Evaluation of Inflammatory Indices in Predicting Adverse Perinatal Outcomes in Pregnant Patients Undergoing Surgery for Acute Appendicitis: A Retrospective Cohort Study From a Tertiary Care Center.

AIM: The aim of this study was to investigate the predictive efficacy of inflammatory indices in predicting adverse perinatal outcomes in pregnant patients who underwent surgery for acute appendicitis.

METHODS

This single-center retrospective cohort study included 98 pregnant women who underwent appendectomy for acute appendicitis between December 2019 and December 2025 at a tertiary care hospital. Patients were classified according to the presence of composite adverse perinatal outcome (CAPO). The predictive value of preoperative inflammatory indices derived from routine complete blood count was evaluated using multivariable logistic regression and receiver operating characteristic (ROC) curve analyses.

RESULTS

In the CAPO+ group, gestational age at delivery, birth weight, and 1- and 5-min Apgar scores were significantly lower, whereas NICU admission rates were significantly higher (all p < 0.001). Among inflammatory indices, PIV, PLR, SII, and SIRI were significantly elevated, whereas LMR was significantly decreased (p < 0.001). Multivariate analysis identified LMR (OR: 0.32; 95% CI: 0.18-0.51) and SIRI (OR: 1.33; 95% CI: 1.16-1.56) as independent predictors of CAPO (p < 0.001). ROC analysis demonstrated that LMR achieved the highest predictive accuracy (AUC: 0.857; cut-off: ≤ 1.69; specificity: 93.4%).

CONCLUSIONS

LMR and SIRI, calculated from routine complete blood count, emerged as independent predictors of CAPO with high predictive accuracy in pregnant patients with acute appendicitis and represent practical biomarkers that can be readily integrated into clinical decision-making without additional cost. Prospective, multicenter studies with larger sample sizes are needed to confirm the broader applicability of these findings.