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

Seyran Coşar , Ümmügülsüm Esenkaya

  • Seyran Coşar: Hüyük Devlet Hastanesi
  • Ümmügülsüm Esenkaya: SAĞLIK BİLİMLERİ ÜNİVERSİTESİ KONYA ŞEHİR HASTANESİ
  • Year : 2026
  • Vol : 42
  • Issue : 1
  •  Page : 27-33
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.
Cite this Article As : Cosar S, Esenkaya U. Azacitidine and Venetoclax Treatment in Acute Myeloid Leukemia: Real-Life Experience. Selcuk Med J 2026;42(1): 27-33

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Conflict of interest : The authors declare that they have no conflict of interest.
This article is published under the CC BY-NC 4.0 license.
Selcuk Medical Journal
2026, Vol. 42 (1)
ISSN: 1017-6616
E-ISSN: 2149-8059
Received : , Accepted : , Published Online :

References

  1. 1. World Health Organization. International Classification of Diseases (ICD-10). Geneva: WHO; 1992.
  2. 2. Wilcox AJ, Weinberg CR, O'Connor JF, et al. Incidence of early loss of pregnancy. N Engl J Med. 1988;319(4):189–194. doi:10.1056/NEJM198807283190401
  3. 3. Wang X, Chen C, Wang L, et al. Conception, early pregnancy loss, and time to clinical pregnancy: a population-based prospective study. Fertil Steril. 2003;79(3):577–584. doi:10.1016/S0015-0282(02)04694-0
  4. 4. Cunningham FG, Leveno KJ, Bloom SL, et al. Williams Obstetrics. 25th ed. McGraw Hill Education; 2018.
  5. 5. Jauniaux E, Farquharson RG, Christiansen OB, et al. Evidence-based guidelines for the investigation and medical treatment of recurrent miscarriage. Hum Reprod. 2006;21(9):2216–2222. doi:10.1093/humrep/del150
  6. 6. Rai R, Regan L. Recurrent miscarriage. Lancet. 2006;368(9535):601–611. doi:10.1016/S0140-6736(06)69204-0
  7. 7. Alijotas-Reig J, Ferrer-Oliveras R. The role of immunology in miscarriage. Curr Opin Obstet Gynecol. 2016;28(3):229–236. doi:10.1097/GCO.0000000000000275
  8. 8. Silver RM, Branch DW, Goldenberg RL. Inflammation and pregnancy loss. J Matern Fetal Neonatal Med. 2011;24(3):273–277. doi:10.3109/14767058.2010.497883
  9. 9. Chaouat G, Ledee-Bataille N, Dubanchet S. Immune cells in uteroplacental tissues throughout pregnancy: a brief review. Reprod Biomed Online. 2007;14(2):256–266. doi:10.1016/S1472-6483(10)60788-9
  10. 10. Zahorec R. Ratio of neutrophil to lymphocyte counts—rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy. 2001;102(1):5–14.
  11. 11. Azab B, Shah N, Radbel J, et al. Value of platelet/lymphocyte ratio as a predictor of all-cause mortality after non-ST-elevation myocardial infarction. J Thromb Thrombolysis. 2012;34(3):326–334. doi:10.1007/s11239-012-0716-1
  12. 12. Hu B, Yang XR, Xu Y, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res. 2014;20(23):6212–6222. doi:10.1158/1078-0432.CCR-14-0442
  13. 13. Korkmazer E, Yücel Y, Çağlayan EK, et al. Assessment of neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in patients with missed abortion. J Turk Ger Gynecol Assoc. 2016;17(3):156–160. doi:10.4274/jtgga.2015.0191
  14. 14. Sert D, Bülbül A. Evaluation of systemic inflammatory markers in missed abortion. Eur J Ther. 2022;28(2):178–183. doi:10.5152/EurJTher.2022.22019.
  15. 15. Çallıoğlu F, Özdemir Ö. Systemic Immune-Inflammation Index in Missed Abortion: A New Marker? J Contemp Med. 2024;14(1):1–5. doi:10.16899/jcm.1354816.
  16. 16. Soysal C, Kılıç S, Aytekin A. Diagnostic value of SII and NLR in women with threatened abortion. Rev Assoc Med Bras. 2023;69(6):e20230714. doi:10.1590/1806-9282.20230714.
  17. 17. Piccinni MP, Scaletti C, Maggi E, Romagnani S. Role of hormone-controlled Th1- and Th2-type cytokines in successful pregnancy. J Neuroimmunol. 2000;109(1):30–33. doi:10.1016/S0165-5728(00)00299-X
  18. 18. Çelik O, Aydin S, Yilmaz E, et al. Inflammatory markers in early pregnancy loss: A prospective study. J Obstet Gynaecol Res. 2019;45(8):1537–1542. doi:10.1111/jog.13990
  19. 19. Aydemir İ, Seçkin KD, Mungan G. Gestational age-specific changes in neutrophil-to-lymphocyte ratio in pregnancy: a longitudinal study. Clin Exp Obstet Gynecol. 2020;47(3):384–388.
  20. 20. Moser G, Guettler J, Forstner D, Gauster M. Maternal Platelets—Friend or Foe of the Human Placenta? Int J Mol Sci.2019;20(22):5639. doi:10.3390/ijms20225639.
  21. 21. Forstner D, Guettler J, Moser G, Gauster M. Changes in Maternal Platelet Physiology during Gestation and Their Interaction with the Placenta. Int J Mol Sci. 2021;22(19):10422. doi:10.3390/ijms221910422.
  22. 22. Govindasamy N, Martin AL, Cao M, et al. 3D biomimetic platform reveals the first interactions of trophoblasts and decidual endothelial cells in the maternal–fetal interface. Dev Cell. 2021;56(24):3569-3583.e7. doi:10.1016/j.devcel.2021.10.018
  23. 23. Yilmaz M, Delibas IB, Isaoglu U, et al. Relationship between mean platelet volume and recurrent miscarriage: a preliminary study. Arch Med Sci. 2015;11(5):989-993. doi:10.5114/aoms.2015.54859.
  24. 24. Kaplanoglu M, Karaca M, Yoldemir T, et al. Decreased mean platelet volume is associated with the severity of first-trimester miscarriage. Clin Appl Thromb Hemost. 2015;21(5):449-454. doi:10.1177/1076029613519851.
  25. 25. Liu X, Shen Y, Wang X, et al. Systemic inflammatory markers in missed miscarriage: a retrospective study. BMC Pregnancy Childbirth. 2021;21:148. doi:10.1186/s12884-021-03657-2.
  26. 26. Demir H, Erbaş Y. Evaluation of hematological inflammatory markers in the same patient during a healthy pregnancy and miscarriage: A self-controlled study. Med Bull Sisli Etfal Hosp. 2022;56(4):454–458. doi:10.14744/SEMB.2022.29033
  27. 27. Turgay B, Zorlu U, Varlı B, Aynaoğlu Yıldız G, Baydemir ŞK, Atabekoğlu CS, Turgay TM. Inflamed Pathways to Motherhood: Evaluating Obstetric and Neonatal Outcomes in Rheumatic Pregnancies. J Clin Med. 2025;14(16):5692. doi:10.3390/jcm14165692