Derived inflammatory indicators for identifying preeclampsia in pregnant patients with systemic lupus erythematosus: a case–control study
6 affiliations
- 1Department of Epidemiology, School of Public Health, Southern Medical University
- 2Reproductive Medicine Center, The Eighth Affiliated Hospital, Southern Medical University (The First People’s Hospital of Shunde)
- 3Sanshui District Center for Disease Control and Prevention
- 4Institute of Nephrology, Guangdong Provincial Key Laboratory of Autophagy and Major Chronic Non-Communicable Diseases, Affiliated Hospital of Guangdong Medical University
- 5Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University
- 6Department of Obstetrics, Dongguan Maternal and Child Health Hospital
Abstract
Background Pregnant women with systemic lupus erythematosus (SLE) are at high risk of preeclampsia (PE). However, overlapping clinical features between the two conditions make it challenging to detect superimposed PE. Failure to promptly recognize PE significantly increases the risk of adverse pregnancy outcomes. In recent years, complete blood count–derived inflammatory indicators (e.g., platelet-to-lymphocyte ratio) have emerged as readily available, low-cost biomarkers with clinical utility. This study aimed to assess the discriminative capacity of these derived inflammatory indicators, measured within one week before delivery, for identifying superimposed PE in pregnant patients with SLE. Methods This retrospective single-center study included 157 pregnant women with SLE treated at Nanfang Hospital of Southern Medical University from April 2010 to October 2024. Clinical and laboratory data, including complete blood count, liver function tests, and coagulation parameters, were collected. Univariate and multivariate logistic regression were performed to identify risk factors for PE and construct combined models. Model performance was assessed using receiver operating characteristic (ROC) curves, Hosmer–Lemeshow test, calibration plots, and the integrated discrimination improvement (IDI) and net reclassification improvement (NRI) indices. Internal validation used the bootstrap method, and sensitivity analysis used E-values. Results Among the study patients, 35 developed PE. Univariate logistic regression analysis showed significant differences in monocyte-to-lymphocyte ratio (MLR) and platelet-to-lymphocyte ratio (PLR) between groups (P < 0.05). Multivariable logistic regression identified that lower MLR (OR = 0.223, 95% CI: 0.071–0.699) and PLR (OR = 0.344, 95% CI: 0.175–0.675) levels may be associated with an increased risk of superimposed PE in SLE pregnancies. The models based on MLR (AUC = 0.859, 95% CI: 0.782–0.936) and PLR (AUC = 0.860, 95% CI: 0.786–0.934) each showed discriminative capacity for identifying PE in pregnant patients with SLE. Conclusion MLR and PLR may serve as cost-effective and readily available markers for identifying superimposed preeclampsia in pregnant patients with SLE. These preliminary findings warrant validation in larger prospective cohorts, given the small sample size.
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BibTeX
@article{huo2026derived,
title = {{Derived inflammatory indicators for identifying preeclampsia in pregnant patients with systemic lupus erythematosus: a case–control study}},
author = {Jiaxin Huo and Minyi Zhang and Haoyue Hu and Yinghua Xu and Shujie Liu and Jun Chen and Jiayi Zhou and Sishi Song and Manna Sun and Guifang Hu and Mei Zhong},
journal = {BMC Pregnancy and Childbirth},
year = {2026},
month = jul,
doi = {10.1186/s12884-026-09681-2},
url = {https://doi.org/10.1186/s12884-026-09681-2},
note = {CC BY},
}
RIS
TY - JOUR
TI - Derived inflammatory indicators for identifying preeclampsia in pregnant patients with systemic lupus erythematosus: a case–control study
AU - Jiaxin Huo
AU - Minyi Zhang
AU - Haoyue Hu
AU - Yinghua Xu
AU - Shujie Liu
AU - Jun Chen
AU - Jiayi Zhou
AU - Sishi Song
AU - Manna Sun
AU - Guifang Hu
AU - Mei Zhong
PY - 2026
DA - 2026/07/01
JO - BMC Pregnancy and Childbirth
DO - 10.1186/s12884-026-09681-2
UR - https://doi.org/10.1186/s12884-026-09681-2
AB - Background Pregnant women with systemic lupus erythematosus (SLE) are at high risk of preeclampsia (PE). However, overlapping clinical features between the two conditions make it challenging to detect superimposed PE. Failure to promptly recognize PE significantly increases the risk of adverse pregnancy outcomes. In recent years, complete blood count–derived inflammatory indicators (e.g., platelet-to-lymphocyte ratio) have emerged as readily available, low-cost biomarkers with clinical utility. This study aimed to assess the discriminative capacity of these derived inflammatory indicators, measured within one week before delivery, for identifying superimposed PE in pregnant patients with SLE. Methods This retrospective single-center study included 157 pregnant women with SLE treated at Nanfang Hospital of Southern Medical University from April 2010 to October 2024. Clinical and laboratory data, including complete blood count, liver function tests, and coagulation parameters, were collected. Univariate and multivariate logistic regression were performed to identify risk factors for PE and construct combined models. Model performance was assessed using receiver operating characteristic (ROC) curves, Hosmer–Lemeshow test, calibration plots, and the integrated discrimination improvement (IDI) and net reclassification improvement (NRI) indices. Internal validation used the bootstrap method, and sensitivity analysis used E-values. Results Among the study patients, 35 developed PE. Univariate logistic regression analysis showed significant differences in monocyte-to-lymphocyte ratio (MLR) and platelet-to-lymphocyte ratio (PLR) between groups (P < 0.05). Multivariable logistic regression identified that lower MLR (OR = 0.223, 95% CI: 0.071–0.699) and PLR (OR = 0.344, 95% CI: 0.175–0.675) levels may be associated with an increased risk of superimposed PE in SLE pregnancies. The models based on MLR (AUC = 0.859, 95% CI: 0.782–0.936) and PLR (AUC = 0.860, 95% CI: 0.786–0.934) each showed discriminative capacity for identifying PE in pregnant patients with SLE. Conclusion MLR and PLR may serve as cost-effective and readily available markers for identifying superimposed preeclampsia in pregnant patients with SLE. These preliminary findings warrant validation in larger prospective cohorts, given the small sample size.
SN - 1471-2393
ER -