The Effect of Systemic Inflammation on Newborns: The Prognostic Value of the Aggregate Systemic Inflammation Index (AISI) and Systemic Inflammatory Response Index (SIRI)
Abstract
1. Introduction
2. Materials and Methods
2.1. Patients and Data Collection
2.2. Exclusion Criteria for the Study
2.3. Group Selection
2.4. Systemic Inflammatory Response Index (SIRI)
2.5. Aggregate Systemic Inflammation Index (AISI)
2.6. Statistical Analysis
2.7. Ethics Committee Approval
3. Results
3.1. Comparison of Preterm and Term Groups
3.2. Comparison of Early Preterm, Middle Preterm, and Late Preterm Delivery Groups
3.3. Receiver Operating Characteristic (ROC) Analysis Results
4. Discussion
5. Conclusions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
AISI | Aggregate Index of Systemic Inflammation |
MAS | Meconium Aspiration Syndrome |
NICU | Neonatal Intensive Care Unit |
NLR | Neutrophil-to-Lymphocyte Ratio |
PLR | Platelet-to-Lymphocyte Ratio |
PPROM | Preterm Premature Rupture of Membranes |
RDS | Respiratory Distress Syndrome |
ROC | Receiver Operating Characteristic |
SIRI | Systemic Inflammatory Response Index |
SIRS | Systemic Inflammatory Response Syndrome |
TTN | Transient Tachypnea of the Newborn |
References
- Ercan, A.; Firat, A. Impact of Complete Blood Count (CBC) Parameters in Preterm Birth Prediction in Cases with Threatened Preterm Labour (TPL). Clin. Exp. Obstet. Gynecol. 2024, 51, 180. [Google Scholar] [CrossRef]
- Fan, W.; Wei, C.; Liu, Y.; Sun, Q.; Tian, Y.; Wang, X.; Liu, J.; Zhang, Y.; Sun, L. The prognostic value of hematologic inflammatory markers in patients with acute coronary syndrome undergoing percutaneous coronary intervention. Clin. Appl. Thromb./Hemost. 2022, 28, 10760296221146183. [Google Scholar] [CrossRef]
- Tokalioglu, E.O.; Tanacan, A.; Agaoglu, M.O.; Özbebek, Ü.G.; Okutucu, G.; Kayaalp, H.; Uzuner, P.; Sahin, D. Aggregate index of systemic inflammation: A novel systemic inflammatory index for prediction of neonatal outcomes and chorioamnionitis in women with preterm premature rupture of membranes. Int. J. Gynecol. Obstet. 2025, 168, 640–649. [Google Scholar] [CrossRef] [PubMed]
- Yang, Y.; Song, C.; Jia, L.; Dong, Q.; Song, W.; Yin, D.; Dou, K. Prognostic value of multiple complete blood count-derived indices in intermediate coronary lesions. Angiology 2023, 76, 141–153. [Google Scholar] [CrossRef] [PubMed]
- Borzova, N.Y.; Radjabova, N.R.; Sotnikova, N.Y.; Kudryashova, A.; Malyshkina, A. New prognostic criterion for the outcome of pregnancy in patients with threatening preterm birth. Klin. Lab. Diagn. 2022, 67, 97–100. [Google Scholar] [CrossRef]
- Qi, Q.; Zhuang, L.; Shen, Y.; Geng, Y.; Yu, S.; Chen, H.; Liu, L.; Meng, Z.; Wang, P.; Chen, Z. A novel systemic inflammation response index (SIRI) for predicting the survival of patients with pancreatic cancer after chemotherapy. Cancer 2016, 122, 2158–2167. [Google Scholar] [CrossRef]
- Hosseninia, S.; Ghobadi, H.; Garjani, K.; Hosseini, S.A.H.; Aslani, M.R. Aggregate index of systemic inflammation (AISI) in admission as a reliable predictor of mortality in COPD patients with COVID-19. BMC Pulm. Med. 2023, 23, 107. [Google Scholar] [CrossRef]
- Jiang, Y.; Luo, B.; Lu, W.; Chen, Y.; Peng, Y.; Chen, L.; Lin, Y. Association Between the Aggregate Index of Systemic Inflammation and Clinical Outcomes in Patients with Acute Myocardial Infarction: A Retrospective Study. J. Inflamm. Res. 2024, 17, 7057–7067. [Google Scholar] [CrossRef]
- Jimoh, M.A.; Arinola, G.O.; Abdus-Salam, A.; Adenipekun, A. Systemic inflammation response index and aggregate inflammation systemic index in male and female cancers: Implication for gender based immunotherapy. J. Clin. Exp. Investig. 2023, 14, em00827. [Google Scholar] [CrossRef]
- Xiu, J.; Lin, X.; Chen, Q.; Yu, P.; Lu, J.; Yang, Y.; Chen, W.; Bao, K.; Wang, J.; Zhu, J.; et al. The aggregate index of systemic inflammation (AISI): A novel predictor for hypertension. Front. Cardiovasc. Med. 2023, 10, 1163900. [Google Scholar] [CrossRef]
- Cakir, U.; Tayman, C. Evaluation of systemic inflammatory indices in the diagnosis of early onset neonatal sepsis in very low birth weight infants. J. Neonatal-Perinat. Med. 2024, 17, 169–176. [Google Scholar] [CrossRef]
- Akin, M.S.; Akyol, O.; Okman, E.; Yazici, A.; Sari, F.N.; Dizdar, E.A. Systemic Inflammatory Indices as Predictors of Lung Maturation in Preterm Infants Born Before 32 Weeks of Gestation. J. Pediatr. Intensive Care 2024. [Google Scholar] [CrossRef]
- Hrubaru, I.; Motoc, A.; Moise, M.L.; Miutescu, B.; Citu, I.M.; Pingilati, R.A.; Popescu, D.E.; Dumitru, C.; Gorun, F.; Olaru, F.; et al. The predictive role of maternal biological markers and inflammatory scores NLR, PLR, MLR, SII, and SIRI for the risk of preterm delivery. J. Clin. Med. 2022, 11, 6982. [Google Scholar] [CrossRef]
- Zinellu, A.; Paliogiannis, P.; Mangoni, A.A. Aggregate index of systemic inflammation (AISI), disease severity, and mortality in COVID-19: A systematic review and meta-analysis. J. Clin. Med. 2023, 12, 4584. [Google Scholar] [CrossRef] [PubMed]
- Haryati, H.; Wicaksono, B.; Syahadatina, M. Complete blood count derived inflammation indexes predict outcome in COVID-19 patients: A study in Indonesia. J. Infect. Dev. Ctries. 2023, 17, 319–326. [Google Scholar] [CrossRef]
- Ghobadi, H.; Mohammadshahi, J.; Javaheri, N.; Fouladi, N.; Mirzazadeh, Y.; Aslani, M.R. Role of leukocytes and systemic inflammation indexes (NLR, PLR, MLP, dNLR, NLPR, AISI, SIR-I, and SII) on admission predicts in-hospital mortality in non-elderly and elderly COVID-19 patients. Front. Med. 2022, 9, 916453. [Google Scholar] [CrossRef]
- Göçmen, A.; Demir, T.G. The aggregate index of systemic inflammation as a predictor of mortality in stroke patients. Cureus 2024, 16, e64007. [Google Scholar] [CrossRef]
- Feier, C.V.I.; Muntean, C.; Bolboacă, S.D.; Olariu, S. Exploratory evaluation of pre-treatment inflammation profiles in patients with colorectal cancer. Diseases 2024, 12, 61. [Google Scholar] [CrossRef]
- Yang, Y.; Xu, Y.; Liu, S.; Lu, P.; Zhou, H.; Yang, M. The systemic inflammation indexes predict all-cause mortality in peritoneal dialysis patients. Ren. Fail. 2023, 45, 2160348. [Google Scholar] [CrossRef]
- Beser, D.M.; Ozgurluk, I.; Oluklu, D.; Yildiz, E.G.; Kara, O.; Tanacan, A.; Sahin, D. Impact of neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), systemic inflammation index (SII), systemic inflammation response index (SIR-I), and aspartate transaminase/platelet ratio (APRI) in predicting pregnancy outcom. Ann. Med. Res. 2023, 30, 1001–1007. [Google Scholar] [CrossRef]
- Zheng, L.; Ge, R.; Weng, X.; Lin, L. Predictive Value of Serum Immune-Inflammatory Markers for Adverse Pregnancy Outcomes in Pregnant Women with Thrombophilia: A Retrospective Cohort Study. J. Inflamm. Res. 2024, 17, 6083–6091. [Google Scholar] [CrossRef] [PubMed]
- Fang, J.; Lin, Y.; Chen, Z.; Lin, Y.; Pan, M. The association of inflammatory markers with maternal-neonatal outcome after cervical cerclage. J. Inflamm. Res. 2023, 16, 245–255. [Google Scholar] [CrossRef] [PubMed]
- Pantea, M.; Kalapala, C.; Thakur, B.R.; Iacob, D.; Borțea, C.I.; Herlo, A.; Marc, F.; Tanasescu, S.; Bucur, A. Predictive Role of Maternal Laboratory Parameters and Inflammatory Scores in Determining Systemic Inflammatory Response Syndrome in Newborns at Birth. J. Pers. Med. 2024, 14, 672. [Google Scholar] [CrossRef]
Preterm Group (n = 528) | Term Group (n = 528) | p | |
---|---|---|---|
Age (years) (Median (Min–Max)) | 33.5 (19–47) | 34 (23–53) | 0.534 |
Gravida (Median (Min–Max)) | 1 (1–6) | 2 (1–6) | 0.053 |
Parity (Median (Min–Max)) | 0 (0–4) | 1 (0–4) | <0.001 |
Abortus (Median (Min–Max)) | 0 (0–3) | 0 (0–3) | <0.001 |
Smoking (n, %) | 195 (36.9%) | 78 (14.8%) | <0.001 |
Employment Status (n, %) | 195 (36.9%) | 210 (39.8%) | 0.342 |
Education (n, %) | |||
Primary school | 144 (27.3%) | 46 (8.7%) | <0.001 |
High school | 315 (59.7%) | 431 (81.6%) | <0.001 |
College/University | 69 (13.1%) | 51 (9.7%) | <0.001 |
Yearly income level (n, %) | |||
Low | 27 (5.1%) | 28 (5.3%) | <0.001 |
Medium | 132 (25%) | 448 (84.8%) | <0.001 |
High | 369 (69.9%) | 52 (9.8%) | <0.001 |
Hospitalization Week (Median (Min–Max)) | 34 (27–36) | 39 (37–42) | <0.001 |
1st minute APGAR score (Median (Min–Max)) | 6 (2–7) | 8 (7–9) | <0.001 |
5th minute APGAR score (Median (Min–Max)) | 8 (5–9) | 9 (8–10) | <0.001 |
NICU (n, %) | 189 (35.8%) | 24 (4.5%) | <0.001 |
RDS | 164 (31.1%) | 0 (0%) | <0.001 |
Bacterial sepsis | 146 (27.7%) | 16 (3%) | <0.001 |
TTN | 21 (4%) | 13 (2.5%) | 0.222 |
MAS | 8 (1.5%) | 6 (1.1%) | 0.788 |
Congenital Pneumonia | 49 (9.3%) | 0 (0%) | <0.001 |
Duration of NICU Hospitalization(Median (Min–Max)) | 0 (0–28) | 0 (0–10) | <0.001 |
SIRI (Median (Min–Max)) | |||
1st trimester | 1.4 (0–16) | 1.3 (0.1–26.5) | 0.028 |
Hospitalization Time | 2.1 (0–16.4) | 1.5 (0.01–20.3) | <0.001 |
AISI (Median (Min–Max)) | |||
1st trimester | 482.3 (0–3554.7) | 356.7 (3.1–4789.3) | <0.001 |
Hospitalization Time | 310.8 (0–3136) | 306.8 (5.2–5981.8) | 0.545 |
Early Preterm (n = 78) | Middle Preterm (n = 111) | Late Preterm (n = 339) | p | |
---|---|---|---|---|
Age (years) (Median (Min–Max)) | 34 (24–44) | 34 (23–46) | 33 (19–47) | 0.667 |
Gravida (Median (Min–Max)) | 1 (1–4) | 1 (1–5) | 1 (1–6) | 0.597 |
Parity (Median (Min–Max)) | 0 (0–3) | 0 (0–3) | 0 (0–4) | 0.935 |
Abortus (Median (Min–Max)) | 0 (0–1) | 0 (0–3) | 0 (0–2) | 0.655 |
Smoking (n, %) | 21 (26.9%) | 36 (32.4%) | 138 (40.7%) | 0.041 |
Employment Status (n, %) | 24 (30.8%) | 27 (24.3%) | 144 (42.5%) | 0.001 |
Education (n, %) | ||||
Primary school | 18 (23.1%) | 12 (10.8%) | 114 (33.6%) | <0.001 |
High school | 51 (65.4%) | 75 (67.6%) | 189 (55.8%) | <0.001 |
College/University | 9 (11.5%) | 24 (21.6%) | 36 (10.6%) | <0.001 |
Yearly income level (n, %) | ||||
Low | 0 (0%) | 12 (10.8%) | 15 (4.4%) | <0.001 |
Medium | 15 (19.2%) | 9 (8.1%) | 108 (31.9%) | <0.001 |
High | 63 (80.8%) | 90 (81.1%) | 216 (63.7%) | <0.001 |
Hospitalization Week (Median (Min–Max)) | 30 (27–31) | 32 (32–33) | 35 (34–36) | <0.001 |
1st minute APGAR score (Median (Min–Max)) | 2 (2–3) | 5 (4–6) | 6 (6–7) | <0.001 |
5th minute APGAR score (Median (Min–Max)) | 6 (5–7) | 7 (6–8) | 8 (8–9) | <0.001 |
NICU (n, %) | 78 (100%) | 90 (81.1%) | 21 (6.2%) | <0.001 |
RDS | 78 (100%) | 86 (77.5%) | 0 (0%) | <0.001 |
Bacterial sepsis | 63 (80.8%) | 72 (64.9%) | 11 (3.2%) | <0.001 |
TTN | 0 (0%) | 0 (0%) | 21 (6.2%) | 0.002 |
MAS | 0 (0%) | 0 (0%) | 8 (2.4%) | 0.104 |
Congenital Pneumonia | 23 (29.5%) | 26 (23.4%) | 0 (0%) | <0.001 |
Duration of NICU Hospitalization(Median (Min–Max)) | 15 (7–28) | 7 (0–7) | 0 (0–10) | <0.001 |
SIRI (Median (Min–Max)) | ||||
1st trimester | 5.7 (4.0–16) | 2.7 (1.8–4.3) | 0.9 (0–2.3) | <0.001 |
Hospitalization Time | 6.8 (5.2–16.4) | 3.5 (3.0–4.9) | 1.4 (0–2.9) | <0.001 |
AISI (Median (Min–Max)) | ||||
1st trimester | 1571 (576–3554) | 857 (460–1680) | 302 (0–952) | <0.001 |
Hospitalization Time | 1219 (354–3136) | 612 (236–1371) | 165 (0–674) | <0.001 |
Variables | AUC | S.E. | p | OR (95% CI) | Cutt-Off | Sensitivity | Specificity |
---|---|---|---|---|---|---|---|
Preterm Delivery | |||||||
AISI | 0.625 | 0.017 | <0.001 | 0.592–0.659 | 399.2 | 59.7% | 59.8% |
SIRI | 0.648 | 0.017 | <0.001 | 0.615–0.680 | 1.7 | 59.1% | 58.9% |
NICU | |||||||
AISI | 0.855 | 0.016 | <0.001 | 0.823–0.886 | 558.8 | 79.3% | 79.2% |
SIRI | 0.878 | 0.014 | <0.001 | 0.851–0.906 | 2.4 | 81.7% | 81.6% |
RDS | |||||||
AISI | 0.941 | 0.007 | <0.001 | 0.927–0.955 | 694 | 87.8% | 87.8% |
SIRI | 0.956 | 0.006 | <0.001 | 0.944–0.967 | 3.1 | 89% | 59.5% |
Sepsis | |||||||
AISI | 0.865 | 0.016 | <0.001 | 0.833–0.896 | 602.1 | 79.6% | 79.2% |
SIRI | 0.822 | 0.014 | <0.001 | 0.854–0.910 | 3 | 85.8% | 85.7% |
Congenital Pneumonia | |||||||
AISI | 0.892 | 0.015 | <0.001 | 0.863–0.920 | 753.8 | 81.6% | 81.9% |
SIRI | 0.905 | 0.011 | <0.001 | 0.883–0.927 | 3.4 | 85.7% | 83.8% |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2025 by the author. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Kırat, S. The Effect of Systemic Inflammation on Newborns: The Prognostic Value of the Aggregate Systemic Inflammation Index (AISI) and Systemic Inflammatory Response Index (SIRI). Diagnostics 2025, 15, 1544. https://doi.org/10.3390/diagnostics15121544
Kırat S. The Effect of Systemic Inflammation on Newborns: The Prognostic Value of the Aggregate Systemic Inflammation Index (AISI) and Systemic Inflammatory Response Index (SIRI). Diagnostics. 2025; 15(12):1544. https://doi.org/10.3390/diagnostics15121544
Chicago/Turabian StyleKırat, Samet. 2025. "The Effect of Systemic Inflammation on Newborns: The Prognostic Value of the Aggregate Systemic Inflammation Index (AISI) and Systemic Inflammatory Response Index (SIRI)" Diagnostics 15, no. 12: 1544. https://doi.org/10.3390/diagnostics15121544
APA StyleKırat, S. (2025). The Effect of Systemic Inflammation on Newborns: The Prognostic Value of the Aggregate Systemic Inflammation Index (AISI) and Systemic Inflammatory Response Index (SIRI). Diagnostics, 15(12), 1544. https://doi.org/10.3390/diagnostics15121544