The role of first trimester serum inflammatory indexes (NLR, PLR, MLR, SII, SIRI, and PIV) and the -hCG to PAPP-A ratio in predicting preeclampsia

Objective: The aim of this study was to investigate the predictive value of inflammation parameters and indices measured in the first trimester for the detection of preeclampsia. Materials and methods: In this retrospective analysis, we examined the medical records of 276 eligible pregnancies at a tertiary referral center from 2022 to 2023. The cases were categorized into the Control group (n = 171), the Mild Preeclampsia group (n = 63), and the Severe Preeclampsia group (n = 42). We examined the demographic characteristics and perinatal outcomes of all participants. Additionally, we analyzed laboratory parameters, including neutrophil-to-lymphocyte ratio (NLR), platelet -to -lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune inflammation index (SII) (neutrophil*platelet/lymphocyte), systemic inflammation response index (SIRI)(neutrophil*monocyte/lymphocyte), pan -immune inflammation value (PIV) (neutrophil*platelet*monocyte/lymphocyte), and the beta-hCG to PAPP-A ratio in the first trimester. Receiver operating characteristic curve (ROC) analysis was conducted to identify the optimal cut-off levels for inflammatory markers in predicting preeclampsia. Results: SIRI and PIV exhibited statistical significance in differentiating between the preeclampsia and control groups for predicting preeclampsia. The determined cut-off value for SIRI was 1.5, providing a sensitivity of 56.2% and a specificity of 55.6% (p = 0.012). Likewise, the cut-off value for PIV was 394.4, with a sensitivity of 55.2% and a specificity of 55% (p = 0.013). NLR, PLR, MLR, SII, and beta-hCG to PAPP-A ratio could not predict preeclampsia. Conclusions: This study suggests that SIRI and PIV hold promise as potential tools for predicting the risk of preeclampsia during the first trimester.