Araştırma Makalesi

Early Detection of Fetal Growth Restriction: Contribution of the HALP Score and First-Trimester Maternal BMI

Cilt: 36 Sayı: 2026 20 Ekim 2026
PDF İndir
EN TR

Early Detection of Fetal Growth Restriction: Contribution of the HALP Score and First-Trimester Maternal BMI

Öz

Aim: To evaluate the predictive value of the first-trimester Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score for fetal growth restriction (FGR), and to examine whether combining the HALP score with maternal body mass index (BMI) enhances risk prediction.
Materials and Methods: We retrospectively analyzed prospectively collected data from pregnant women followed at a tertiary center between January 2023 and June 2025. A total of 176 singleton pregnancies were included, consisting of 88 women diagnosed with FGR and 88 gestational age–matched controls. First-trimester hematological parameters were used to calculate the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and HALP score. Diagnostic performance was assessed using receiver operating characteristic (ROC) analysis, and subgroup analyses were performed according to maternal BMI.
Results: The HALP score was significantly lower in the FGR group than in controls (p<0.001). A higher HALP score was independently associated with a lower likelihood of FGR (OR: 0.40, 95% CI: 0.25–0.62; p<0.001). ROC analysis demonstrated that the HALP score had the highest diagnostic accuracy, with an AUC of 0.845 (95% CI: 0.783–0.895). At a cutoff value of ≤3.31, the sensitivity and specificity were 80.68% and 78.41%, respectively. In exploratory subgroup analyses among women with low HALP scores, overweight women (BMI 25.0–29.9 kg/m²) had a lower likelihood of FGR than women with a BMI <25 kg/m². However, no formal HALP × BMI interaction analysis was performed.
Conclusions: The first-trimester HALP score is a valuable predictor of FGR. Exploratory analyses suggest that the combined evaluation of HALP and maternal BMI may improve risk stratification, although formal interaction analyses are required to confirm this observation. Prospective multicenter studies are warranted to validate these findings.

Anahtar Kelimeler

Body Mass İndex, Fetal Growth Restriction, HALP Score, NLR, PLR

Etik Beyan

The study protocol was registered by Selcuk University Faculty of Medicine Local Ethics Committee with a protocol number of 2025/581 and retrospectively registered.

Teşekkür

We would like to thank you for your time and consideration of our manuscript, and we look forward to your valuable feedback.

Kaynakça

  1. 1. Consensus definition of fetal growth restriction: a Delphi procedure. Ultrasound Obstet Gynecol. 2016;48(3):333-9.
  2. 2. American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Obstetrics and the Society for Maternal-Fetal Medicine. ACOG Practice Bulletin No. 204: Fetal Growth Restriction. Obstet Gynecol. 2019;133(2):e97-e109.
  3. 3. Barker DJ. The developmental origins of adult disease. J Am Coll Nutr. 2004;23(6 Suppl):588S-595S. 4. Burton GJ, Jauniaux E. Pathophysiology of placental-derived fetal growth restriction. Am J Obstet Gynecol. 2018;218(2S):S745-S761.
  4. 5. Chaiworapongsa T, Chaemsaithong P, Yeo L, Romero R. Pre-eclampsia part 1: current understanding of its pathophysiology. Nat Rev Nephrol. 2014 Aug;10(8):466-80.
  5. 6. Unterscheider J, Daly S, Geary MP, Kennelly MM, McAuliffe FM, O’Donoghue K. Optimizing the definition of intrauterine growth restriction: the multicenter prospective PORTO Study. Am J Obstet Gynecol. 2013;208(4):290.e1-6.
  6. 7. Antunes IR, Lobo GAR, Araujo Júnior E, Pares DBDS. Predictive values of clinical parameters and biophysical and biochemical markers in the first trimester for the detection of small-for-gestational age fetuses. J Perinat Med. 2020;49(1):73-79.
  7. 8. Kurtoglu E, Kokcu A, Celik H, Tosun M, Malatyalioglu E. May ratio of neutrophil to lymphocyte be useful in predicting the risk of developing preeclampsia? A pilot study. J Matern Fetal Neonatal Med. 2015;28(1):97-9.
  8. 9. Gezer C, Ekin A, Ertas IE, Ozeren M, Solmaz U, Mat E, Taner CE. High first-trimester neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios are indicators for early diagnosis of preeclampsia. Ginekol Pol. 2016;87(6):431-5.
  9. 10. Seyhanli Z, Bayraktar B, Karabay G, Filiz AA, Bucak M, Agaoglu RT, et al. Can maternal inflammatory and nutritional status, evaluated by the hemoglobin, albumin, lymphocyte, and platelet (HALP) score and the prognostic nutritional index (PNI) in the first trimester, predict late-onset fetal growth restriction? BMC Pregnancy Childbirth. 2024;24(1):620.
  10. 11. Ağaoğlu RT, Özgürlük I, Öztürk Özge, Kurt DDS, Hızlı B, Vural ZY, et al. The significance of Systemic Immune Inflammation Index (SII) and Systemic Inflammation Response Index (SIRI) in fetuses with fetal growth restriction. Academic Journal of Health, 1(2), 37–41.

Kaynak Göster

APA
Bertizlioğlu, M., Soykan Sert, Z., Aktaş, G., Kılıç, Ş., & Orgul, G. (2026). Early Detection of Fetal Growth Restriction: Contribution of the HALP Score and First-Trimester Maternal BMI. Genel Tıp Dergisi, 36(2026), 1-5. https://doi.org/10.54005/geneltip.1925791
AMA
1.Bertizlioğlu M, Soykan Sert Z, Aktaş G, Kılıç Ş, Orgul G. Early Detection of Fetal Growth Restriction: Contribution of the HALP Score and First-Trimester Maternal BMI. Genel Tıp Derg. 2026;36(2026):1-5. doi:10.54005/geneltip.1925791
Chicago
Bertizlioğlu, Mete, Zekiye Soykan Sert, Görkem Aktaş, Şeyma Kılıç, ve Gokcen Orgul. 2026. “Early Detection of Fetal Growth Restriction: Contribution of the HALP Score and First-Trimester Maternal BMI”. Genel Tıp Dergisi 36 (2026): 1-5. https://doi.org/10.54005/geneltip.1925791.
EndNote
Bertizlioğlu M, Soykan Sert Z, Aktaş G, Kılıç Ş, Orgul G (01 Ekim 2026) Early Detection of Fetal Growth Restriction: Contribution of the HALP Score and First-Trimester Maternal BMI. Genel Tıp Dergisi 36 2026 1–5.
IEEE
[1]M. Bertizlioğlu, Z. Soykan Sert, G. Aktaş, Ş. Kılıç, ve G. Orgul, “Early Detection of Fetal Growth Restriction: Contribution of the HALP Score and First-Trimester Maternal BMI”, Genel Tıp Derg, c. 36, sy 2026, ss. 1–5, Eki. 2026, doi: 10.54005/geneltip.1925791.
ISNAD
Bertizlioğlu, Mete - Soykan Sert, Zekiye - Aktaş, Görkem - Kılıç, Şeyma - Orgul, Gokcen. “Early Detection of Fetal Growth Restriction: Contribution of the HALP Score and First-Trimester Maternal BMI”. Genel Tıp Dergisi 36/2026 (01 Ekim 2026): 1-5. https://doi.org/10.54005/geneltip.1925791.
JAMA
1.Bertizlioğlu M, Soykan Sert Z, Aktaş G, Kılıç Ş, Orgul G. Early Detection of Fetal Growth Restriction: Contribution of the HALP Score and First-Trimester Maternal BMI. Genel Tıp Derg. 2026;36:1–5.
MLA
Bertizlioğlu, Mete, vd. “Early Detection of Fetal Growth Restriction: Contribution of the HALP Score and First-Trimester Maternal BMI”. Genel Tıp Dergisi, c. 36, sy 2026, Ekim 2026, ss. 1-5, doi:10.54005/geneltip.1925791.
Vancouver
1.Mete Bertizlioğlu, Zekiye Soykan Sert, Görkem Aktaş, Şeyma Kılıç, Gokcen Orgul. Early Detection of Fetal Growth Restriction: Contribution of the HALP Score and First-Trimester Maternal BMI. Genel Tıp Derg. 01 Ekim 2026;36(2026):1-5. doi:10.54005/geneltip.1925791