Polycystic ovary syndrome (PCOS) is a common endocrine-metabolic disorder in women of reproductive age, often associated with low-grade chronic inflammation. This study aimed to investigate the relationship between composite inflammatory markers—Neutrophil-to-Lymphocyte Ratio (NLR), Systemic Immune Inflammation Index (SII), Systemic Inflammation Response Index (SIRI), and Aggregate Index of Systemic Inflammation (AISI)—and clinical phenotypes of PCOS, including oligo-/amenorrhea, hyperandrogenism, and polycystic ovarian morphology (PCOM). In this retrospective cross-sectional study, women with PCOS were categorized into subgroups based on clinical phenotypes. Composite inflammatory markers were calculated from complete blood count parameters, and their association with clinical, hormonal, and ultrasonographic findings was analyzed. ROC analysis assessed the discriminatory value of each marker. Inflammatory markers were significantly higher in the oligo-/amenorrhea and PCOM groups. In oligo-/amenorrhea, NLR (2.42 vs. 1.96, p = 0.028), AISI (282.16 vs. 188.73, p = 0.005), SII (664.59 vs. 519.86, p = 0.008), and SIRI (0.97 vs. 0.70, p = 0.005) were elevated. In PCOM, NLR (2.85 vs. 2.25, p = 0.025), AISI (323.15 vs. 262.78, p = 0.049), SII (738.52 vs. 641.27, p = 0.030), and SIRI (1.10 vs. 0.90, p = 0.046) were also higher. AISI showed the best discrimination for oligo-/amenorrhea (AUC = 0.652), while NLR was most predictive for PCOM (AUC = 0.617). Composite inflammatory markers are elevated in specific PCOS phenotypes, especially oligo-/amenorrhea and PCOM, and may reflect low-grade inflammation. These markers may help identify patients at higher cardiometabolic risk and guide preventive strategies.

To evaluate the impact of fibroid size on maternal and neonatal outcomes, determine whether a dose–response pattern exists across size categories (< 5 cm, 5–10 cm, > 10 cm), and identify a threshold at which pregnancy risk increases significantly. This retrospective cohort study included 651 pregnant women with sonographically confirmed uterine fibroids. Participants were stratified into three groups based on the maximum diameter of the largest fibroid: 10 cm. Outcomes assessed included preterm birth, PPROM, malpresentation, caesarean delivery, postpartum haemorrhage (PPH), fetal growth restriction (FGR), NICU admission, miscarriage, surgical outcomes such as operative time and blood loss, and a composite adverse perinatal outcome (CAPO). Logistic regression analysis was performed to identify variables independently associated with CAPO. Adverse events rose stepwise with fibroid size. Preterm birth occurred in 12.3%, 24.1% and 36.1% of the size groups (p < 0.001); PPROM in 2.5%, 10.6% and 13.9% (p < 0.001); malpresentation in 13.3%, 28.6% and 47.2% (p < 0.001). Caesarean deliveries were 56.6%, 67.3% and 92.1%, while PPH rose from 1.3 to 30.6% (both p < 0.001). Operative blood loss and time likewise increased with diameter. Neonatally, mean birthweight declined (3150 g, 2995 g, 2870 g; p = 0.003); NICU admission rose from 13.5 to 34.1% (p < 0.001), and CAPO from 14.8 to 35.1% (p < 0.001). Multivariate analysis showed that fibroids > 5 cm independently predicted CAPO (aOR: 1.84 for 5–10 cm; 3.78 for > 10 cm), while maternal age, parity, IVF were not significant. Descriptive subgroup analysis revealed longer operative times and greater blood loss in women with multiple, cervical, or combined-type fibroids. Fibroid diameter emerged as a key determinant of obstetric and neonatal risk. Lesions > 5 cm, particularly > 10 cm, were associated with markedly increased rates of maternal haemorrhage, preterm birth, and neonatal morbidity. Such pregnancies should be managed as high-risk, with enhanced antenatal surveillance and individualized delivery planning.

To evaluate the prognostic value of albumin-associated inflammatory indices in predicting delivery latency in pregnancies complicated by preterm premature rupture of membranes (PPROM). This retrospective study included a cohort of singleton pregnancies diagnosed with PPROM between 24 and 34 weeks of gestation. Inflammatory indices calculated at admission included leukocyte-to-albumin ratio (LAR), neutrophil-to-albumin ratio (NAR), monocyte-to-albumin ratio (MAR), fibrinogen-to-albumin ratio (FAR), systemic immune-inflammation index to albumin ratio (SII/Alb), systemic inflammation response index to albumin ratio (SIRI/Alb), neutrophil percentage-to-albumin ratio (NPAR), and C-reactive protein-to-albumin ratio (CAR). Latency periods were categorized as ≤ 48 hours (h), 72 h, 96 h, and 7 days. Receiver operating characteristic (ROC) analyses were performed to assess predictive performance. This retrospective study evaluated 311 PPROM cases managed at a tertiary center between January 2023 and December 2023. Among the evaluated indices, LAR, NAR, and FAR demonstrated consistent and statistically significant associations with shorter latency periods across all predefined intervals (≤ 48 h, 72 h, 96 h, and 7 days). FAR exhibited the strongest predictive performance for delivery within 48 h (AUC: 0.637), followed by NAR and LAR. NPAR and CAR showed moderate predictive value at 72 h and 96 h (AUCs ~ 0.566–0.603), and NPAR remained significant at the 7-day mark (AUC: 0.605). SII/Alb was predictive at 72 and 96 h (AUCs: 0.584 and 0.616, respectively), while SIRI/Alb reached significance only at 96 h (AUC: 0.574). MAR did not demonstrate predictive value at any time point. Albumin-associated inflammatory indices—particularly LAR, NAR, and FAR—are promising, cost-effective markers for identifying PPROM patients at risk for imminent delivery. These easily accessible laboratory parameters may support individualized management strategies. Further prospective studies are warranted to validate these findings and explore their role in clinical decision-making.