The Association of Inflammatory Markers with Maternal-Neonatal Outcome After Cervical Cerclage

Abstract

Objective

Cervical cerclage is effective in prolonging the number of weeks gestation in patients with cervical insufficiency(CI). However, valuable predictors with successful cervical cerclage remain limited. It aimed to evaluate the value of the systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) to predict the outcomes of cervical cerclage.

Methods

This study analyzed 374 participants. Inflammatory markers were calculated using maternal peripheral blood. The association of inflammatory markers and the outcome of cervical cerclage were analyzed. And the optimal cut-off values of inflammatory markers were calculated. Also, the Chi-square test and logistic and linear regression analyses were performed to evaluate inflammatory markers with the maternal outcome and neonatal outcomes.

Results

374 pregnancies were included in this study. Finally, 268 (71.7%) participants suffered successful cervical cerclage. This study demonstrated that the baseline BMI (cm²/kg), the bulging membrane, cervical dilation (≥2cm), the amniotic sac herniation, the neutrophils counts, the systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) were significant difference between the successful and unsuccessful groups (all P<0.05). Additionally, maternal blood inflammatory markers, such as WBC, lymphocyte, neutrophils, monocyte, platelet counts, SII, and SIRI, were significantly associated with maternal-neonatal outcomes. Furthermore, the results demonstrated that the SII level had the highest OR (OR=4.626; 95% CI (2.500–8.560)), as well as the following: SIRI level (OR = 3.795; 95% CI (1.989–7.242)), cervical dilation (≥2cm) (OR =3.477; 95% CI (1.458–10.844)), and amniotic sac herniation (OR = 1.796; 95% (0.473–4.975)).

Conclusion

This study demonstrated that the baseline SII level and SIRI level are important biochemical markers for predicting the outcome of cervical cerclage and maternal-neonatal outcomes with non-invasive procedures. They can help to provide personalized treatment before surgery and enhance postoperative surveillance.

Keywords:

• cervical cerclage
• maternal-neonatal
• outcome
• inflammatory markers
• peripheral blood

Patient Consent for Publication

The Hospital Ethics Committee of Fujian Provincial Maternity and Children’s Hospital, an affiliated hospital of Fujian Medical University, approved the study (2022KYLLR03050) and complied with the Declaration of Helsinki. And all individuals participating in this study signed written informed consent.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis, and interpretation, or in all these areas; took part in drafting, revising, or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the report has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

All authors declare that they have no competing interests in this work.

Additional information

Funding

This work was funded by grants from the Fujian Science and Technology Innovation Joint Fund Project (2020Y9148), Natural Science Foundation of Fujian Province (No.2021J01406) and Fujian Provincial Technology Innovation Project (grant no. 2020Y9147), Natural Science Foundation of Fujian Province (No.2021J01420).