Systemic immune inflammation indices: novel predictors for preterm premature rupture of membranes and associated complications

Abstract

Aim: This study aimed to investigate the relationship between systemic immune inflammation (SII) and response indices (SIRI), which are new markers of systemic inflammation derived from immune cells, and preterm premature rupture of membranes (PPROM), as well as adverse pregnancy outcomes. Materials and Methods: The retrospective study included 75 singleton pregnancies complicated with PPROM between 24 and 34 gestational weeks and 75 healthy pregnant women who delivered at term (control group). Inflammation indices were calculated based on neutrophil (N), platelet (P), lymphocyte (L), and monocyte (M) counts as follows: The neutrophil-to-lymphocyte ratio (NLR) = N/L; the platelet-to-lymphocyte ratio (PLR) = P/L; SII = (N×P)/L; and SIRI = (N×M)/L. Results: The median NLR (4.8 vs. 3.5, p <0.001), median PLR (145.1 vs. 126.5, p<0.001), median SII (1208.6 vs. 807.4, p<0.001), and median SIRI (3.1 vs. 2.0, p<0.001) were higher in the PPROM group than the control group. Multiple logistic regression analysis showed that increased SIRI (OR = 7.05, p=0.010), as well as increased CRP levels were determined as independent predictors of PPROM. In PPROM group, SIRI was higher in the presence with complications compared to without complications (3.4 vs. 2.5, p<0.001). The SIRI showed superior diagnostic performance in predicting the presence and complications of PPROM compared to other inflammation indices. Conclusions: PPROM had higher leukocyte-based inflammation indices than the control group. Due to superior diagnostic performance of SIRI in distinguishing both PPROM and complications compared to other leukocyte-based inflammation indices, it may serve as a significant screening tool in PPROM.

Keywords

• preterm premature rupture of membranes
• immune inflammation index
• pregnancy complications
• neonatal outcomes

Sistemik immün enflamasyon indeksleri: erken membran yırtılması ve ilişkili komplikasyonlar için yeni belirleyiciler

Abstract

Amaç: Bu çalışmada, immün hücrelerden türetilen sistemik inflamasyonun yeni belirteçleri olan sistemik immün inflamasyon (SII) ve yanıt (SIRI) indeksleri ile preterm erken membran rüptürü (PPROM) ve olumsuz gebelik sonuçları arasındaki ilişkinin araştırılması amaçlandı. Gereç ve Yöntem: Retrospektif çalışmaya 24-34. gebelik haftaları arasında PPROM ile komplike olan 75 tekil gebelik ve miadında doğum yapan 75 sağlıklı gebe (kontrol grubu) dahil edildi. Nötrofil (N), trombosit (P), lenfosit (L) ve monosit (M) sayılarına göre inflamasyon indeksleri şu şekilde hesaplandı: Nötrofil-lenfosit oranı (NLR) = N/L; trombosit-lenfosit oranı (PLR) = P/L; SII = (N×P)/L; ve SIRI = (N×M)/L. Bulgular: Medyan NLR (4,8 vs. 3,5, p <0,001), medyan PLR (145,1 vs. 126,5, p<0,001), medyan SII (1208,6 vs. 807,4, p<0,001) ve medyan SIRI (3,1 vs. 2,0, p<0.001) PPROM grubunda kontrol grubuna göre daha yüksekti. Çoklu lojistik regresyon analizi, artan SIRI'nin (OR = 7.05, p=0.010) yanı sıra artan CRP düzeylerinin PPROM'un bağımsız belirleyicileri olduğunu gösterdi. PPROM grubunda SIRI, komplikasyon varlığında komplikasyon olmayanlara göre daha yüksekti (3,4'e karşı 2,5, p<0,001). SIRI, diğer inflamasyon indeksleriyle karşılaştırıldığında PPROM'un varlığını ve komplikasyonlarını öngörmede üstün tanısal performans gösterdi. Sonuçlar: PPROM'lu gebelerde lökosit bazlı inflamasyon indeksleri kontrol grubuna göre daha yüksekti. SIRI'nin hem PPROM'u hem de komplikasyonları ayırt etmedeki tanısal performansı diğer lökosit bazlı inflamasyon indekslerine kıyasla daha üstündü. Bu nedenle, PPROM hastaları ayırt etmede SIRI önemli bir tarama aracı olarak hizmet edebilir.

Keywords

• erken membran rüptürü
• immün inflamasyon indeksi
• hamilelik komplikasyonları
• yenidoğan sonuçları

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