Predictive Value of First-Trimester Aggregate Index of Systemic Inflammation (AISI) and Other Inflammatory Indices for Gestational Diabetes Mellitus and Associated Obstetric Outcomes

Abstract

Problem

To investigate the value of the first-trimester aggregate index of systemic inflammation (AISI) and other combined inflammatory markers in the prediction of gestational diabetes mellitus (GDM) and related obstetric outcomes.

Method of Study

The data of pregnant women diagnosed with GDM between September 2021 and November 2024, as well as an equal number of control patients, were retrospectively analyzed. The patients' AISI, neutrophil lymphocyte ratio (NLR), systemic immune-inflammatory index (SII), and systemic inflammatory response index (SIRI) values were calculated from the hemogram parameters of the participants at 11–14 weeks of gestation. The clinical characteristics, laboratory results, combined inflammatory indices, obstetric outcomes, the need for neonatal intensive care unit (NICU) admission, and the presence of composite adverse perinatal outcome (CAPO) of the groups were then compared. Receiver operating characteristic (ROC) curve analyses were performed to investigate the value of the indices that reached statistical significance in predicting GDM.

Results

The GDM group exhibited significantly higher SII and AISI values, rate of NICU admission, and CAPO compared to the control group (p = 0.036, p = 0.011, p < 0.01, and p < 0.01, respectively). The gestational age at birth was significantly lower in the GDM group compared to the control group, while the neonatal weight was higher (p < 0.01, p < 0.01, respectively). The ROC curve analyses yielded an area under the curve (AUC) of 0.566 and 0.581 for SII and AISI for GDM prediction, respectively (p = 0.036 and p = 0.011, respectively).

Conclusions

First-trimester AISI and SII may be useful markers for identifying pregnancies at high risk for developing GDM.