Systemic inflammatory indices in the first trimester: emerging tools for early prediction of preeclampsia

Vollständiger Abstract

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Aim To investigate the association between first-trimester systemic inflammatory indices and the subsequent development of preeclampsia and to evaluate their predictive performance as early screening markers. Methods This retrospective case-control study included 123 women who subsequently developed preeclampsia and 121 healthy pregnant controls. Inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), aggregate index of systemic inflammation (AISI), and systemic inflammation marker index (SIMI), were calculated and compared between groups. Receiver operating characteristic (ROC) curve analysis was performed to assess their predictive value. Results Maternal age and gestational age at sampling were similar between groups, whereas parity was significantly higher in the preeclampsia group (P < .001). Women who subsequently developed preeclampsia had significantly lower neutrophil counts and higher lymphocyte counts than controls. Accordingly, NLR, SII, SIRI, and AISI were significantly lower in the preeclampsia group (P < .01), while PLR and SIMI did not differ significantly. ROC analysis demonstrated that NLR had the highest predictive performance (AUC: 0.677, 95% CI: 0.610–0.744), followed by SIRI (AUC: 0.648, 95% CI: 0.579–0.717). Although statistically significant, the overall discriminative abilities of these markers were limited. Conclusion First-trimester inflammatory indices are associated with the subsequent development of preeclampsia. Among the evaluated markers, NLR and SIRI demonstrated the best predictive performance; however, their clinical utility as standalone screening tools appears limited. These inexpensive biomarkers may contribute to multifactorial prediction models for identifying women at risk for preeclampsia.