Br J Hosp Med (Lond). 2026 Aug 6;87(8):50744. doi: 10.31083/BJHM50744.
ABSTRACT
AIMS/BACKGROUND: The coexistence of gestational diabetes mellitus (GDM) and preeclampsia (PE) significantly increases the risk of adverse neonatal outcomes. However, effective predictive tools for this high-risk population remain limited. This study aimed to evaluate the predictive value of inflammatory and placental-related biomarkers for adverse neonatal outcomes in pregnant women with GDM and PE.
METHODS: This retrospective observational study enrolled 230 pregnant women with GDM and PE between February 2022 and February 2025. Participants were divided into an event group (n = 53) and a non-event group (n = 177) based on the occurrence of adverse neonatal outcomes. Baseline characteristics, inflammatory markers, and placental growth factor (PlGF) levels were collected. Independent predictive factors were identified using univariate and multivariate logistic regression analyses, with collinearity diagnostics performed. Receiver operating characteristic (ROC) curves were plotted to evaluate the discriminative performance of individual markers and combined predictive models.
RESULTS: Univariate analysis indicated that fasting blood glucose, PlGF, glycated hemoglobin (HbA1c), neutrophil-lymphocyte ratio (NLR), systemic immune-inflammatory index (SII), and systemic inflammatory response index (SIRI) were significantly associated with adverse neonatal outcomes (all p < 0.05). Multivariate logistic regression, after adjustment for collinearity, identified elevated fasting blood glucose, reduced PlGF, increased HbA1c, and elevated SII as independent risk factors for adverse neonatal outcomes (all p < 0.001). ROC curve analysis demonstrated that the combined model incorporating these four variables achieved the highest predictive accuracy, with an area under the curve (AUC) of 0.944 (95% confidence interval [CI]: 0.902-0.986), sensitivity of 94.3%, and specificity of 84.7%, significantly outperforming individual markers.
CONCLUSION: In pregnant women with GDM and PE, fasting blood glucose, PlGF, HbA1c, and SII represent independent predictors of adverse neonatal outcomes. A composite panel integrating metabolic, placental, and inflammatory biomarkers exhibits strong discriminative value and may provide objective evidence for neonatal risk stratification in this high-risk population, thereby informing targeted clinical management.
PMID:42689903 | DOI:10.31083/BJHM50744
