Sistemik İmmün-İnflamasyon İndeksi (SII) Düşük Tehdidinin Sonucunu Öngörebilir mi?

Öz

Amaç: Son yıllarda inflamatuar belirteçler ilgi görmeye başlamıştır ve gebelik sonuçlarını daha doğru bir şekilde tahmin edebilen maliyet etkin, yaygın olarak bulunabilen, kolayca uygulanabilir ve yorumlanabilir biyobelirteçler için arayış devam etmektedir. Bu çalışmanın amacı, düşük tehdidi (DT) sonucunun tahmininde sistemik immün-inflamasyon indeksi (SII) (nötrofil × trombosit/lenfosit) için bir kesme değeri belirlemektir. Gereç ve Yöntem: Bu retrospektif vaka-kontrol çalışması adın Hastalıkları, Doğum ve Perinatoloji kliniğimizde tasarlanmıştır. Çalışmaya polikliniklerde takip edilen veya hastaneye yatırılan ve gebelikleri hastanemizde sonlanan DT'li tekil gebe kadınlar dahil edildi. Gebelikleri düşükle sonuçlanan kadınlar Grup I'e dahil edildi. Gebelikleri doğumla sonuçlanan kadınlar Grup II'ye dahil edildi. Receiver operating characteristic (ROC) eğrileri, TM sonucunu tahmin etmede inflamatuar indekslerin performansını değerlendirmek için kullanıldı. Bulgular: Bu çalışmaya DT tanısı almış toplam 730 gebe kadın dahil edildi. Grup I'de 239 hasta ve Grup II'de 491 hasta vardı. SII, Grup II'de istatistiksel olarak anlamlı derecede daha yüksekti (856.6'ya karşı 938.4; p<0.001) ve ROC eğrisi ile %31.8 duyarlılık ve %83.3 özgüllük saptandı. SII için eğri altında kalan alan (EAA) 0.594 idi (%95 CI: 55.8 ila 63, p < 0.001). Sonuç: DT olgularında maternal kandaki yüksek SII, inflamatuar bir süreci göstermekte ve doğumla sonuçlanmaktadır. Klinisyenler, düşük için ≤692/L (özgüllük %83.3) SII değerleri konusunda dikkatli olmalıdır.

Anahtar Kelimeler

• Abort
• Düşük tehdidi
• Gebelik
• Sistemik immün-inflamasyon indeksi

Etik Beyan

Bu çalışma, Etlik Zübeyde Hanım Kadın Hastalıkları ve Doğum Eğitim ve Araştırma Hastanesi'nde etik kurul tarafından retrospektif çalışma olarak onaylandı (21 Nisan 2022; no: 05/2022).

Can the Systemic Immune-Inflammation Index (SII) Predict the Outcome of Threatened Miscarriage?

Öz

Aim: Inflammatory markers have gained attention in recent years and the search continues for cost-effective, widely available, easily applicable, and interpretable biomarkers that can more accurately predict pregnancy outcomes. The study aims to determine a cut-off value for systemic immune-inflammation index (SII) (neutrophil × platelet /lymphocyte) in the prediction of the outcome of threatened miscarriage (TM). Materials and Methods: This retrospective case-control study was designed at the Obstetrics-Gynecology and Perinatology Clinics. Singleton pregnant women with TM who were followed up in the outpatient clinics or hospitalized and whose pregnancy resulted in our hospital were included in the study. Women whose pregnancies resulted in miscarriage were included in Group I. Women whose pregnancies resulted in childbirth were in Group II. Receiver operating characteristic (ROC) curves were used to assess the performance of inflammatory indexes in predicting the outcome of TM. Results: A total of 730 pregnant women with the diagnosis of TM were included in the present study. There were 239 patients in Group I and there were 491 patients in Group II. SII was statistically significantly higher in Group II (856.6 vs. 938.4; p<0.001), and the ROC curve produced a sensitivity of 31.8% and a specificity of 83.3%. The area under the curve (AUC) for the SII was 0.594 (95% CI: 55.8 to 63, p < 0.001). Conclusion: Elevated SII in maternal blood in TM cases indicates an inflammatory process but results in delivery. Clinicians should be cautious about SII values of ≤692/L (specificity of 83.3%) for miscarriage.

Anahtar Kelimeler

• Abortion
• Pregnancy
• Systemic immune-inflammation index
• Threatened miscarriage

Etik Beyan

This study was approved by the local ethics committee as a retrospective study at Etlik Zübeyde Hanım Maternity and Women's Health Teaching and Research Hospital, Ankara, Turkiye (21 April 2022; no: 05/2022).

Kaynakça

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