Journal of global health
Systemic inflammatory indices for predicting severe placenta accreta spectrum: a retrospective cohort study
By Lu X, Lei X, Guo C and 7 others.
Abstract
Background
Placenta Accreta Spectrum (PAS) disorders are associated with substantial maternal morbidity, and distinguishing mild from severe forms prenatally remains difficult. Inflammatory indices derived from peripheral blood counts have emerged as promising biomarkers, yet their role in grading PAS severity has been insufficiently investigated. This study aimed to assess the discriminative value of the systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and other inflammatory indices for differentiating severe from mild PAS within an already diagnosed PAS population in late pregnancy.
Methods
This retrospective single-centre cohort study included 1,276 patients with histopathologically confirmed PAS. Third-trimester neutrophil, lymphocyte, monocyte, and platelet counts were used to derive neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), SII, and SIRI. Multivariable logistic regression, receiver operating characteristic curve analysis, and decision curve analysis (DCA) were conducted.