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Peer-reviewedCC BYHematology, Transfusion and Cell Therapy

HEMATOLOGICAL INFLAMMATORY INDICES ASSOCIATED WITH METABOLIC COMORBIDITIES IN WOMEN WITH RECURRENT PREGNANCY LOSS

4 affiliations
  1. 1Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
  2. 2Instituto Gonçalo Moniz (IGM), FIOCRUZ, Salvador, BA, Brazil
  3. 3Maternidade Climério de Oliveira (COM), Salvador, BA, Brazil
  4. 4Faculdade de Medicina da Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil

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.

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BibTeX
@article{neto2026hematological,
  title = {{HEMATOLOGICAL INFLAMMATORY INDICES ASSOCIATED WITH METABOLIC COMORBIDITIES IN WOMEN WITH RECURRENT PREGNANCY LOSS}},
  author = {Francisco Das Chagas Barros NETO and Victoria Nascimento SUZART and Elisangela Vitoria ADORNO and Robson Da Paixão DE SOUZA and Marcia Cristina Santana MOREIRA and Manoel Alfredo Curvelo SARNO and Carlos Augusto Santos de MENEZES and Sabrina Oliveira de CARVALHO and Cynara Gomes BARBOSA},
  journal = {Hematology, Transfusion and Cell Therapy},
  year = {2026},
  month = oct,
  doi = {10.1016/j.htct.2026.106734},
  url = {https://doi.org/10.1016/j.htct.2026.106734},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - HEMATOLOGICAL INFLAMMATORY INDICES ASSOCIATED WITH METABOLIC COMORBIDITIES IN WOMEN WITH RECURRENT PREGNANCY LOSS
AU  - Francisco Das Chagas Barros NETO
AU  - Victoria Nascimento SUZART
AU  - Elisangela Vitoria ADORNO
AU  - Robson Da Paixão DE SOUZA
AU  - Marcia Cristina Santana MOREIRA
AU  - Manoel Alfredo Curvelo SARNO
AU  - Carlos Augusto Santos de MENEZES
AU  - Sabrina Oliveira de CARVALHO
AU  - Cynara Gomes BARBOSA
PY  - 2026
DA  - 2026/10/23
JO  - Hematology, Transfusion and Cell Therapy
DO  - 10.1016/j.htct.2026.106734
UR  - https://doi.org/10.1016/j.htct.2026.106734
AB  - 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.
SN  - 2531-1379
SN  - 2531-1387
ER  -