Yücel KAYA, Emrah DAĞDEVİREN, İlteriş YAMAN, Emrullah AKAY, Sultan CAN
Journal of Academic Research in Medicine - 2026;16(2):63-69
Objective: To determine whether preoperative inflammation-related indices calculated from routine hematological parameters are associated with objectively measured postpartum hemorrhage (PPH) following cesarean section. Methods: A retrospective cohort design was applied at a tertiary referral center and included 226 women who delivered by cesarean section between July 2025 and January 2026. Postpartum blood loss was calculated using a standardized formula-based approach. According to the quantified blood loss, patients were classified as <1000 mL or >=1000 mL. We conducted a comparative analysis of preoperative inflammatory markers-specifically neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, systemic immune-inflammation index (SII), systemic inflammatory response index, and pan-immune-inflammation value-across the study cohorts. Furthermore, the prognostic utility of these indices was assessed using receiver operating characteristic (ROC) curves, and multivariable logistic regression modeling was subsequently used to identify independent associations. Results: Baseline maternal and obstetric characteristics did not differ significantly between the study groups. Among the investigated indices, only SII values were significantly higher in women with postpartum blood loss >=1000 mL. SII demonstrated a weak but statistically significant positive correlation with total blood loss. ROC analysis yielded an area under the curve (AUC) of 0.625 for SII. After adjustment for relevant covariates, an SII threshold of >=1175 remained independently associated with an increased risk of clinically significant PPH. Conclusion: Although the discriminative ability of SII as a standalone test was modest (AUC=0.625), elevated preoperative SII levels were independently associated with increased postpartum blood loss after cesarean delivery. Therefore, SII may serve as an adjunctive biomarker that complements established clinical risk factors in preoperative risk stratification.
