Preterm erken membran rüptürü olgularında C-reaktif protein-albümin-lenfosit (CALLY) indeksinin değerlendirilmesi

Abstract

Amaç: Bu çalışma, erken membran rüptürü (PPROM) ile komplike olan gebeliklerde C-reaktif protein-albümin-lenfosit (CALLY) indeksinin prognostik önemini ve yenidoğan sonuçları ile olası ilişkisini değerlendirmek amacıyla yapılmıştır. Gereç ve Yöntem: Bu prospektif çalışma, 1 Aralık 2024 ile 1 Mart 2025 tarihleri arasında Etlik Şehir Hastanesi Perinatoloji Kliniğinde takip edilen PPROM tanısı konmuş hamile kadınları içermektedir. PPROM grubu 181 kadından oluşurken, anne ve gebelik yaşı açısından eşleştirilmiş 170 sağlıklı hamile kadın kontrol grubu olarak kullanılmıştır. Anne ve yenidoğan sonuçları ile CRP, WBC ve CALLY indeksi gibi laboratuvar parametreleri değerlendirildi. Sonuçlar: PPROM grubunda doğum ağırlığı anlamlı olarak daha düşüktü (2318,6±493,7 g vs. 3014,0±438,1 g, p<0,001) ve daha uzun yenidoğan yoğun bakım ünitesi (NICU) kalış süresi (5,0±10,7 gün vs. 1,0±2,8 gün, p<0,001) vardı. CRP (11,8±14,9 mg/L vs. 5,5±4,2 mg/L, p<0,001) ve WBC (12,9±4,4 ×10³/µL vs. 10,6±2,2 ×10³/µL, p<0,001) gibi inflamatuar belirteçler PPROM grubunda önemli ölçüde yükselirken, CALLY indeksi belirgin şekilde daha düşüktü (18,0±28,1 vs. 31,8±38,6, p<0,001). PPROM grubunda yenidoğan komplikasyonları, NICU yatışları (38,7% vs. 12,4%, p<0,001), fetal distres (10,5% vs. 0,6%, p<0,001) ve korioamnionit (3,3% vs. 0,0%, p=0,017) dahil olmak üzere, anlamlı olarak daha sık görülmüştür. Daha düşük CALLY indeksi, olumsuz yenidoğan sonuçları riskinin artmasıyla ilişkiliydi. Sonuç: Bulgularımız, inflamasyon ve beslenme durumunu yansıtan CALLY indeksinin, PPROM'da yenidoğan morbiditesinin yararlı bir öngörücüsü olabileceğini göstermektedir. Daha düşük indeks, inflamasyonun artması ve kötü yenidoğan sonuçları ile ilişkiliydi.

Keywords

• CALLY indeksi
• erken membran rüptürü
• yenidoğan sonuçları
• inflamasyon
• anne sağlığı.

Evaluation of the C-reactive protein-albumin-lymphocyte (CALLY) index in cases of preterm premature rupture of membranes

Abstract

Aims: This study aimed to evaluate the prognostic significance of the C-reactive protein-albumin-lymphocyte (CALLY) index in pregnancies complicated by preterm prelabor rupture of membranes (PPROM). Methods: This prospective study included pregnant women diagnosed with PPROM who were followed at the Perinatology Clinic of Ankara Etlik City Hospital between December 1, 2024, and March 1, 2025. The PPROM group consisted of 181 women, while 170 healthy pregnant women, matched for maternal and gestational age, served as controls. Maternal and neonatal outcomes, along with laboratory parameters such as CRP, WBC, and the CALLY index, were evaluated. Results: The PPROM group had significantly lower birth weight (2318.6±493.7 g vs. 3014.0±438.1 g, p<0.001) and longer neonatal intensive care unit (NICU) stay (5.0±10.7 days vs. 1.0±2.8 days, p<0.001) compared to the control group. Inflammatory markers, including CRP (11.8±14.9 mg/L vs. 5.5±4.2 mg/L, p<0.001) and WBC (12.9±4.4×10³/µL vs. 10.6±2.2×10³/µL, p<0.001), were significantly elevated in the PPROM group, while the CALLY index was notably lower (18.0±28.1 vs. 31.8±38.6, p<0.001). Neonatal complications were significantly more frequent in the PPROM group, including NICU admission (38.7% vs. 12.4%, p<0.001), fetal distress (10.5% vs. 0.6%, p<0.001), and chorioamnionitis (3.3% vs. 0.0%, p=0.017). The area under the curve (AUC) for the CALLY index was 0.681 (95% CI: 0.626–0.736, p<0.001). Conclusion: The CALLY index was lower in pregnancies with PPROM and showed a fair ability to distinguish PPROM cases from healthy controls. These findings suggest that CALLY may serve as a supportive marker reflecting inflammation in PPROM.

Keywords

• CALLY index
• preterm prelabor rupture of membranes
• neonatal outcomes
• inflammation
• maternal health

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