The Predictive Role of Maternal Biological Markers and Inflammatory Scores NLR, PLR, MLR, SII, and SIRI for the Risk of Preterm Delivery
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Ethics and Design
2.2. Patient Inclusion and Study Groups
2.3. Study Variables and Definitions
2.4. Statistical Analysis
3. Results
3.1. Background Analysis
3.2. Laboratory Analysis
3.3. ROC and AUC Analysis
3.4. Risk Analysis
4. Discussion
4.1. Important Findings
4.2. Study Limitations and Future Perspectives
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables * | Prematurity Group (n = 243) | No Prematurity Group (n = 243) | Significance |
---|---|---|---|
General characteristics | |||
Age (years), mean ± SD | 29.6 ± 4.9 | 29.9 ± 5.0 | 0.504 |
BMI (kg/m2), mean ± SD | 26.2 ± 3.3 | 22.4 ± 3.1 | <0.001 |
Previous pregnancies | 0.892 | ||
1 | 152 (61.3%) | 157 (61.7%) | |
2 | 62 (23.4%) | 59 (25.9%) | |
≥3 | 29 (15.3%) | 27 (12.3%) | |
Number of births | 0.099 | ||
1 | 187 (77.0%) | 171 (70.4%) | |
≥2 | 56 (23.0%) | 72 (29.6%) | |
Comorbidities ** | 0.274 | ||
0 | 176 (72.4%) | 189 (77.8%) | |
1 | 54 (22.2%) | 40 (16.5%) | |
≥2 | 13 (5.3%) | 14 (5.8%) | |
Obstetrical characteristics | |||
Week of birth, mean ± SD | 35.9 ± 4.7 | 37.7 ± 5.1 | <0.001 |
PPROM | 18 (7.4%) | 4 (1.6%) | 0.002 |
Abnormal placental implantation | 24 (9.9%) | 18 (7.4%) | 0.332 |
Cesarean delivery | 36 (14.8%) | 41 (21.0%) | 0.075 |
UTIs during pregnancy | 44 (18.1%) | 28 (11.5%) | 0.041 |
History of pregnancy loss | 4 (5.8%) | 9 (3.7%) | 0.285 |
History of induced abortion | 11 (4.5%) | 7 (2.9%) | 0.336 |
COVID-19 during pregnancy | 17 (7.0%) | 6 (2.5%) | 0.018 |
COVID-19 vaccination status | 31 (12.8%) | 44 (18.1%) | 0.102 |
Smoking status | 24 (9.9%) | 9 (3.7%) | 0.006 |
Variables * | Prematurity Group (n = 243) | No Prematurity Group (n = 243) | Significance |
---|---|---|---|
Trimester of analysis | 0.783 | ||
2nd trimester | 103 (42.4%) | 106 (43.6%) | |
3rd trimester | 140 (57.6%) | 137 (56.4%) | |
Serum parameters | |||
WBC (×109/L) | 9.22 ± 5.70 | 8.94 ± 5.21 | 0.048 |
Lymphocytes (×109/L) | 0.76 ± 0.48 | 1.05 ± 0.89 | <0.001 |
Neutrophils (×109/L) | 8.10 ± 5.13 | 7.24 ± 4.97 | 0.061 |
Monocytes (×109/L) | 0.56 ± 0.17 | 0.52 ± 0.19 | 0.014 |
PLT (×109/L) | 210.8 ± 72.3 | 232.1 ± 79.6 | 0.002 |
Hb (g/dL) | 11.72 ± 1.54 | 12.99 ± 1.60 | <0.001 |
Inflammatory scores | |||
NLR | 13.75 ± 9.13 | 9.06 ± 7.17 | <0.001 |
dNLR | 6.92 ± 3.17 | 5.11 ± 3.09 | <0.001 |
PLR | 286.2 ± 195.4 | 237.0 ± 203.8 | 0.007 |
MLR | 0.86 ± 0.33 | 0.79 ± 0.21 | 0.005 |
SII | 2351 ± 1044 | 2185 ± 1142 | 0.095 |
SIRI | 6.94 ± 4.86 | 6.12 ± 4.91 | 0.064 |
Inflammatory Scores | AUC | 95% CI | SE | Sensitivity | Specificity | Significance | |
---|---|---|---|---|---|---|---|
Lower Bound | Upper Bound | ||||||
NLR dNLR | 0.694 0.655 | 0.561 0.538 | 0.843 | 0.078 | 71% | 66% | 0.009 |
0.822 | 0.074 | 65% | 70% | 0.022 | |||
PLR | 0.682 | 0.556 | 0.857 | 0.081 | 70% | 69% | 0.015 |
MLR | 0.607 | 0.462 | 0.705 | 0.093 | 66% | 63% | 0.048 |
SII | 0.580 | 0.494 | 0.736 | 0.125 | 52% | 65% | 0.113 |
SIRI | 0.496 | 0.317 | 0.692 | 0.183 | 48% | 69% | 0.157 |
Risk | (95% CI) | Significance | |
---|---|---|---|
Hazard Ratio | |||
NLR | 3.61 | 1.94–6.15 | <0.001 |
dNLR | 3.13 | 1.82–5.34 | <0.001 |
PLR | 4.07 | 1.25–7.84 | <0.001 |
MLR | 1.96 | 1.44–3.78 | 0.002 |
SII | 1.50 | 0.94–1.45 | 0.134 |
SIRI | 1.24 | 0.92–1.97 | 0.090 |
Adjusted Odds Ratio * | |||
NLR | 4.23 | 1.81–7.36 | <0.001 |
dNLR | 3.09 | 1.72–5.94 | <0.001 |
PLR | 5.65 | 2.30–8.05 | <0.001 |
MLR | 2.17 | 1.39–2.51 | 0.046 |
SII | 1.58 | 0.99–1.93 | 0.217 |
SIRI | 1.66 | 0.89–1.87 | 0.195 |
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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. https://doi.org/10.3390/jcm11236982
Hrubaru I, Motoc A, Moise ML, Miutescu B, Citu IM, Pingilati RA, 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. Journal of Clinical Medicine. 2022; 11(23):6982. https://doi.org/10.3390/jcm11236982
Chicago/Turabian StyleHrubaru, Ingrid, Andrei Motoc, Marius Liviu Moise, Bogdan Miutescu, Ioana Mihaela Citu, Raja Akshay Pingilati, Daniela-Eugenia Popescu, Catalin Dumitru, Florin Gorun, Flavius Olaru, and et al. 2022. "The Predictive Role of Maternal Biological Markers and Inflammatory Scores NLR, PLR, MLR, SII, and SIRI for the Risk of Preterm Delivery" Journal of Clinical Medicine 11, no. 23: 6982. https://doi.org/10.3390/jcm11236982