Evaluation Of Hematologic Inflammatory Markers İn Missed Abortus: A Retrospective Case-Control Study

Objective: This study aims to evaluate the relationship between hematological inflammatory markers neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte
ratio (PLR), and systemic immune-inflammatory index (SII) and missed abortion, as well as to investigate their potential predictive roles.
Materials and Methods: In this retrospective cross-sectional study, the missed group included 150 pregnant women diagnosed with missed abortion between
the ages of 18 and 40. This group was compared to a control group of 150 pregnant women with healthy singleton pregnancies, matched according to gestational
week. Demographic data and laboratory results for all cases were collected retrospectively from the hospital automation system. Exclusion criteria included multiple
pregnancy, recurrent pregnancy loss, chronic illness, history of malignancy, smoking or alcohol use, hereditary thrombophilia, and a history of anhydramnios.
Results: The demographic characteristics of the groups were similar (p>0.05). Mean lymphocyte levels were higher in the missed abortion group compared to the
control group (p=0.037). The median NLR value was 2.88 (2.26–3.66) in the control group and 2.62 (1.81–3.44) in the missed abortion group, showing a significant
difference (p=0.018). No significant differences were observed between the groups in other hematological parameters (WBC, neutrophil count, RBC, platelet count,
HCT, MCV, MPV, PDW, RDW, INR, and hemoglobin) or in inflammatory indices such as PLR (p=0.057) and SII (p=0.073). In the subgroup analysis of pregnancies under 12
weeks, WBC and lymphocyte levels were higher in the missed abortion group, whereas PLR was higher in the control group (p<0.05).
Conclusion: The etiology of missed abortion remains unexplained in most cases. This study suggests that NLR and lymphocyte levels may have predictive value in the
diagnosis of missed abortion. Particularly in early pregnancy, careful evaluation of these parameters may contribute to the identification of high-risk cases.