Could the First Trimester Complete Blood Cell Indices Be Used to Predict Adverse Outcomes in Pregnant Women with Asthma?

Yıl 2025, Cilt: 47 Sayı: 5, 721 - 726, 04.09.2025

Hakkı Şerbetçi , Atakan Tanacan , Refaettin Şahin , Osman Onur Özkavak , Zahid Ağaoğlu , Şengül Kara , Özgür Kara , Dilek Sahin

https://doi.org/10.20515/otd.1656310

Öz

The objective of this study was to investigate the efficacy of complete blood cell indices, specifically the neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and systemic immune-response index (SIRI), in predicting composite adverse outcomes in pregnant women with asthma. This study employed a retrospective cohort design, enrolling 307 low-risk pregnant women and 97 pregnant women with asthma. The neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and systemic immune-response index (SIRI) were compared between pregnant women with asthma and the low-risk pregnancy group in the first trimester. A significant difference was observed in the first trimester SII between pregnant women with asthma and the low-risk pregnancy group (p=0.034). The neutrophil-to-lymphocyte ratio (NLR) and systemic immune response index (SIRI) demonstrated no significant differences between the groups. Moreover, pregnant women with asthma had significantly higher eosinophil count values as expected. The first trimester white blood cell count (WBC) and platelet count (PLT) were found to be significantly higher in the asthma group (p=0.014 and p=0.031, respectively). In the asthma group, no significant difference was found between the composite adverse pregnancy outcomes due to SII, SIRI, and NLR. Pregnant women with asthma exhibited significantly elevated values for SII, WBC, PLT and eosinophils. In our study, we observed no association between groups in complete blood cell indices due to the composite adverse effects of pregnancy. Further studies with larger groups are required to evaluate the efficacy of complete blood cell indices in pregnant women with asthma.

Anahtar Kelimeler

Asthma , pregnancy , complete blood cell indices , perinatology , immune system

Astımlı gebe kadınlarda birinci trimester tam kan sayımı indeksleri olumsuz sonuçları tahmin etmek için kullanılabilir mi?

Öz

Bu çalışmanın amacı, astımlı gebelerde tam kan sayımı indekslerinin, özellikle nötrofil-lenfosit oranı (NLR), sistemik immün-inflamasyon indeksi (SII) ve sistemik immün-yanıt indeksinin (SIRI) bileşik olumsuz sonuçları öngörmedeki etkinliğini araştırmaktır. Bu çalışmada retrospektif bir kohort tasarımı kullanılmış ve 307 düşük riskli gebe ile 97 astımlı gebe çalışmaya dahil edilmiştir. Nötrofil-lenfosit oranı (NLR), sistemik immün-inflamasyon indeksi (SII) ve sistemik immün-yanıt indeksi (SIRI) ilk trimesterde astımlı gebeler ile düşük riskli gebelik grubu arasında karşılaştırıldı. Astımlı gebeler ile düşük riskli gebelik grubu arasında ilk trimester SII açısından anlamlı bir fark gözlendi (p=0.034). Nötrofil-lenfosit oranı (NLR) ve sistemik inflamasyon yanıt indeksi (SIRI) gruplar arasında anlamlı farklılık göstermedi. Ayrıca, astımlı gebelerde eozinofil sayısı beklendiği gibi anlamlı derecede yüksekti. İlk trimester beyaz küre sayısı (WBC) ve trombosit sayısı (PLT) astım grubunda anlamlı olarak daha yüksek bulunmuştur (sırasıyla p=0,014 ve p=0,031). Astım grubunda, SII, SIRI ve NLR'ye bağlı bileşik olumsuz gebelik sonuçları arasında anlamlı bir fark bulunmamıştır. Astımlı gebelerde SII, WBC, PLT ve eozinofil değerleri anlamlı derecede yüksek bulunmuştur. Çalışmamızda, gebeliğin bileşik yan etkilerine bağlı olarak tam kan hücresi indekslerinde gruplar arasında bir ilişki gözlenmemiştir. Astımlı gebelerde tam kan hücresi indekslerinin etkinliğini değerlendirmek için daha büyük gruplarla yapılacak ileri çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

Astım , gebelik , tam kan sayımı indeksleri , perinatoloji , immün sistem

Kaynakça

• 1. Gans MD, Gavrilova T. Understanding the immunology of asthma: Pathophysiology, biomarkers, and treatments for asthma endotypes. Paediatric respiratory reviews. 2020;36:118–27.
• 2. Bravo-Solarte, D. C., Garcia-Guaqueta, D. P., & Chiarella, S. E. (2023). Asthma in pregnancy. Allergy and asthma proceedings, 44(1), 24–34.
• 3. Sheiner E, Mazor M, Levy A, Wiznitzer A, Bashiri A. Pregnancy outcome of asthmatic patients: a population-based study. The Journal of Maternal-Fetal & Neonatal Medicine. 2005;18(4):237–40.
• 4. Grosso A, Locatelli F, Gini E, Albicini F, Tirelli C, Cerveri I, et al. The course of asthma during pregnancy in a recent, multicase–control study on respiratory health. Allergy, Asthma & Clinical Immunology. 2018;14:1–5.
• 5. Murphy VE, Clifton VL, Gibson PG. Asthma exacerbations during pregnancy: incidence and association with adverse pregnancy outcomes. Thorax. 2006 Feb 1;61(2):169 LP – 176.
• 6. Ben-Zvi I, Livneh A. Chronic inflammation in FMF: markers, risk factors, outcomes and therapy. Nature Reviews Rheumatology. 2011;7(2):105–12. 7. Zahorec R. Neutrophil-to-lymphocyte ratio, past, present and future perspectives. Bratisl Lek Listy. 2021;122(7):474–88.
• 8. Cheng W, Bu X, Xu C, Wen G, Kong F, Pan H, et al. Higher systemic immune-inflammation index and systemic inflammation response index levels are associated with stroke prevalence in the asthmatic population: a cross-sectional analysis of the NHANES 1999-2018. Frontiers in immunology. 2023;14:1191130.
• 9. Global Initiatiave for Asthma. Global strategy for Asthma Management and Prevention [Internet]. Available from: https://ginasthma.org/ (Accesed on August 2023)
• 10. Alobaidi AH, Alsamarai AM, Alsamarai MA. Inflammation in asthma pathogenesis: Role of T cells, macrophages, epithelial cells and type 2 inflammation. Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry (Formerly Current Medicinal Chemistry-Anti-Inflammatory and Anti-Allergy Agents). 2021;20(4):317–32.
• 11. Tupper OD, Håkansson KEJ, Ulrik CS. Remission and changes in severity over 30 years in an adult asthma cohort. The Journal of Allergy and Clinical Immunology: In Practice. 2021;9(4):1595–603.
• 12. Ke J, Qiu F, Fan W, Wei S. Associations of complete blood cell count-derived inflammatory biomarkers with asthma and mortality in adults: a population-based study. Frontiers in Immunology. 2023;2.
• 13. Murphy VE. Managing asthma in pregnancy. Breathe. 2015;11(4):258–67.
• 14. Vaezi, A., Haghighi, L., Beigmohammadi, F., & Nojomi, M. (2017). Maternal Asthma, Pregnancy, Delivery and Birth Outcomes: A Retrospective Cohort Study. Iranian journal of allergy, asthma, and immunology, 16(2), 92–98.
• 15. Christoforaki V, Zafeiriou Z, Daskalakis G, Katasos T, Siristatidis C. First trimester neutrophil to lymphocyte ratio (NLR) and pregnancy outcome. Journal of Obstetrics and Gynaecology. 2020;40(1):59–64.
• 16. Galliazzo S, Nigro O, Bertù L, Guasti L, Grandi AM, Ageno W, et al. Prognostic role of neutrophils to lymphocytes ratio in patients with acute pulmonary embolism: a systematic review and meta-analysis of the literature. Internal and emergency medicine. 2018;13(4):603–8.
• 17. Longo LD. Respiratory gas exchange in the placenta. Comprehensive Physiology. 2011;351–401.
• 18. Rejnö G, Lundholm C, Gong T, Larsson K, Saltvedt S, Almqvist C. Asthma during pregnancy in a population-based study-pregnancy complications and adverse perinatal outcomes. PLoS One. 2014;9(8):e104755.
• 19. Murphy VE, Namazy JA, Powell H, Schatz M, Chambers C, Attia J, et al. A meta‐analysis of adverse perinatal outcomes in women with asthma. BJOG: An International Journal of Obstetrics & Gynaecology. 2011;118(11):1314–23.
• 20. Wang G, Murphy VE, Namazy J, Powell H, Schatz M, Chambers C, et al. The risk of maternal and placental complications in pregnant women with asthma: a systematic review and meta-analysis. The Journal of Maternal-Fetal & Neonatal Medicine. 2014;27(9):934–42.
• 21. Blais L, Kettani FZ, Forget A. Relationship between maternal asthma, its severity and control and abortion. Human Reproduction. 2013;28(4):908–15.
• 22. Baghlaf H, Spence AR, Czuzoj-Shulman N, Abenhaim HA. Pregnancy outcomes among women with asthma. J Matern Fetal Neonatal Med. 2019;32(8):1325-1331.
• 23. Tanacan A, Fadiloglu E, Celebioglu ED, et al. The Effect of Asthma Severity on Perinatal Outcomes: A Tertiary Hospital Experience. Z Geburtshilfe Neonatol. 2021;225(4):333-340.
• 24. Guarnieri M, Balmes JR. Outdoor air pollution and asthma. The Lancet. 2014;383(9928):1581–92.
• 25. Zeiger RS, Schatz M, Dalal AA, Chen W, Sadikova E, Suruki RY, et al. Blood eosinophil count and outcomes in severe uncontrolled asthma: a prospective study. The Journal of Allergy and Clinical Immunology: In Practice. 2017;5(1):144–53.