Erken gebelik kaybını tahmin etmede hematolojik parametrelerin rolü
Öz
Amaç: Çalışmamızın amacı erken gebelik kaybını tahmin etmede hematolojik parametrelerin rolünü araştırmaktır.
Gereç ve Yöntem: Ocak 2021-2024 tarihleri arasında hastanemize başvuran, gebelik kesesi ölçümleri 6-7 hafta aralığında olan, yaşları 18-45 arasında değişen 284 gebe çalışmaya dahil edildi. Erken gebelik kaybı geçiren 133 gebe çalışma grubuna dahil edilirken, kontrol grubunu ≥37 hafta doğum yapan 151 sağlıklı gebe oluşturdu. Erken gebelik kaybı yaşayan gebeler ile ≥37 hafta doğum yapan gebeler karşılaştırıldı. Tüm hastaların yaş, vücut kitle indeksi, gravida, parite, abortus, sigara içme durumu ve hematolojik parametreleri retrospektif olarak değerlendirildi.
Bulgular: SII ve SIRI, erken gebelik kaybı grubunda kontrol grubuna göre anlamlı derecede daha yüksek saptandı (p=0.044, p=0.042, sırasıyla). PIV, erken gebelik kaybı grubunda grubunda kontrol grubuna göre anlamlı derecede daha yüksek saptandı (p=0.048). Gruplar arasında NLR, PLR, MLR ve MPV açısından anlamlı bir fark saptanmadı.
Sonuç: SII, SIRI ve PIV gibi hematolojik parametreler erken gebelik kaybıyla ilişkili inflamatuar süreçler hakkında değerli bilgiler sağlar. Bu parametrelerin rutin doğum öncesi tarama protokollerine entegre edilmesi, kayıp riski taşıyan gebeliklerin erken tespitini ve yönetimini iyileştirebilir. Standart eşik değerlerini belirlemek için daha fazla çalışmaya ihtiyaç vardır.
Anahtar Kelimeler
Erken gebelik kaybı pan immun inflamasyon değeri sistemik immun inflamasyon indeksi sistemik inflamatuar yanıt indeksi
Kaynakça
- Wilcox AJ, Weinberg CR, O’Connor JF, et al. Incidence of early loss of pregnancy. N Engl J Med. 1988;319(4):189-194.
- Atlıhan U, Ertan B, Özgözen E, Güney M. The role of ultrasonography in predicting first trimester pregnancy loss. Turkish Journal of Reproductive Medicine and Surgery. 2024;8(3):69-74.
- Clement EG, Horvath S, McAllister A, Koelper NC, Sammel MD, Schreiber CA. The language of first-trimester non-viable pregnancy: Patient-reported preferences and clarity. Obstet Gynecol. 2019;133(1):149-154.
- Bas FY, Tola EN, Sak S, Cankaya BA. The role of complete blood inflammation markers in the prediction of spontaneous abortion. Pak J Med Sci. 2018;34(6):1381-1385.
- Challis JR, Lockwood CJ, Myatt L, Norman JE, Strauss JF 3rd, Petraglia F. Inflammation and pregnancy. Reprod Sci. 2009;16(2):206– 15.
- Zhao M, Duan X, Mi L, Shi J, Li N, Yin X, Han X, Wang J, Han G, Hou J, Yin F. Prognosis of hepatocellular carcinoma and its association with immune cells using systemic inflammatory response index. Future Oncol. 2022 Jun;18(18):2269-2288. doi: 10.2217/fon-2021-1087. Epub 2022 Apr 20. PMID: 35440159.
- Yeh C-C, Kao H-K, Huang Y, Tsai T-Y, Young C-K, Lu C-Y, et al. Discovering the clinical and prognostic role of pan-ımmune-ınflammation values on oral cavity squamous cell carcinoma. Cancers. 2023; 15(1):322.
- Atlıhan U, Bıldacı TB, Erkılınç S, Yavuz O, Avşar HA, Ata C. The role of neutrophil/lymphocyte ratio, platelet/lymphocyte ratio and mean platelet volume in diagnosis of hydrosalpinx. ETD. 2024;63(3):449-56.
- Calleja-Agius J, Jauniaux E, Pizzey AR, Muttukrishna S. Investigation of systemic inflammatory response in first trimester pregnancy failure. Hum Reprod. 2012;27(2): 349–57
- Ata N, Kulhan M, Kulhan NG, Turkler C. Can neutrophil-lymphocyte and platelet-lymphocyte ratios predict threat- ened abortion and early pregnancy loss? Ginekol Pol. 2020;91(4):210-215.
- Huang Y, Gao Y, Wu Y, Lin H. Prognostic value of systemic immune-inflammation index in patients with urologic cancers: a meta-analysis. Cancer Cell Int. 2020 Oct 12; 20:499. doi: 10.1186/s12935-020-01590-4. PMID: 33061851; PMCID: PMC7552553.
- Qi, Qi, et al. A novel systemic inflammation response index (SIRI) for predicting the survival of patients with pancreatic cancer after chemotherapy. Cancer 122.14 (2016): 2158-2167.
- Palomino-Secca, I., Peña-Tuya, M., Quintana-García, L.A. et al. Pan-immune-inflammation value and survival in patients with breast cancer from a Peruvian reference hospital. Sci Rep 14, 17132 (2024). https://doi.org/10.1038/s41598-024-68304-y
- Turgut, E., Yildirim, M., Sakcak, B., Ayhan, S. G., Tekin, O. M., & Sahin, D. (2022). Predicting miscarriage using systemic immune‐inflammation index. Journal of Obstetrics and Gynaecology Research, 48(3), 587-592.
- Agaoglu, Z., Tanacan, A., Ipek, G., Peker, A., Ozturk Agaoglu, M., & Sahin, D. (2024). Systemic Inflammation Response Index and Systemic Immune-inflammation Index for Prediction of Pregnancy Loss: a Case–control Study. Reproductive Sciences, 1-8.
- Soykan Sert, Z., & Bülbül, R. (2023). Can the systemic immune-inflammation index be a useful marker for the prediction of a missed abortion in the first trimester of pregnancy? Dubai Medical Journal, 6(1), 14-19.
- Sahin, R., Tanacan, A., Serbetci, H., Agaoglu, Z., Karagoz, B., Haksever, M., ... & Şahin, D. (2023). The role of first-trimester NLR (neutrophil to lymphocyte ratio), systemic immune-inflammation index (SII), and, systemic immune-response index (SIRI) in the prediction of composite adverse outcomes in pregnant women with systemic lupus erythematosus. Journal of Reproductive Immunology, 158, 103978.
- Soysal, C., Sarı, H., Işıkalan, M. M., Özkaya, E. B., Ulaş, Ö., Taşçı, Y., & Keskin, N. (2023). Role of the systemic immune‐inflammation index in threatened abortion patients and predicting of abortion. Journal of Obstetrics and Gynaecology Research, 49(7), 1723-1728.
- Erin, K. B., Ali, A. O., Erden, Ö., Kulaksız, D., & Erin, R. (2023). Can We Predict Spontaneous Abortion Cases Using the Systemic Immune Inflammation Index?
- Genç, Şerife Özlem, and Hüseyin Erdal. Are pan-immune-inflammation value, systemic inflammatory response index and other hematologic inflammatory indexes clinically useful to predict first-trimester pregnancy loss. (2023).
- Topkara Sucu S, Dereli ML, Özkan S, Sucu S, Küçükkayıkçı AS, Çağlar A. Association of haematological inflammatory parameters with miscarriages. JGON. 2024;21(2):95-101.
Role of hematologic parameters in predicting early pregnancy loss
Öz
Aim: To investigate the role of hematologic parameters in predicting early pregnancy loss (EPL).
Materials and Methods: Two hundred eighty-four pregnant women aged between 18 and 45 years who were admitted to our hospital between January 2021-2024 and whose gestational sac measurements were in the 6th-7th weeks, were included in the study. One hundred thirty-three pregnant women who experienced EPL were included in the study group, and the control group consisted of 151 healthy pregnant women who gave birth at ≥37 weeks. Pregnant women who experienced EPL and those who give birth at ≥37 weeks were compared. Age, body mass index (BMI), gravida, parity, abortion, smoking status, and hematologic parameters of all patients were evaluated retrospectively.
Results: SII was significantly higher in the EPL group compared with the control group (p=0.044). SIRI was significantly higher in the EPL group compared with the control group (p=0.042). PIV was significantly higher in the EPL group compared with the control group (p=0.048). No significant difference was found in terms of NLR, PLR, MLR, and MPV between the groups.
Conclusion: Hematologic parameters such as SII, SIRI, and PIV provide valuable information about inflammatory processes associated with early pregnancy loss. Integration of these parameters into routine prenatal screening protocols may improve the early detection and management of pregnancies at risk of loss. Further studies are needed to determine standard threshold values.
Anahtar Kelimeler
Early pregnancy loss pan immune inflamation value systemic immune inflamation index systemic inflammatory response index
Kaynakça
- Wilcox AJ, Weinberg CR, O’Connor JF, et al. Incidence of early loss of pregnancy. N Engl J Med. 1988;319(4):189-194.
- Atlıhan U, Ertan B, Özgözen E, Güney M. The role of ultrasonography in predicting first trimester pregnancy loss. Turkish Journal of Reproductive Medicine and Surgery. 2024;8(3):69-74.
- Clement EG, Horvath S, McAllister A, Koelper NC, Sammel MD, Schreiber CA. The language of first-trimester non-viable pregnancy: Patient-reported preferences and clarity. Obstet Gynecol. 2019;133(1):149-154.
- Bas FY, Tola EN, Sak S, Cankaya BA. The role of complete blood inflammation markers in the prediction of spontaneous abortion. Pak J Med Sci. 2018;34(6):1381-1385.
- Challis JR, Lockwood CJ, Myatt L, Norman JE, Strauss JF 3rd, Petraglia F. Inflammation and pregnancy. Reprod Sci. 2009;16(2):206– 15.
- Zhao M, Duan X, Mi L, Shi J, Li N, Yin X, Han X, Wang J, Han G, Hou J, Yin F. Prognosis of hepatocellular carcinoma and its association with immune cells using systemic inflammatory response index. Future Oncol. 2022 Jun;18(18):2269-2288. doi: 10.2217/fon-2021-1087. Epub 2022 Apr 20. PMID: 35440159.
- Yeh C-C, Kao H-K, Huang Y, Tsai T-Y, Young C-K, Lu C-Y, et al. Discovering the clinical and prognostic role of pan-ımmune-ınflammation values on oral cavity squamous cell carcinoma. Cancers. 2023; 15(1):322.
- Atlıhan U, Bıldacı TB, Erkılınç S, Yavuz O, Avşar HA, Ata C. The role of neutrophil/lymphocyte ratio, platelet/lymphocyte ratio and mean platelet volume in diagnosis of hydrosalpinx. ETD. 2024;63(3):449-56.
- Calleja-Agius J, Jauniaux E, Pizzey AR, Muttukrishna S. Investigation of systemic inflammatory response in first trimester pregnancy failure. Hum Reprod. 2012;27(2): 349–57
- Ata N, Kulhan M, Kulhan NG, Turkler C. Can neutrophil-lymphocyte and platelet-lymphocyte ratios predict threat- ened abortion and early pregnancy loss? Ginekol Pol. 2020;91(4):210-215.
- Huang Y, Gao Y, Wu Y, Lin H. Prognostic value of systemic immune-inflammation index in patients with urologic cancers: a meta-analysis. Cancer Cell Int. 2020 Oct 12; 20:499. doi: 10.1186/s12935-020-01590-4. PMID: 33061851; PMCID: PMC7552553.
- Qi, Qi, et al. A novel systemic inflammation response index (SIRI) for predicting the survival of patients with pancreatic cancer after chemotherapy. Cancer 122.14 (2016): 2158-2167.
- Palomino-Secca, I., Peña-Tuya, M., Quintana-García, L.A. et al. Pan-immune-inflammation value and survival in patients with breast cancer from a Peruvian reference hospital. Sci Rep 14, 17132 (2024). https://doi.org/10.1038/s41598-024-68304-y
- Turgut, E., Yildirim, M., Sakcak, B., Ayhan, S. G., Tekin, O. M., & Sahin, D. (2022). Predicting miscarriage using systemic immune‐inflammation index. Journal of Obstetrics and Gynaecology Research, 48(3), 587-592.
- Agaoglu, Z., Tanacan, A., Ipek, G., Peker, A., Ozturk Agaoglu, M., & Sahin, D. (2024). Systemic Inflammation Response Index and Systemic Immune-inflammation Index for Prediction of Pregnancy Loss: a Case–control Study. Reproductive Sciences, 1-8.
- Soykan Sert, Z., & Bülbül, R. (2023). Can the systemic immune-inflammation index be a useful marker for the prediction of a missed abortion in the first trimester of pregnancy? Dubai Medical Journal, 6(1), 14-19.
- Sahin, R., Tanacan, A., Serbetci, H., Agaoglu, Z., Karagoz, B., Haksever, M., ... & Şahin, D. (2023). The role of first-trimester NLR (neutrophil to lymphocyte ratio), systemic immune-inflammation index (SII), and, systemic immune-response index (SIRI) in the prediction of composite adverse outcomes in pregnant women with systemic lupus erythematosus. Journal of Reproductive Immunology, 158, 103978.
- Soysal, C., Sarı, H., Işıkalan, M. M., Özkaya, E. B., Ulaş, Ö., Taşçı, Y., & Keskin, N. (2023). Role of the systemic immune‐inflammation index in threatened abortion patients and predicting of abortion. Journal of Obstetrics and Gynaecology Research, 49(7), 1723-1728.
- Erin, K. B., Ali, A. O., Erden, Ö., Kulaksız, D., & Erin, R. (2023). Can We Predict Spontaneous Abortion Cases Using the Systemic Immune Inflammation Index?
- Genç, Şerife Özlem, and Hüseyin Erdal. Are pan-immune-inflammation value, systemic inflammatory response index and other hematologic inflammatory indexes clinically useful to predict first-trimester pregnancy loss. (2023).
- Topkara Sucu S, Dereli ML, Özkan S, Sucu S, Küçükkayıkçı AS, Çağlar A. Association of haematological inflammatory parameters with miscarriages. JGON. 2024;21(2):95-101.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Kadın Hastalıkları ve Doğum |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 8 Eylül 2025 |
| Gönderilme Tarihi | 14 Mart 2025 |
| Kabul Tarihi | 13 Mayıs 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 64 Sayı: 3 |
