The role of the Systemic Inflammatory Response Index (SIRI) and other maternal biochemical markers in determining the severity of intrahepatic cholestasis of pregnancy.

Objectives: To investigate the roles of the systemic inflammatory response index (SIRI) and other biochemical markers obtained from maternal blood in determining the diagnosis and severity of pregnancy cholestasis.

Material and methods: In this retrospective case-control study, a total of 815 pregnant women including 546 healthy pregnant women [serum total bile acid (TBA) level < 10 μmol/L, control group], 185 patients with mild cholestasis [serum TBA level < 40 μmol/L, mild intrahepatic cholestasis of pregnancy (ICP) group] and 84 patients with severe cholestasis (serum TBA level ≥ 40 μmol/L, severe ICP group) were evaluated. The groups were compared regarding demographic data, clinical characteristics, SIRI (neutrophilcount*monocytecount/lymphocyte count), and other laboratory data. Cut-off values that could predict ICP were calculated.

Results: The average neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), and systemic inflammatory response index (SIRI) were found to be statistically significantly higher in the severe ICP group compared with the control group and mild ICP group (p < 0.01 and p < 0.05). The best SIRI cut-off value was 2.3302 (60.3% sensitivity and 52.2% specificity) [area under the curve: 0.590 ± 0.023, 95% confidence interval (CI): 0.546-0.634; p < 0.001].

Conclusions: SIRI may be a useful marker in determining the diagnosis and severity of ICP. However, were commend that studies be conducted in larger groups and indifferent trimesters.