First-trimester maternal BMI and systemic inflammatory indices as predictors of obesity-related adverse maternal outcomes: a retrospective cohort study

Dinçer Sümer; Ahmet Arif Filiz; Gülsena Bağcı; Elif Aykaç; Demet Sümer; Gülten Çirkin Tekeş; Figen Günday; Kadriye Yakut Yücel

First-trimester maternal BMI and systemic inflammatory indices as predictors of obesity-related adverse maternal outcomes: a retrospective cohort study

Abstract

Aims: To investigate the association between first-trimester maternal obesity, adverse obstetric outcomes, and complete blood count (CBC)-derived inflammatory indices, and to compare the predictive performance of maternal body-mass index (BMI) and inflammatory markers for obesity related adverse maternal outcomes. Methods: This retrospective cohort study included 648 singleton pregnancies evaluated between 11 and 14 weeks of gestation. According to first-trimester BMI, participants were classified as normal weight (n=301), overweight (n=222), or obese (n=125). Maternal characteristics, obstetric outcomes, and inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), Systemic Inflammatory Response Index (SIRI), Systemic Immune-inflammation Index (SII), and pan-immune-inflammation value (PIV), were analyzed. Logistic regression and receiver operating characteristic (ROC) analyses were performed. Results: Gestational diabetes mellitus, gestational hypertension, preeclampsia, cesarean delivery, and composite adverse maternal outcome (CAMO) were significantly more frequent among overweight and obese female (all p<0.05). Leukocyte and platelet counts were significantly higher in obese female, whereas SIRI, SII, NLR, and PIV did not differ significantly among BMI groups. In multivariable analysis, first-trimester BMI (aOR: 1.116, p<0.001, 95% CI: 1.064-1.171), maternal age (aOR: 1.088, p=0.001, 95% CI:1.036-1.143), and MLR (aOR: 5.446, p=0.020, 95% CI: 1.306-22.712) remained independently associated with CAMO. ROC analysis showed modest discriminatory performance of first-trimester BMI for CAMO (AUC: 0.680, 95% CI: 0.623-0.738), while a combined model including BMI, maternal age, and MLR improved discrimination (AUC: 0.726, 95% CI: 0.669-0.783) Conclusion: Maternal first-trimester BMI remained the strongest predictor of obesity-related adverse maternal outcomes. Although MLR was independently associated with adverse maternal outcomes, the incremental improvement in predictive performance beyond maternal BMI was modest and of limited clinical significance. These findings require validation in larger prospective studies before clinical application.

Keywords

Supporting Institution

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Ethical Statement

The study protocol complied with the ethical standards of the Declaration of Helsinki and received approval from the institutional ethics committee (Approval No. AEŞH-BADEK2-2025-539; 14 October 2025).

Thanks

none

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Details

Primary Language

English

Subjects

Obstetrics and Gynaecology

Journal Section

Research Article

Authors

Dinçer Sümer ^*
0000-0002-7034-6811
Türkiye

Ahmet Arif Filiz
0000-0002-6137-0270
Türkiye

Gülsena Bağcı
0009-0006-7849-0515
Türkiye

Elif Aykaç
0009-0007-4140-0640
Türkiye

Demet Sümer
0000-0001-6943-3128
Türkiye

Gülten Çirkin Tekeş
0000-0002-2564-2435
Türkiye

Figen Günday
0009-0004-9648-8748
Türkiye

Kadriye Yakut Yücel
0000-0003-3182-4312
Türkiye

Publication Date

October 25, 2026

Submission Date

July 8, 2026

Acceptance Date

August 9, 2026

Published in Issue

Year 2026 Volume: 8 Number: 6

IZ

https://izlik.org/JA77NN27AC

Cite

RIS / Bibtex

APA

Sümer, D., Filiz, A. A., Bağcı, G., Aykaç, E., Sümer, D., Çirkin Tekeş, G., Günday, F., & Yakut Yücel, K. (2026). First-trimester maternal BMI and systemic inflammatory indices as predictors of obesity-related adverse maternal outcomes: a retrospective cohort study. Anatolian Current Medical Journal, 8(6), 1086-1093. https://izlik.org/JA77NN27AC

AMA

1.Sümer D, Filiz AA, Bağcı G, et al. First-trimester maternal BMI and systemic inflammatory indices as predictors of obesity-related adverse maternal outcomes: a retrospective cohort study. Anatolian Curr Med J / ACMJ / acmj. 2026;8(6):1086-1093. https://izlik.org/JA77NN27AC

Chicago

Sümer, Dinçer, Ahmet Arif Filiz, Gülsena Bağcı, et al. 2026. “First-Trimester Maternal BMI and Systemic Inflammatory Indices As Predictors of Obesity-Related Adverse Maternal Outcomes: A Retrospective Cohort Study”. Anatolian Current Medical Journal 8 (6): 1086-93. https://izlik.org/JA77NN27AC.

EndNote

Sümer D, Filiz AA, Bağcı G, Aykaç E, Sümer D, Çirkin Tekeş G, Günday F, Yakut Yücel K (October 1, 2026) First-trimester maternal BMI and systemic inflammatory indices as predictors of obesity-related adverse maternal outcomes: a retrospective cohort study. Anatolian Current Medical Journal 8 6 1086–1093.

IEEE

[1]D. Sümer et al., “First-trimester maternal BMI and systemic inflammatory indices as predictors of obesity-related adverse maternal outcomes: a retrospective cohort study”, Anatolian Curr Med J / ACMJ / acmj, vol. 8, no. 6, pp. 1086–1093, Oct. 2026, [Online]. Available: https://izlik.org/JA77NN27AC

ISNAD

Sümer, Dinçer - Filiz, Ahmet Arif - Bağcı, Gülsena - Aykaç, Elif - Sümer, Demet - Çirkin Tekeş, Gülten - Günday, Figen - Yakut Yücel, Kadriye. “First-Trimester Maternal BMI and Systemic Inflammatory Indices As Predictors of Obesity-Related Adverse Maternal Outcomes: A Retrospective Cohort Study”. Anatolian Current Medical Journal 8/6 (October 1, 2026): 1086-1093. https://izlik.org/JA77NN27AC.

JAMA

1.Sümer D, Filiz AA, Bağcı G, Aykaç E, Sümer D, Çirkin Tekeş G, Günday F, Yakut Yücel K. First-trimester maternal BMI and systemic inflammatory indices as predictors of obesity-related adverse maternal outcomes: a retrospective cohort study. Anatolian Curr Med J / ACMJ / acmj. 2026;8:1086–1093.

MLA

Sümer, Dinçer, et al. “First-Trimester Maternal BMI and Systemic Inflammatory Indices As Predictors of Obesity-Related Adverse Maternal Outcomes: A Retrospective Cohort Study”. Anatolian Current Medical Journal, vol. 8, no. 6, Oct. 2026, pp. 1086-93, https://izlik.org/JA77NN27AC.

Vancouver

1.Dinçer Sümer, Ahmet Arif Filiz, Gülsena Bağcı, Elif Aykaç, Demet Sümer, Gülten Çirkin Tekeş, Figen Günday, Kadriye Yakut Yücel. First-trimester maternal BMI and systemic inflammatory indices as predictors of obesity-related adverse maternal outcomes: a retrospective cohort study. Anatolian Curr Med J / ACMJ / acmj [Internet]. 2026 Oct. 1;8(6):1086-93. Available from: https://izlik.org/JA77NN27AC