Cervical insufficiency is a known risk factor for spontaneous preterm delivery and often leads to pregnancy loss in the second trimester. The aim of the study was to determine whether the Systemic Immune-Inflammation Index (SII), Systemic Inflammatory Response Index (SIRI) and Pan-Immune Inflammation Value (PIV) before and after cerclage, as well as alterations in these indices, can predict preterm birth and composite adverse perinatal outcomes (CAPOs). This retrospective study included 104 singleton pregnancies in which cervical cerclage was performed between 12 and 24 weeks’ gestation. Inflammatory indices were calculated from complete blood counts obtained within 48 h before and after the cerclage. Delta scores were calculated as the difference between preoperative and postoperative inflammatory index values. Patients were categorized into term (≥ 37 weeks) and preterm (< 37 weeks) delivery groups. ROC analysis was performed to assess the predictive value of inflammatory indices for preterm birth and CAPOs. Higher pre-SII, post-SII and post-PIV scores were significantly associated with preterm delivery and CAPOs (p < 0.05). Delta-SII values were significantly lower in the preterm group and were associated with shorter cerclage-to-delivery intervals, increased cesarean rates, and CAPOs. ROC analysis showed that pre-SII (AUC: 0.657, 95% CI: 0.55–0.77, p = 0.006), post-SII (AUC: 0.721, 95% CI: 0.62–0.82, p < 0.001), delta-SII (AUC: 0.635, 95% CI: 0.53–0.74, p = 0.019) and post-PIV (AUC: 0.624, 95% CI: 0.51–0.74, p = 0.030) had a statistically significant predictive accuracy for preterm birth. Post-SII also predicted CAPOs with an AUC of 0.723 (95% CI: 0.62–0.82, p < 0.001). Systemic inflammatory indices, particularly the delta-SII, pre-SII, post-SII, and post-PIV, are promising biomarkers for predicting the outcome of cervical cerclage. Monitoring these indices may help clinicians identify high-risk patients and optimize prenatal care to improve maternal and neonatal outcomes.
Filiz et al. (Fri,) studied this question.