AI Summary & Key Takeaways
AI InsightThese findings require validation in larger prospective studies before clinical application.
📌 3 Key Takeaways
Abstract
Aims: To investigate the association between first-trimester maternal obesity, adverse obstetric outcomes, and complete blood count (CBC)-derived inflammatory indices, and to compare the predictive performance of maternal body-mass index (BMI) and inflammatory markers for obesity related adverse maternal outcomes. Methods: This retrospective cohort study included 648 singleton pregnancies evaluated between 11 and 14 weeks of gestation. According to first-trimester BMI, participants were classified as normal weight (n=301), overweight (n=222), or obese (n=125). Maternal characteristics, obstetric outcomes, and inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), Systemic Inflammatory Response Index (SIRI), Systemic Immune-inflammation Index (SII), and pan-immune-inflammation value (PIV), were analyzed. Logistic regression and receiver operating characteristic (ROC) analyses were performed. Results: Gestational diabetes mellitus, gestational hypertension, preeclampsia, cesarean delivery, and composite adverse maternal outcome (CAMO) were significantly more frequent among overweight and obese female (all p<0.05). Leukocyte and platelet counts were significantly higher in obese female, whereas SIRI, SII, NLR, and PIV did not differ significantly among BMI groups. In multivariable analysis, first-trimester BMI (aOR: 1.116, p<0.001, 95% CI: 1.064-1.171), maternal age (aOR: 1.088, p=0.001, 95% CI:1.036-1.143), and MLR (aOR: 5.446, p=0.020, 95% CI: 1.306-22.712) remained independently associated with CAMO. ROC analysis showed modest discriminatory performance of first-trimester BMI for CAMO (AUC: 0.680, 95% CI: 0.623-0.738), while a combined model including BMI, maternal age, and MLR improved discrimination (AUC: 0.726, 95% CI: 0.669-0.783) Conclusion: Maternal first-trimester BMI remained the strongest predictor of obesity-related adverse maternal outcomes. Although MLR was independently associated with adverse maternal outcomes, the incremental improvement in predictive performance beyond maternal BMI was modest and of limited clinical significance. These findings require validation in larger prospective studies before clinical application.