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

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.