Predictive value of platelet distribution width, neutrophil-to-lymphocyte ratio, and alanine aminotransferase for recurrence of pregnancy loss in early gestation.

This study aimed to evaluate the value of combined platelet distribution width, neutrophil-to-lymphocyte ratio, and alanine aminotransferase detection in predicting recurrence risk among patients with recurrent pregnancy loss in early pregnancy. A retrospective case-control study was conducted among 305 patients with early pregnancy RPL from January 2024 to May 2025. Patients were divided into a pregnancy loss group (n=116) and a live birth group (n=189). Peripheral blood platelet distribution width, neutrophil-to-lymphocyte ratio, alanine aminotransferase, and related laboratory parameters were compared between the groups. Platelet distribution width, neutrophil-to-lymphocyte ratio, and alanine aminotransferase levels were significantly higher in the pregnancy loss group than in the live birth group. Multivariate logistic regression identified platelet distribution width, neutrophil-to-lymphocyte ratio, and alanine aminotransferase as independent risk factors for recurrent pregnancy loss. Receiver operating characteristic analysis showed that the combined platelet distribution width+neutrophil-to-lymphocyte ratio+alanine aminotransferase model had an area under the curve of 0.706, outperforming any single marker. These findings suggest that combined detection of platelet distribution width, neutrophil-to-lymphocyte ratio, and alanine aminotransferase may provide a simple and effective tool for early risk stratification in patients with recurrent pregnancy loss, reflecting potential platelet activation, inflammatory immune imbalance, and hepatic metabolic stress.