ArticleBMC pregnancy and childbirth2026
Derived inflammatory indicators for identifying preeclampsia in pregnant patients with systemic lupus erythematosus: a case-control study.
Article in BMC pregnancy and childbirth, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPregnant women with systemic lupus erythematosus (SLE) are at high risk of preeclampsia (PE). However, overlapping clinical features between the two conditions make it challenging to detect superimposed PE. Failure to promptly recognize PE significantly increases the risk of adverse pregnancy outcomes. In recent years, complete blood count-derived inflammatory indicators (e.g., platelet-to-lymphocyte ratio) have emerged as readily available, low-cost biomarkers with clinical utility. This study aimed to assess the discriminative capacity of these derived inflammatory indicators, measured within one week before delivery, for identifying superimposed PE in pregnant patients with SLE.
methodsThis retrospective single-center study included 157 pregnant women with SLE treated at Nanfang Hospital of Southern Medical University from April 2010 to October 2024. Clinical and laboratory data, including complete blood count, liver function tests, and coagulation parameters, were collected. Univariate and multivariate logistic regression were performed to identify risk factors for PE and construct combined models. Model performance was assessed using receiver operating characteristic (ROC) curves, Hosmer-Lemeshow test, calibration plots, and the integrated discrimination improvement (IDI) and net reclassification improvement (NRI) indices. Internal validation used the bootstrap method, and sensitivity analysis used E-values.
resultsAmong the study patients, 35 developed PE. Univariate logistic regression analysis showed significant differences in monocyte-to-lymphocyte ratio (MLR) and platelet-to-lymphocyte ratio (PLR) between groups (P < 0.05). Multivariable logistic regression identified that lower MLR (OR = 0.223, 95% CI: 0.071-0.699) and PLR (OR = 0.344, 95% CI: 0.175-0.675) levels may be associated with an increased risk of superimposed PE in SLE pregnancies. The models based on MLR (AUC = 0.859, 95% CI: 0.782-0.936) and PLR (AUC = 0.860, 95% CI: 0.786-0.934) each showed discriminative capacity for identifying PE in pregnant patients with SLE.
conclusionMLR and PLR may serve as cost-effective and readily available markers for identifying superimposed preeclampsia in pregnant patients with SLE. These preliminary findings warrant validation in larger prospective cohorts, given the small sample size.
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