Department of Perinatology, Ankara Etlik City Hospital, Ankara, Turkey.
Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara, Turkey.
Am J Reprod Immunol. 2024 Jul;92(1):e13899. doi: 10.1111/aji.13899.
To investigate the role of inflammatory markers, including neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and monocyte to lymphocyte ratio (MLR), c-reactive protein (CRP) to albumin ratio (CAR), fibrinogen to albumin ratio (FAR), and fibrinogen to CRP ratio (FCR) in predicting the latency period (≤72 vs. >72 hours) before preterm birth.
In a retrospective study, we assessed 135 patients meeting the specified criteria with signs of preterm labor (<34 weeks). The patients were categorized into two groups: 71 patients giving birth within 72 h (latency ≤ 72 h) and 64 patients giving birth after 72 h (latency > 72 h). We examined the demographic and medical characteristics and perinatal outcomes of all participants. Categorical variables between groups were compared using the Chi-square test. The Student's t-test was utilized for normally distributed continuous variables, and the Mann-Whitney U test was applied for non-normally distributed data. Receiver operating characteristic (ROC) curve analysis was conducted to identify the optimal cut-off levels for inflammatory markers in predicting the latency period before birth.
Among the parameters examined, significant differences were observed between the groups only in terms of CAR and FCR. While CAR showed a significantly higher value in the group with latency period ≤72 h (0.537 ± 1.239 vs. 0.247 ± 0.325, p = 0.022), FCR showed a significantly lower value in the group with latency period ≤72 h (63.58 (2.99-1165) vs. 88.93 (9.35-1165), p = 0.013). The identified cut-off value for CAR was 0.190, providing a sensitivity of 57.7% and a specificity of 56.3% (p = 0.022). The cut-off value for FCR was 71.67, with a sensitivity of 42.3% and a specificity of 42.2% (p = 0.013).
The CAR and the FCR, serving as predictive markers for preterm labor, may offer a simple, cost-effective, and easily accessible approach, particularly in resource-limited settings.
探讨炎症标志物，包括中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、单核细胞与淋巴细胞比值（MLR）、C 反应蛋白与白蛋白比值（CAR）、纤维蛋白原与白蛋白比值（FAR）和纤维蛋白原与 C 反应蛋白比值（FCR）在预测早产潜伏期（≤72 小时与>72 小时）中的作用。
本回顾性研究纳入了 135 名符合早产迹象（<34 周）标准的患者。患者分为两组：71 名在 72 小时内分娩（潜伏期≤72 小时）和 64 名在 72 小时后分娩（潜伏期>72 小时）。我们检查了所有参与者的人口统计学和医学特征以及围产期结局。组间的分类变量采用卡方检验进行比较。正态分布的连续变量采用学生 t 检验，非正态分布数据采用 Mann-Whitney U 检验。采用受试者工作特征（ROC）曲线分析确定炎症标志物预测分娩前潜伏期的最佳截断值。
在所检查的参数中，仅在 CAR 和 FCR 方面两组间存在显著差异。CAR 在潜伏期≤72 小时组中具有显著更高的数值（0.537±1.239 与 0.247±0.325，p=0.022），而 FCR 在潜伏期≤72 小时组中具有显著更低的数值（63.58（2.99-1165）与 88.93（9.35-1165），p=0.013）。CAR 的截断值为 0.190，其灵敏度为 57.7%，特异性为 56.3%（p=0.022）。FCR 的截断值为 71.67，灵敏度为 42.3%，特异性为 42.2%（p=0.013）。
CAR 和 FCR 作为预测早产的标志物，可能提供一种简单、经济有效的方法，特别是在资源有限的情况下。
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