Abstract:

Aim: This study aimed to investigate the relationship between systemic immune inflammation (SII) and response indices (SIRI), which are new markers of systemic inflammation derived from immune cells, and preterm premature rupture of membranes (PPROM), as well as adverse pregnancy outcomes. Materials and Methods: The retrospective study included 75 singleton pregnancies complicated with PPROM between 24 and 34 gestational weeks and 75 healthy pregnant women who delivered at term (control group). Inflammation indices were calculated based on neutrophil (N), platelet (P), lymphocyte (L), and monocyte (M) counts as follows: The neutrophil-to-lymphocyte ratio (NLR) = N/L; the platelet-to-lymphocyte ratio (PLR) = P/L; SII = (N×P)/L; and SIRI = (N×M)/L. Results: The median NLR (4.8 vs. 3.5, p <0.001), median PLR (145.1 vs. 126.5, p<0.001), median SII (1208.6 vs. 807.4, p<0.001), and median SIRI (3.1 vs. 2.0, p<0.001) were higher in the PPROM group than the control group. Multiple logistic regression analysis showed that increased SIRI (OR = 7.05, p=0.010), as well as increased CRP levels were determined as independent predictors of PPROM. In PPROM group, SIRI was higher in the presence with complications compared to without complications (3.4 vs. 2.5, p<0.001). The SIRI showed superior diagnostic performance in predicting the presence and complications of PPROM compared to other inflammation indices. Conclusions: PPROM had higher leukocyte-based inflammation indices than the control group. Due to superior diagnostic performance of SIRI in distinguishing both PPROM and complications compared to other leukocyte-based inflammation indices, it may serve as a significant screening tool in PPROM.

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