The significance of Systemic Immune Inflammation Index (SII) and Systemic Inflammation Response Index (SIRI) in fetuses with fetal growth restriction

Abstract

Objectives: Our aim was to investigate the significance of parameters such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune inflammatory index (SII), and systemic inflammatory response index (SIRI) in late fetal growth restriction (FGR) cases.Methods: After applying the exclusion criteria, 70 late FGR cases and 70 healthy pregnant cases matched by maternal age and week of gestation were included in the study. In addition to demographic characteristics, neonatal outcomes, and peripheral blood parameters, we examined whether there were differences between groups in NLR, PLR, MLR, SII, and SIRI scores. We also investigated the association between systemic inflammatory markers and neonatal intensive care unit (NICU) admission. P-values < 0.05 were interpreted as statistically significant. Results:The FGR group had higher leukocyte, neutrophil, NLR, and SII values than the control group (p=0.019; p=0.007; p=0.011; p=0.005, respectively). For the diagnosis of FGR, an optimal cut-off value of ≥4.7946 was found for NLR (with 54.7% sensitivity and 85.7% specificity) and a value of ≥918.15 for SII (with 67.1% sensitivity and 60% specificity). PLR and SII were higher in the FGR group with NICU admission than in the FGR group without NICU admission (p=0.024; p=0.012, respectively). Conclusion:SII, in addition to other clinical data, may contribute to both the diagnosis of FGR and the prediction of NICU admission in FGR cases. This finding is supported by randomized controlled trials with large series of prospective subgroup analyses.