduğunu bulduk. 789.3'ün üzerindeki SII değerleri, %68,4 duyarlılık ve %81.5 özgüllük ile erken doğumu öngördü.
Sonuç: Preterm doğumun erken tespitinde SII’nın NLR ve PLR’den daha değerli olduğunu bulduk. SII, preterm doğum gelişme riski taşıyan gebelerin erken dönemde belirlenmesine yardımcı olabilir.

References

  • 1. Georgiou HM, Di Quinzio MK, Permezel M, Brennecke SP. Predicting Preterm Labour: Current Status and Future Prospects. Dis Markers 2015; 2015:435014.
  • 2. World Health Organisation (WHO). Preterm Birth. February 2018 (cited 2019 December3). Availablefrom: URL: https://www.who. int/news-room/fact-sheets/detail/preterm-birth.
  • 3. Cappelletti M, Presicce P, Lawson MJ, Chaturvedi V, Stankiewicz TE, Vanoni S, et al. Type I interferons regulate susceptibility to inflammation-induced preterm birth. JCI Insight 2017;2(5): e91288.
  • 4. Buhimschi CS, Turan OM, Funai EF, Azpurua H, Bahtiyar MO, Turan S, et al. Fetal adrenal gland volume and cortisol/dehydroepiandrosterone sulfate ratio in inflammation-associated preterm birth. Obstet Gynecol 2008;111(3):715-22.
  • 5. Kurban Y, Alan Y, Uyar İ, Atak Z, Aydemir Ö, Öktem A. Investigation of Neutrophil/Lymphocyte Ratio and Mean Platelet Volume in Patients Diagnosed with Preterm Labor. Paediatr Respir Rev 2021; 40:39-43.
  • 6. Dundar O, Yoruk P, Tutuncu L, Erikci AA, Muhcu M, Ergur AR, et al. Longitudinal study of platelet size changes in gestation and predictive power of elevated MPV in development of pre‐eclampsia. Prenat Diagn 2008;28(11):1052-6.
  • 7. Bozoklu Akkar O, Sancakdar E, Karakus S, Yildiz C, Akkar I, Arslan M, et al. Evaluation of maternal serum 25-hydroxyvitamin d, paraoxonase 1 levels, and neutrophil-to-lymphocyte ratio in spontaneous preterm birth. Med Sci Monit 2016; 22:1238-43.
  • 8. Kokulu K, Günaydın YK, Akıllı NB, Köylü R, Sert ET, Köylü Ö, et al. The Relationship between the neutrophil-to-lymphocyte ratio in acute pancreatitis and the severity and systemic complications of the disease. Turk J Gastroenterol 2018; 29: 684-91.
  • 9. Kim DS, Shin D, Lee MS, Kim HJ, Kim DY, Kim SM, et al. Assessments of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in Korean patients with psoriasis vulgaris and psoriatic arthritis. J Dermatol 2016;43(3):305-10.
  • 10. Daglar H, Kirbas A, Kaya B, Kilincoglu F. The value of complete blood count parameters in predicting preterm delivery. Eur Rev Med Pharmacol Sci 2016;20(5):801-5.
  • 11. Kim M-A, Lee YS, Seo K. Assessment of predictive markers for placental inflammatory response in preterm births. PLoS One 2014;9(10): e107880.
  • 12. Tanacan A, Uyanik E, Unal C, Beksac MS. A cut-off value for systemic immune-inflammation index in the prediction of adverse neonatal outcomes in preterm premature rupture of the membranes. J Obstet Gynaecol Res 2020;46(8):1333-1341.
  • 13. Farzaneh F, Ghobadi S, Absalan A. The accuracy of selected hematology and inflammatory indices for predicting preterm labor; a cross-sectional study. Immunopathol Persa 2019;5(1): e05.
  • 14. Teune MJ, Bakhuizen S, Gyamfi Bannerman C, Opmeer BC, van Kaam AH, van Wassenaer AG, et al. A systematic review of severe morbidity in infants born late preterm. Am J Obstet Gynecol 2011;205(4): 374.e1-9.
  • 15. Aktepe T, Büyükkayacı Duman N. Preterm Doğum Riski Olan Gebeliklerin Yönetiminde Kanıta Dayalı Yaklaşımlar. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi 2020;17(1):309-314.
  • 16. Nadeau-Vallée M, Obari D, Quiniou C, Lubell WD, Olson DM, Girard S, et al. A critical role of interleukin-1 in preterm labor. Cytokine Growth Factor Rev 2016; 28:37-51.
  • 17. Dixon CL, Richardson L, Sheller‐Miller S, Saade G, Menon R. A distinct mechanism of senescence activation in amnion epithelial cells by infection, inflammation, and oxidative stress. Am J Reprod Immunol 2018;79(3):10.1111/aji.12790.
  • 18. Ma M, Zhu M, Zhuo B, Li L, Chen H, Xu L, et al. Use of complete blood count for predicting preterm birth in asymptomatic pregnant women: A propensity score‐matched analysis. J Clin Lab Anal 2020;34(8): e23313.
  • 19. Toprak E, Bozkurt M, Dinçgez Çakmak B, Özçimen EE, Silahlı M, Ender Yumru A, et al. Platelet-to-lymphocyte ratio: A new inflammatory marker for the diagnosis of preterm premature rupture of membranes. J Turk Ger Gynecol Assoc 2017;18(3):122-126.
  • 20. Hu B, Yang XR, Xu Y, Sun YF, Sun C, Guo W, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res 2014;20(23):6212-22.
  • 21. Ustundag Y, Huysal K, Gecgel SK, Unal D. Relationship between C-reactive protein, systemic immune-inflammation index, and routine hemogram-related inflammatory markers in low-grade inflammation. Int J Med Biochem 2018;1(1):24-28.
  • 22. Yang YL, Wu CH, Hsu PF, Chen SC, Huang SS, Chan WL, et al. Systemic immune-inflammation index (SII) predicted clinical outcome in patients with coronary artery disease. Eur J Clin Invest 2020;50(5): e13230.
  • 23. Hou D, Wang C, Luo Y, Ye X, Han X, Feng Y, et al. Systemic immune-inflammation index (SII) but not platelet-albumin-bilirubin (PALBI) grade is associated with severity of acute ischemic stroke (AIS). Int J Neurosci 2021;131(12):1203-1208.
There are 23 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research
Authors

Zekiye Soykan Sert 0000-0003-1496-3732

Ramazan Bülbül 0000-0003-3321-3718

Publication Date June 30, 2022
Acceptance Date April 26, 2022
Published in Issue Year 2022 Volume: 47 Issue: 2

Cite

MLA Soykan Sert, Zekiye and Ramazan Bülbül. “Predictive Value of Systemic Immune-Inflammation Index in Patients With Preterm Labor”. Cukurova Medical Journal, vol. 47, no. 2, 2022, pp. 697-03, doi:10.17826/cumj.1089119.