Prognostic evaluation of systemic immune inflammatory index and hematological parameters in postpartum hemorrhage: a retrospective analysis

Abstract

OBJECTIVES: Postpartum hemorrhage (PPH) is a significant global health risk for mothers. This study investigated the predictive capacity of the systemic immune inflammatory index (SII) to assess the risk of PPH. The SII, which is predicated on cell types of integral to inflammatory processes, correlates with high values of increased inflammatory activity and potentially adverse prognoses. MATERIAL AND METHODS: This retrospective cohort study included female patients aged 15–49 diagnosed with PPH who continued to bleed post-treatment, received transfusions of four or more units of erythrocyte suspension, or underwent laparotomy/re-laparotomy. RESULTS: The study found that Hemoglobin, hematocrit, platelet, and SII values were significantly lower, and lymphocyte counts were elevated in the PPH group. Both univariate and multivariate analyses identified hemoglobin and SII levels as significant determinants of PPH. An SII cutoff value of 915 proved to be an effective predictor of PPH. In subjects with an SII ≥ 915, leukocyte, platelet, and neutrophil values were higher, and lymphocyte counts were lower. Furthermore, the rates of PPH and Intensive Care Unit admissions increased in this cohort. CONCLUSIONS: The findings suggest that the SII is a potentially significant marker for PPH risk prediction. Elevated SII levels beyond the threshold of 915 were associated with heightened PPH risk of PPH.