Evaluating the predictive value of systemic inflammation indices in early pregnancy loss: a retrospective observational study

In addition to chromosomal abnormalities, excessive systemic or local inflammation, particularly in the uterus, may also contribute to the pathogenesis of early pregnancy loss. Recently, several systemic immune inflammation indices, including the systemic immune-inflammation index (SII), the systemic inflammation response index (SIRI), the neutrophil-to-lymphocyte ratio (NLR), and the pan-immune inflammation value (PIV), have been used as potential predictive markers for complicated pregnancies. Early pregnancy loss is associated with an inappropriate inflammatory response in pregnancy. In this retrospective study, we investigated whether these systemic immune inflammation indices are associated with the onset of early pregnancy loss. Six hundred sixty-three women with early pregnancy loss and 700 women without pregnancy complications across gestation were included. Data on complete blood tests were collected at the time of diagnosis, and the immune inflammation indices were calculated and analyzed. Women with early pregnancy loss had significantly decreased counts of total white cells, neutrophils, lymphocytes, monocytes, and platelets. However, the inflammation response indices, SII, SIRI, and NLR, but not PIV, in women with early pregnancy loss did not differ significantly from those in the controls. The predictive probability of early pregnancy loss was 58% using the combined four systemic inflammation indices, which had limited predictive power. In conclusion, our findings suggest that systemic inflammation, as measured by peripheral blood tests, is not strongly associated with early pregnancy loss.