Can inflammatory biomarkers based on first trimester complete blood count parameters predict placental abruption ?: A case-control study.

OBJECTIVES: Placental abruption (PA) is associated with adverse maternal and neonatal outcomes and has an etiological mechanism that is not yet fully understood. The prediction of PA, which has been the subject of numerous studies, remains a challenge. In particular, there is evidence that PA can be considered a chronic process. So, this study aimed to show inflammatory biomarkers based on complete blood count parameters may be used to predict PA. STUDY DESIGN: A sample of 110 cases (pregnant women with PA) and 110 controls (healthy pregnant women with spontaneous labor) were required the study. The present case-control study included a total of 220 pregnant women. Inflammatory makers were used to evaluate the PA prediction RESULTS: Increases in body mass index, mean corpuscular volume and paletelet lymphocyte ratio are considered protective factors, while increases in neutrophil, the systemic inflammatory response index, neutrophil lymphocyte ratio and the pan-immune inflammation score are considered risk factors. Each 1 unit increase in neutrophil count increases the risk of a PA diagnosis by 1.81 times. CONCLUSION: Recent studies indicate a strong heterogeneity of clinical courses leading to PA in premature and term births. In the present study, our results showed that, inflammation is associated with PA.

Evaluation of systemic immune-inflammation index for predicting late-onset fetal growth restriction.

INTRODUCTION: To determine a cut-off value for systemic immune-inflammation index (SII) (neutrophil × platelet/lymphocyte) in the prediction of fetal growth restriction (FGR). MATERIALS AND METHODS: This case-control study was conducted retrospectively at the Obstetrics-Gynecology and Perinatology Clinics of Etlik Zubeyde Hanim Women's Health Education and Training Hospital. Singleton pregnant women with late-onset FGR who were followed up in outpatient clinics or hospitalized and whose pregnancy resulted at our hospital were included in the study group (group I). Healthy early and full-term singleton pregnant women with spontaneous labor who were followed up in the same hospital and whose pregnancy resulted at the same hospital were included in the control group (group II). Receiver-operating characteristic curves were used to assess the performance of SII value in predicting FGR. RESULTS: We recruited 79 cases (pregnant with late-onset fetal growth restriction) and 79 controls (healthy pregnant), matched for age, body mass index, and parity. ΔSII was statistically significantly higher in the pregnant with late-onset FGR compared with healthy pregnant (123 vs - 65; p = 0.039). The values in ROC curves with the best balance of sensitivity/specificity were > 152 109/L (49% sensitivity, 70% specificity) and > 586 109/L (27% sensitivity, 90% specificity) for late-onset FGR. DISCUSSION: Higher ΔSII levels in maternal blood indicate an inflammatory process causing FGR. The cut-off value for ΔSII (> 586 109/L) at 90% specificity can be used as a screening test. In the presence of ΔSII levels > 586 109/L (27% sensitivity and 90% specificity), the physicians should be more cautious about risk for FGR. Therefore, pregnant women at risk for FGR should be checked more frequently and monitored closely. However, further studies are needed to confirm our findings.

The role of inflammation in cases with gestational diabetes mellitus: Systemic immune inflammatory index according to trimesters.

PROBLEM: This study aims to investigate the role of the systemic immune-inflammatory index (SII) in inflammation by analyzing SII values by trimester in gestational diabetes mellitus (GDM). METHOD OF STUDY: Between May 2019 and June 2020, we retrospectively enrolled 467 pregnant women who were followed from the first trimester to delivery in our hospital. We evaluated the sociodemographic characteristics, laboratory test results, SII values, Apgar scores, and newborn birth weights of pregnant women diagnosed with GDM. We also compared the SII values of GDM for the 1st, 2nd, and 3rd trimesters with the control group. RESULTS: When examining the SII values of the GDM group in these three trimesters, without including the control group, we found that the SII value of the GDM group in the 3rd trimester was significantly higher than in the 1st trimester, with a gradual increase with each trimester (p = .007). Additionally, the SII value was higher in the GDM group compared to the control group (p = .008). We conducted a Receiver Operating Characteristic (ROC) analysis of the SII value between the groups by trimester. The diagnostic significance of SII between the GDM and control groups was observed in the 3rd trimester, as the area under the curve (AUC) was close to 0.5 and not associated with a specific cutoff value. When examining the relationship between 3rd-trimester SII and study parameters, we found it had a positive and low correlation with the length of prepartum hospitalization, 50 g Oral Glucose Tolerance Test (OGTT), and maximal vertical pocket. CONCLUSION: SII levels were significantly higher in third-trimester GDM patients; however, despite elevated levels of inflammation, fetuses did not experience harm.

Evaluation of maternal serum sestrin-2 levels in intrauterine growth restriction.

BACKGROUND: Sestrin-2 (SESN2) is a antioxidant protein that can be activated by a number of conditions, including DNA damage and hypoxia. AIMS: Our objective was to evaluate maternal serum SESN2 levels in patients with intrauterine growth restriction (IUGR) and its association with adverse perinatal outcomes. METHODS: This prospective study included a total of 87 pregnant women admitted to our tertiary care center between 2018 August and 2019 July. The study group consisted of a total of 44 patients who had been diagnosed with IUGR. Forty-three low-risk and gestational age-matched pregnant women were taken as control group. Demographic data, maternal serum SESN2 levels, and maternal-neonatal outcomes were evaluated. SESN2 levels were analyzed by the enzyme-linked immunosorbent assay (ELISA) method and compared between groups. RESULTS: Maternal serum SESN2 levels were significantly higher in the IUGR group compared to control group (22.38 ng/ml vs. 13.0 ng/ml, p < 0.001). In correlation analysis, a negative significant correlation was found between SESN2 levels and gestational week at delivery (r = - 0.387, p < 0.001). The ideal cut-off value for detecting IUGR was 9.5 ng/ml, and the area under the curve was 0.719 (95%CI: 0.610-0.827). Birth interval, gestational week at birth, birth weight, and 1-5-min Apgar scores were lower in the IUGR group (p < 0.001). CONCLUSIONS: Maternal serum SESN2 levels are elevated in IUGR and are associated with adverse neonatal outcome. Considering that SESN2 is involved in pathogenesis, it can be used as a new marker for the evaluation of IUGR.