Clinical Significance of First Trimester Combined Inflammatory Markers in Predicting Adverse Obstetric Outcomes in Multiple Sclerosis

To evaluate the clinical utility of first trimester composite inflammatory markers—including systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), and pan-immune-inflammation value (PIV)—in predicting adverse obstetric outcomes in pregnancies complicated by multiple sclerosis (MS). This retrospective case–control study included 63 pregnant women with MS and 66 healthy controls. Complete blood count–derived inflammatory indices were calculated from first trimester laboratory data. Obstetric outcomes were compared between groups, and ROC analyses were conducted to assess the predictive value of inflammatory markers. Among MS patients, those who experienced adverse obstetric outcomes had significantly higher levels of SII, SIRI, and PIV compared to those with favorable outcomes.SII demonstrated the highest diagnostic accuracy with an AUC of 0.795. Compared to healthy controls, the MS group had significantly lower gestational age at delivery, neonatal birth weight, and Apgar scores, and higher rates of preterm birth, oligohydramnios, and NICU admission. Composite hematological inflammatory indices, particularly SII, may serve as early, non-invasive markers of obstetric risk in pregnant women with MS. These findings highlight the persistent subclinical inflammation in MS pregnancies and support the potential role of inflammatory markers in individualized antenatal surveillance.