Background
Fetal growth restriction (FGR) is a major pregnancy complication associated with stillbirth, perinatal morbidity, mortality and long-term consequences for the offspring. Therefore, its prediction, early detection and appropriate follow-up are essential components of prenatal care. In most cases, also referred to as late-onset idiopathic FGR (IL-FGR), symptoms appear after 34 weeks and the underlying pathology is unclear. Our aim was to investigate the relationship between altered inflammation and pathogenesis using inflammatory indices calculated from the complete blood count.
Methods
We conducted a retrospective case-control study in a large tertiary hospital between 2022 and 2023. Data from all participants at the time of screening for fetal aneuploidy and structural anomalies at 11–14 weeks were retrospectively reviewed and compared.
Results
A total of 106 eligible participants with IL-FGR and 106 women who experienced a healthy prenatal and perinatal period were included. Neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), pan-immune inflammation value (PIV) and SIRI/body-mass index (BMI) were significantly higher in the IL-FGR group (p < 0.001 for all). SIRI/BMI with a cut-off value of >76.3 × 103 × kg/μL × m2 (64 % sensitivity, 80 % specificity) showed the best discriminatory performance for IL-FGR prediction. Correlation analysis of gestational age-adjusted parameters with these indices showed a negative correlation with birthweight, suggesting that higher values of the inflammatory indices at the 11–14-week aneuploidy screening are associated with a greater likelihood of severe IL-FGR.
Conclusions
Our results suggest an association between high SII, SIRI, PIV and SIRI/BMI and an increased risk of future IL-FGR. SIRI/BMI may be an important component of regression models that could be used in the future as a screening tool for predicting FGR. However, our results require further validation by future studies to confirm the specific clinical implications of these indices.
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