AI Summary & Key Takeaways
AI InsightElevated first-trimester NLR and SII and increased third-trimester MPV may reflect gestational stage-dependent immune activation; however, their overall discriminative performance remains limited.
📌 3 Key Takeaways
Abstract
Aims: To evaluate trimester-specific changes in hematologic inflammatory indices in pregnancies complicated by intrahepatic cholestasis of pregnancy (ICP) and to determine their potential discriminative performance. Methods: This retrospective case–control study included 84 pregnancies with ICP and 96 healthy controls. Complete blood count parameters obtained in each trimester were used to calculate neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), Systemic Immune-inflammation Index (SII), Systemic Inflammation Response Index (SIRI), pan-immune-inflammation value (PIV), and mean platelet volume (MPV). Groups were compared using appropriate statistical tests. Receiver operating characteristic (ROC) analysis was performed to assess the discriminatory performance of first-trimester indices. Results: Third-trimester body mass index, gestational age at delivery, and birth weight differed significantly between groups (p≤0.001). In trimester-based comparisons, first-trimester neutrophil count, platelet count, NLR, and SII were significantly higher in the ICP group (p=0.042; p=0.011; p=0.005; and p=0.028, respectively). Second-trimester hemoglobin and neutrophil counts were modestly increased in ICP (p=0.038 and p=0.022). In the third trimester, only MPV was significantly elevated in the ICP group (p<0.001). ROC analysis demonstrated modest discriminatory ability for first-trimester NLR (AUC=0.621; p=0.005) and SII (AUC=0.595; p=0.028), whereas other indices were not significant. Conclusion: Selected inflammatory indices demonstrate trimester-specific associations with ICP. Elevated first-trimester NLR and SII and increased third-trimester MPV may reflect gestational stage-dependent immune activation; however, their overall discriminative performance remains limited. These markers may serve as supportive but not standalone diagnostic tools.