Zhuang Yunting, Xiao Yanxuan, Bai Ruiyan, Song Yao, Lin Zeshan, Yu Yiqi, Chen Qian, Wang Zhijian
Department of Obstetrics, Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China.
School of Nursing, Southern Medical University, Guangzhou, People's Republic of China.
J Inflamm Res. 2025 Mar 25;18:4359-4366. doi: 10.2147/JIR.S504552. eCollection 2025.
Preeclampsia (PE) is a syndrome exclusive to pregnancy, presenting substantial risks to maternal and fetal health. Systemic immune-inflammatory response is a prominent feature of PE.
A retrospective study was conducted involving 749 pregnant women in Guangzhou, China from September 2018 to September 2024. Three hundred and seventy participants were diagnosed with PE, 166 of which had adverse pregnancy outcomes (APOs). Immuno-inflammatory markers expressed in peripheral blood were evaluated during the second-trimester. APOs included postpartum haemorrhage (PPH), premature rupture of membranes (PROM), placental abruption, fetal growth restriction, neonatal intensive care unit (NICU) transfer, and fetal distress. The relationship between immune-inflammatory markers and PE and APOs was analyzed.
Women with PE were at higher risk of APOs and had higher levels of neutrophil-to-lymphocyte ratio (NLR), systemic immunoinflammatory index (SII) and systemic inflammatory response index (SIRI). The AUC values for NLR, SII, and SIRI with PE were 0.594, 0.649, and 0.646 (P < 0.001), with cut-off values of 4.389, 994.863, and 2.406, respectively. For APOs in PE, the AUC values were 0.632, 0.627 and 0.669, with cut-off values of 4.959, 1070.408 and 3.346, respectively. Analysis indicated higher SII levels with increased incidences of fetal growth restriction, NICU transfer and fetal distress, and SIRI levels with NICU transfer and fetal distress (P < 0.05).
Elevated levels of immune-inflammatory markers including NLR, SII, and SIRI are associated with PE and APOs. Our findings underscored the different optimal cut-off values of immune-inflammatory markers in the pregnant women between PE and the APOs.
子痫前期（PE）是一种妊娠特有的综合征，对母婴健康构成重大风险。全身免疫炎症反应是PE的一个突出特征。
对2018年9月至2024年9月在中国广州的749名孕妇进行了一项回顾性研究。370名参与者被诊断为PE，其中166名有不良妊娠结局（APO）。在孕中期评估外周血中表达的免疫炎症标志物。APO包括产后出血（PPH）、胎膜早破（PROM）、胎盘早剥、胎儿生长受限、新生儿重症监护病房（NICU）转诊和胎儿窘迫。分析免疫炎症标志物与PE和APO之间的关系。
患有PE的女性发生APO的风险更高，且中性粒细胞与淋巴细胞比值（NLR）、全身免疫炎症指数（SII）和全身炎症反应指数（SIRI）水平更高。NLR、SII和SIRI诊断PE的AUC值分别为0.594、0.649和0.646（P<0.001），截断值分别为4.389、994.863和2.406。对于PE中的APO，AUC值分别为0.632、0.627和0.669，截断值分别为4.959、1070.408和3.346。分析表明，SII水平升高与胎儿生长受限、NICU转诊和胎儿窘迫的发生率增加有关，SIRI水平与NICU转诊和胎儿窘迫有关（P<0.05）。
包括NLR、SII和SIRI在内的免疫炎症标志物水平升高与PE和APO有关。我们的研究结果强调了PE患者与APO患者中免疫炎症标志物的不同最佳截断值。
