Hematological Inflammatory Indices Associated With Metabolic Comorbidities in Women With Recurrent Pregnancy Loss
Year: 2026
Type: article
Study design: Observational Study
Abstract: Introduction Recurrent pregnancy loss (RPL) involves several pathophysiological mechanisms, particularly immunological, inflammatory, and endocrine and metabolic pathways. Comorbidities such as diabetes mellitus (DM) and obesity promote a state of chronic low-grade inflammation, which may be associated with impaired embryo implantation and pregnancy maintenance. Accordingly, inflammatory ratio-based indices, such as the systemic immune-inflammation index (SII) and platelet-to-lymphocyte ratio (PLR), have attracted increasing interest as potential biomarkers of systemic inflammation (BAKIRCI; ATES; YALVAÇ, 2026; HANTOUSHZADEH et al., 2024). Objective To evaluate the association between endocrine and metabolic comorbidities, C-reactive protein (CRP), and inflammatory indices in women with RPL. Methods A cross-sectional study was conducted involving 287 women diagnosed with RPL who were receiving care at specialized healthcare services in Salvador, Bahia, Brazil. Ethics approval number: CAAE 83666724.3.0000.8035. Associations between DM and obesity and CRP, SII, and PLR were investigated. Participants’ obstetric history was stratified according to the number of pregnancy losses into two groups: up to three losses and four or more losses. The analyses were then repeated within each group, with statistical significance set at p<0.05 using the Mann-Whitney U test. Results Women with DM had significantly higher PLR (p=0.0372) and SII (p=0.0191) values, suggesting a greater systemic inflammatory status. Obesity was associated with higher CRP levels, further supporting its role as a pro-inflammatory condition. In the stratified analysis, these associations were observed primarily among women with up to three pregnancy losses. In this group, obesity remained associated with increased CRP levels (p=0.0158), where as DM remained significantly associated with SII (p=0.0132). No significant associations were identified between the evaluated comorbidities and inflammatory markers among women with four or more pregnancy losses.Discussion:The findings of this study showed that women with DM had significantly higher PLR and SII values, whereas obesity was associated with increased CRP levels, indicating a greater systemic inflammatory status. Consistently, Agaoglu et al. (2024) reported significantly higher SII, PLR, neutrophil-to-lymphocyte ratio (NLR), and systemic inflammatory response index (SIRI) values in women with RPL compared with women without a history of pregnancy loss. Taken together, these findings support an association between RPLand systemic inflammation, with complete blood count-derived inflammatory indices representing potential markers of this process. Conclusion DM was consistently associated with elevated hematological inflammatory indices, particularly SIIandPLR, in women withRPL. Obesity was associated with increased CRP levels, further supporting the involvement of low-grade systemic inflammation in the study population. Metabolic and inflammatory alterations may be more pronounced among women with up to three pregnancy losses.
Institutions: Universidade Federal da Bahia, Instituto Gonçalo Moniz
Language: English
Subfield: Immunology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: diamond
OpenAlex ID: W7223158207