{"id":59,"title":"First-Trimester Hematologic Inflammatory Markers and Pregnancy Loss in Women With Unexplained Recurrent Pregnancy Loss: A Retrospective Study of Associations and Discrimination","title_zh":"早孕期血液炎症标志物与不明原因复发性流产女性妊娠丢失的关联及判别能力：一项回顾性研究","url":"https://pubmed.ncbi.nlm.nih.gov/42985969","doi":"10.1002/iid3.70535","pmid":"42985969","journal":"Immun Inflamm Dis","kind":"paper","lang":"en","published_at":"2026-11-01T00:00:00+00:00","fetched_at":"2026-11-08T03:43:52+00:00","authors":["Wang R","Mu F","Zhang W","Wang K","Wang F"],"primary_topic":"early-pregnancy","topics":[{"slug":"early-pregnancy","score":8.0,"hits":["pregnancy loss","recurrent pregnancy loss"]},{"slug":"art-clinical","score":1.0,"hits":["live birth"]},{"slug":"repro-tox","score":1.0,"hits":["body mass index"]}],"topic_score":8.0,"preference_score":0.0,"preference_labels":[],"llm_score":70.0,"final_score":70.0,"score_dims":{"novelty":60,"rigor":72,"impact":62,"relevance":88,"translation":58},"recommend_reason":"单中心回顾性设计且缺乏外部验证，但样本量尚可、指标易获取，对URPL风险分层有初步参考价值，适合浏览。","keywords":["不明原因复发性流产","早孕期","血常规炎症指标","中性粒细胞/淋巴细胞比值","全身免疫炎症指数","妊娠丢失"],"selected":1,"story_id":242,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"pubmed-art","source_name":"PubMed · 辅助生殖临床","source_tier":1,"mention_count":2,"has_interpretation":false,"journal_key":null,"journal_tier":"unknown","journal_if":null,"is_mock":false,"summary_zh":"回顾性纳入517例不明原因复发性流产女性，按结局分为妊娠丢失组265例和活产组252例，用孕4—8周血常规计算NLR、MLR、PLR、SII和SIRI，并行多因素logistic回归与ROC分析。校正年龄、教育、民族和BMI后，NLR、SIRI、SII升高与妊娠丢失风险增加相关；NLR判别能力最高（AUC=0.752），SII次之（0.716）。提示早孕期血常规炎症指标与URPL妊娠丢失相关，但需前瞻性多中心外部验证。","summary":"OBJECTIVE: This study aims to investigate whether complete blood count (CBC)-derived systemic inflammation indices are associated with pregnancy loss in women with unexplained recurrent pregnancy loss (URPL). METHODS: This retrospective observational study included 517 women with URPL who were recruited from Lanzhou University Second Hospital between September 2019 and December 2022. Participants were categorized into the pregnancy loss (n = 265) group and live birth (n = 252) group. CBCs obtained at 4-8 weeks of gestation were used to calculate the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI). We fitted multivariable logistic regression models adjusted for age, education, ethnicity, and body mass index. We assessed in-sample discriminative performance using receiver operating characteristic (ROC) curves. RESULTS: Compared with the live birth group, the pregnancy loss group had higher neutrophil counts, NLR, SII, SIRI, MLR, and PLR, and lower lymphocyte counts (all p < 0.001). After adjustment, higher NLR (OR = 3.05, 95% CI: 2.25-4.21), SIRI (OR = 2.74, 95% CI: 1.77-4.33), and SII (per 100-unit increase, OR = 1.36, 95% CI: 1.24-1.51) were associated with greater odds of pregnancy loss. In tertile analyses, compared with the lowest tertile, the highest tertile was associated with higher odds of pregnancy loss for NLR (OR = 5.51), SII (OR = 2.88), SIRI (OR = 2.55), MLR (OR = 2.41), and PLR (OR = 3.41), with all p-values for trend < 0.001. In ROC analyses, NLR showed the highest in-sample discriminative performance (AUC = 0.752), followed by SII (AUC = 0.716). CONCLUSION: First-trimester CBC-derived inflammatory indices, particularly NLR and SII, were associated with pregnancy loss in women with URPL and may have potential discriminative value within this cohort. These findings require confirmation in prospective, multicenter studies with broader confounder assessment and external validation before any clinical application can be considered.","interpretation_basis":null,"fulltext_status":null,"interpretation":null,"fulltext":{"available":false,"status":null,"reason":"尚未抓取全文（未入选、分数未达阈值，或还没跑 fulltext 步骤）","pmcid":null,"license":null,"chars":0,"source":null,"fetched_at":null}}