Novel Hematological Inflammatory Indices in Early Pregnancy: The Predictive Value of the Cumulative Inflammatory Index and Mean Corpuscular Volume/Lymphocyte for Gestational Diabetes Mellitus.

AIM: To evaluate the predictive value of first and second trimester hematological inflammatory indices-including the novel cumulative inflammatory index (IIC) and mean corpuscular volume-to-lymphocyte ratio (MCVL)-for the subsequent development of gestational diabetes mellitus (GDM). Additionally, the study will assess whether these markers differ between GDM subgroups managed with diet alone versus insulin therapy.

METHODS

This case-control study enrolled 150 pregnant women, with 75 diagnosed with GDM and 75 serving as healthy controls. Hematological inflammatory indices-namely, NLR, MLR, PLR, dNLR, AISI, SII, SIRI, IIC, and MCVL-were calculated from first- and second-trimester complete blood count parameters.

RESULTS

First-trimester inflammatory indices (NLR, MLR, PLR, dNLR, AISI, SII, SIRI, IIC, and MCVL) were significantly elevated in the GDM group compared to controls (all p < 0.05). NLR demonstrated the highest discriminative accuracy (AUC 0.782; 95% CI: 0.709-0.855), followed by SIRI (AUC 0.778) and IIC (AUC 0.775). Among GDM patients, 22 (29.3%) required insulin therapy. Insulin-treated patients exhibited significantly higher SIRI_1 than diet-managed patients (p = 0.025), and showed a substantially elevated inflammatory burden across multiple second-trimester indices. First-trimester fasting glucose was positively correlated with several second-trimester inflammatory indices, including AISI_1 (r = 0.351, p = 0.002) and SII_2 (r = 0.342, p = 0.003).

CONCLUSION

First-trimester hematological inflammatory indices, including the novel IIC and MCVL, are associated with subsequent development of GDM. Furthermore, these indices offer moderate predictive accuracy when derived from routine antenatal blood tests. The clinical usefulness of these findings necessitates prospective validation in larger, multicenter cohorts.