Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug;194(4):1359-1364.
doi: 10.1007/s11845-025-03992-7. Epub 2025 Jun 23.

First-trimester inflammation and dyslipidemia in preterm delivery: the role of monocyte-to-HDL cholesterol ratio and lipid profiles

Didem Kaymak  1 , Simge Berrak Beyoglu Oruc  2 , Ebru Alıcı Davutoğlu  3
Affiliations

First-trimester inflammation and dyslipidemia in preterm delivery: the role of monocyte-to-HDL cholesterol ratio and lipid profiles

Didem Kaymak et al. Ir J Med Sci. 2025 Aug.

Abstract

Background: Preterm delivery (PTD) remains a leading cause of neonatal morbidity and mortality. Maternal inflammatory disturbances during early pregnancy may contribute to PTD pathogenesis. Alterations in lipid metabolism, particularly decreased high-density lipoprotein cholesterol (HDLc) and the HDLc-to-low-density lipoprotein cholesterol (HDLc/LDLc) ratio, alongside inflammatory markers such as the monocyte-to-HDLc ratio (MHR), have been associated with adverse pregnancy outcomes. However, their predictive role for PTD requires further investigation.

Aim: This study aimed to evaluate the relationship between first-trimester maternal lipid profiles, HDLc, HDLc/LDLc ratio, and MHR, and the subsequent risk of PTD.

Methods: A retrospective analysis was conducted on 152 pregnant women, including 53 PTD cases and 99 term deliveries. First-trimester complete blood counts and lipid profiles were assessed. MHR was calculated as the monocyte count divided by the HDLc level. Regression and correlation analyses evaluated associations, while receiver operating characteristic (ROC) curve analysis assessed MHR's predictive value for PTD.

Results: PTD cases exhibited significantly lower HDLc levels and HDLc/LDLc ratios and higher MHR values (p < 0.05). HDLc showed a negative correlation with PTD risk (r = - 0.308, p = 0.000), while MHR correlated positively (r = 0.250, p = 0.002). ROC analysis identified an MHR cut-off of 0.0078 for PTD prediction (AUC = 0.652, 95% CI 0.562-0.741, p = 0.002).

Conclusion: First-trimester elevated MHR and reduced HDLc levels may serve as early biomarkers for PTD risk, reflecting underlying inflammatory and metabolic dysregulation. Early assessment of MHR could enhance risk stratification and guide preventive strategies. Further studies are warranted to validate these findings.

Keywords: First-trimester biomarkers; Inflammation; Maternal lipid profile; Monocyte-to-HDL ratio (MHR); Preterm delivery.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by the Ethics Committee of Agri İbrahim Çeçen University (approval number: 2023-SR-086, Number: E-95531838–050.99–69627). All the procedures were performed following the ethical standards of the institutional research committee and the 1964 Helsinki declaration and its later amendments. The informed consent requirement was waived by the Ethics Committee of Agri İbrahim Çeçen University because of the retrospective study design. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The levels of monocyte, HDLc, LDLc, total cholesterol, triglyceride and the MHR, HDLc/LDL, HDLc/total cholesterol, and HDLc/triglyceride of patients. MHR: monocyte-to-high-density lipoprotein ratio, HDLc: high-density lipoprotein cholesterol, LDLc: low-density lipoprotein cholesterol, MHR: monocyte-to-HDLc ratio
Fig. 2
Fig. 2
Receiver operating curve for MHR for the predicting preterm delivery. MHR: monocyte-to-high-density lipoprotein ratio
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Mathews TJ, MacDorman MF (2008) Infant mortality statistics from the 2005 period linked birth/infant death data set. Natl Vital Stat Rep 57(2):1–32 - PubMed
    1. Lindstrom K, Winbladh B, Haglund B, Hjern A (2007) Preterm infants as young adults: a Swedish national cohort study. Pediatrics 120:70–77 - PubMed
    1. Frey HA, Klebanoff MA (2016) The epidemiology, etiology, and costs of preterm birth. Semin Fetal Neonat Med 21:68–73 - PubMed
    1. Goldenberg RL, Culhane JF, Iams JD, Romero R (2008) Epidemiology and causes of preterm birth. Lancet 371:75–84 - PMC - PubMed
    1. Ossoli A, Remaley AT, Vaisman B et al (2016) Plasma derived and synthetic high-density lipoprotein inhibit tissue factor in endothelial cells and monocytes. Biochem J 473:211–219 - PubMed

LinkOut - more resources