Our study aimed to investigate the value of inflammatory indices in predicting the latency period until birth in patients with preterm premature rupture of membranes (PPROM). This retrospective study was conducted on PPROM cases between 24 and 34 weeks of gestation at Ankara Etlik City Hospital Perinatology Department from October 2023 to April 2024. A total of 146 participants were divided into two groups: Group 1 included 73 patients who gave birth within 72 hours (h) of PPROM diagnosis, and Group 2 included 73 patients who gave birth after 72 h. This study evaluated the prognostic significance of various inflammatory markers neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), systemic immune inflammation index (SII), systemic inflammatory response index (SIRI), pan-immune inflammation value (PIV), immature granulocytes (IG), multi-inflammatory index (MII)-1, MII-2, and MII-3 in predicting the latency period in patients with PPROM. Only MII-1, MII-2, and MII-3 reliably predicted labor within 72 h. The cut-off value for MII-1 was > 48.3, with a sensitivity of 57.7% and specificity of 57.3% (AUC: 0.598, 95% CI: 0.503–0.692, p = 0.042). For MII-2, the cut-off was > 1037.6, with a sensitivity of 57.7% and specificity of 57.3% (AUC: 0.611, 95% CI: 0.516–0.705, p = 0.021). MII-3 had a cut-off of > 10919.9, with a sensitivity of 53.5% and specificity of 52% (AUC: 0.595, 95% CI: 0.501–0.690, p = 0.046). Our findings show that, among NLR, PLR, MLR, SII, SIRI, PIV, IG, MII-1, MII-2, and MII-3, only MII-1, MII-2, and MII-3 levels are statistically significant in predicting birth timing.

The aim of this study was to evaluate the potential of immunonutritional markers, specifically the hemoglobin, albumin, lymphocyte, and platelet (HALP) score and the prognostic nutritional index (PNI), in predicting late-onset fetal growth restriction (LO-FGR) during the first trimester. This retrospective study was conducted at a tertiary care center between October 2022 and August 2023. The study included a total of 213 singleton pregnancies, with 99 women in the LO-FGR group and 114 in the healthy control group, matched by maternal age and gestational age at delivery. All blood samples were collected between 11 and 14 weeks of gestation (during the first-trimester screening test). We analyzed first-trimester laboratory parameters, specifically focusing on hemoglobin levels, white blood cells (WBCs), lymphocytes, platelets, and albumin levels. Afterwards, we calculated the HALP score and PNI, and then compared the values of both groups. Both HALP score (3.58 ± 1.31 vs. 4.19 ± 1.8, p = 0.012) and PNI (36.75 ± 2.9 vs. 39.37 ± 3.96, p < 0.001) were significantly lower in the FGR group than in the control group. The HALP score cut-off value of < 3.43 in predicting FGR had a sensitivity of 62.3% and specificity of 54.5% (AUC = 0.600, 95% CI: 0.528–0.672, p = 0.012). The PNI cut-off value of < 37.9 in predicting FGR had a sensitivity of 65.8% and specificity of 62.9% (AUC = 0.707, 95% CI: 0.632–0.778, p < 0.001). While the HALP score was not a significant predictor of composite adverse neonatal outcomes in the FGR group, PNI showed a cut-off value of < 37.7 with a sensitivity of 60.9% and specificity of 59.7% (AUC = 0.657, 95% CI: 0.581–0.733, p < 0.001). The HALP score and PNI are valuable prognostic tools for predicting the risk of FGR in the first trimester. Low PNI values are also associated with composite adverse neonatal outcomes in pregnancies complicated by FGR.

This study aimed to evaluate the association between mean uterine artery pulsatility index (UtA-PI) ≥ 95th percentile at 20–24 weeks and early-onset preeclampsia (EOPE, < 34 weeks) in pregnancies identified as high risk in first-trimester preeclampsia (PE) screening. This retrospective cohort study included 727 singleton pregnancies with high-risk first-trimester PE screening results (≥ 1/100) and mean UtA-PI measurements at 20–24 weeks. Patients were categorized into two groups: UtA-PI ≥ 95th percentile (n = 111) and < 95th percentile (n = 616). Gestational age-specific reference ranges were derived from a separate cohort of 1,012 low-risk pregnancies. The incidence of EOPE, gestational age at delivery, and birth weight were compared between groups. Multivariate logistic regression identified independent EOPE risk factors, presented as adjusted odds ratios (ORs) and 95% confidence intervals (CIs). EOPE incidence was significantly higher in the UtA-PI ≥ 95th percentile group compared to the < 95th percentile group (13.5% vs. 2.1%, p < 0.001). In multivariate analysis, mean UtA-PI ≥ 95th percentile remained an independent predictor of EOPE (adjusted OR: 12.01, 95% CI: 4.89–29.50, p < 0.001), along with chronic hypertension (adjusted OR: 4.61, 95% CI: 1.76–12.06, p = 0.002) and renal disease (adjusted OR: 38.32, 95% CI: 8.93–164.27, p < 0.001). EOPE also developed in patients with normal UtA-PI, particularly in those with underlying medical comorbidities. In pregnancies identified as high risk in first-trimester PE screening and under aspirin prophylaxis, mean UtA-PI ≥ 95th percentile at 20–24 weeks is associated with a significantly increased EOPE risk. However, maternal comorbidities, such as chronic hypertension, pregestational diabetes, and renal disease, also contribute to EOPE risk even when UtA-PI remains within the normal range. These findings suggest that second-trimester risk stratification should incorporate both UtA-PI and maternal comorbidities rather than relying solely on Doppler parameters. Prospective studies are needed to validate these findings and assess whether aspirin discontinuation is safe in pregnancies with both normal UtA-PI and no additional medical comorbidities.