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. 2025 Apr 1;28(4):545-551.
doi: 10.4103/njcp.njcp_530_24. Epub 2025 Apr 26.

An Assessment of the Relationship Between Fetal Growth Restriction and Maternal Serum Markers of Systemic Inflammation (NLR, SIRI, SII, and PIV)

A Akay  1   2 , Y Akdaş-Reis  2 , S Yilmaz-Ergani  3 , K Hajiyeva  2 , Y Engin-Üstün  2
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Free article

An Assessment of the Relationship Between Fetal Growth Restriction and Maternal Serum Markers of Systemic Inflammation (NLR, SIRI, SII, and PIV)

A Akay et al. Niger J Clin Pract. .
Free article

Abstract

Background: The processes involved in inflammatory regulation are crucial during pregnancy.

Aim: This study aims to identify the association between fetal growth restriction (FGR) and neutrophil-to-lymphocyte ratio (NLR), systemic inflammatory response index (SIRI), Systemic immune-inflammatory index (SII), and pan-immune inflammatory value (PIV).

Methods: This retrospective case-control study was conducted between 2015 and 2021. The study group comprised cases diagnosed with FGR, while the control group was randomly selected from a healthy cohort of pregnancies. The levels of inflammatory markers were calculated from the blood count results of the cases. A comparison was conducted between the two groups' obstetric and neonatal outcomes and serum inflammatory markers.

Results: A total of 1052 cases were included in the study, with 526 (50%) belonging to the FGR group. The mean age was found to be similar in both groups (P = .311). A significant increase in neutrophils, NLR, SIRI, SII, and PIV was observed in the FGR group (P < .05). The multivariate logistic regression analysis results demonstrated that elevated neutrophil, NLR, and SII values were independent risk factors for FGR (P < .001). No notable discrepancy was observed in these markers between the early and late FGR (P > .05). A significant inverse relationship was observed between neutrophils, NLR, and SII, and gestational age and fetal weight at birth (P < .05).

Conclusion: The findings indicated that elevations in neutrophils, NLR, and SII are independent risk factors for FGR. These markers reflecting maternal systemic inflammation, have been linked to FGR and associated poor neonatal outcomes.

Keywords: Fetal growth restriction (FGR); neutrophil-to-lymphocyte ratio (NLR); neutrophils; pan-immune inflammatory value (PIV); systemic immune-inflammatory index (SII).

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References

REFERENCES

    1. Nardozza LM, Caetano AC, Zamarian AC, Mazzola JB, Silva CP, Marçal VM, et al. Fetal growth restriction: Current knowledge. Arch Gynecol Obstet 2017;295:1061–77.
    1. Shrivastava D, Master A. Fetal growth restriction. J Obstet Gynaecol India 2020;70:103–10.
    1. Akgun N, Namli Kalem M, Yuce E, Kalem Z, Aktas H. Correlations of maternal neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) with birth weight. J Matern Fetal Neonatal Med 2017;30:2086–91.
    1. Tolunay HE, Eroğlu H, Varli EN, Akşar M, Şahin D, Yücel A. Evaluation of first-trimester neutrophil-lymphocyte ratio and platelet-lymphocyte ratio values in pregnancies complicated by intrauterine growth retardation. Turk J Obstet Gynecol 2020;17:98–101.
    1. Seyhanli Z, Bayraktar B, Baysoz OB, Karabay G, Sucu ST, Ulusoy CO, et al. The role of first trimester serum inflammatory indexes (NLR, PLR, MLR, SII, SIRI, and PIV) and the β-hCG to PAPP-A ratio in predicting preeclampsia. J Reprod Immunol 2024;162:104190.

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