Dayanan Ruken, Bayraktar Burak, Karabay Gulsan, Filiz Ahmet Arif, Tonyali Nazan Vanli, Cakir Betul Tokgoz, Aktemur Gizem, Seyhanli Zeynep, Gultekin Ismail Burak, Celen Sevki
Department of Perinatology, Ankara Etlik City Hospital, Ankara, Turkey.
Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara, Turkey.
BMC Pregnancy Childbirth. 2025 Jul 12;25(1):759. doi: 10.1186/s12884-025-07877-6.
To evaluate the prognostic value of albumin-associated inflammatory indices in predicting delivery latency in pregnancies complicated by preterm premature rupture of membranes (PPROM).
This retrospective study included a cohort of singleton pregnancies diagnosed with PPROM between 24 and 34 weeks of gestation. Inflammatory indices calculated at admission included leukocyte-to-albumin ratio (LAR), neutrophil-to-albumin ratio (NAR), monocyte-to-albumin ratio (MAR), fibrinogen-to-albumin ratio (FAR), systemic immune-inflammation index to albumin ratio (SII/Alb), systemic inflammation response index to albumin ratio (SIRI/Alb), neutrophil percentage-to-albumin ratio (NPAR), and C-reactive protein-to-albumin ratio (CAR). Latency periods were categorized as ≤ 48 hours (h), 72 h, 96 h, and 7 days. Receiver operating characteristic (ROC) analyses were performed to assess predictive performance.
This retrospective study evaluated 311 PPROM cases managed at a tertiary center between January 2023 and December 2023. Among the evaluated indices, LAR, NAR, and FAR demonstrated consistent and statistically significant associations with shorter latency periods across all predefined intervals (≤ 48 h, 72 h, 96 h, and 7 days). FAR exhibited the strongest predictive performance for delivery within 48 h (AUC: 0.637), followed by NAR and LAR. NPAR and CAR showed moderate predictive value at 72 h and 96 h (AUCs ~ 0.566–0.603), and NPAR remained significant at the 7-day mark (AUC: 0.605). SII/Alb was predictive at 72 and 96 h (AUCs: 0.584 and 0.616, respectively), while SIRI/Alb reached significance only at 96 h (AUC: 0.574). MAR did not demonstrate predictive value at any time point.
Albumin-associated inflammatory indices—particularly LAR, NAR, and FAR—are promising, cost-effective markers for identifying PPROM patients at risk for imminent delivery. These easily accessible laboratory parameters may support individualized management strategies. Further prospective studies are warranted to validate these findings and explore their role in clinical decision-making.
评估白蛋白相关炎症指标在预测妊娠合并胎膜早破（PPROM）分娩延迟方面的预后价值。
这项回顾性研究纳入了一组在妊娠24至34周期间被诊断为PPROM的单胎妊娠队列。入院时计算的炎症指标包括白细胞与白蛋白比值（LAR）、中性粒细胞与白蛋白比值（NAR）、单核细胞与白蛋白比值（MAR）、纤维蛋白原与白蛋白比值（FAR）、全身免疫炎症指数与白蛋白比值（SII/Alb）、全身炎症反应指数与白蛋白比值（SIRI/Alb）、中性粒细胞百分比与白蛋白比值（NPAR）以及C反应蛋白与白蛋白比值（CAR）。潜伏期分为≤48小时（h）、72小时、96小时和7天。进行受试者操作特征（ROC）分析以评估预测性能。
这项回顾性研究评估了2023年1月至2023年12月在一家三级中心管理的311例PPROM病例。在评估的指标中，LAR、NAR和FAR在所有预定义间隔（≤48小时、72小时、96小时和7天）内均显示出与较短潜伏期一致且具有统计学意义的关联。FAR在48小时内分娩的预测性能最强（AUC：0.637），其次是NAR和LAR。NPAR和CAR在72小时和96小时显示出中等预测价值（AUC约为0.566 - 0.603），并且NPAR在7天标记时仍具有统计学意义（AUC：0.605）。SII/Alb在72小时和96小时具有预测性（AUC分别为0.584和0.616），而SIRI/Alb仅在96小时达到统计学意义（AUC：0.574）。MAR在任何时间点均未显示出预测价值。
白蛋白相关炎症指标——尤其是LAR、NAR和FAR——是有前景的、具有成本效益的标志物，可用于识别有即将分娩风险的PPROM患者。这些易于获取的实验室参数可能支持个体化管理策略。需要进一步的前瞻性研究来验证这些发现并探索它们在临床决策中的作用。
