<b>The role of systemic inflammatory indices in predicting nausea and vomiting in pregnancy and the need for hospitalization</b>

Background: Hyperemesis gravidarum (HG), in which altered inflammation plays an important role in the pathogenesis, is a severe form of nausea and vomiting in pregnancy (NVP) that can lead to serious consequences for both mother and offspring. Aims: To investigate the role of systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI) and pan-immune inflammation value (PIV) in predicting NVP and severity. Study design: A retrospective study Methods: A total of 278 eligible patients with NVP and 278 gestational age-matched healthy pregnant women were included. Participants with NVP were categorized into mild (n=58), moderate (n=140) and severe NVP (n=80). Patients with moderate or severe NVP, who almost always require hospitalization, were assigned to the ‘inpatient treatment' group. First trimester complete blood count derived indices were calculated and compared between groups Results: SII and PIV were significantly higher in the NVP group than in the control group, while SII, SIRI and PIV were significantly higher in the inpatient treatment group than in the mild NVP group. While SII was better than PIV in predicting NVP development (p&lt;0.001), there was no significant superiority between SII, SIRI and PIV in predicting inpatient treatment needs. An SII with a cut-off value of &gt;966x103/µL (63.67% sensitivity, 68.35% specificity) had the highest discriminatory power for prediction. Conclusion: Our results suggest an association between high SII and PIV and an increased risk of NVP, which can be used as a first trimester screening test to improve treatment planning for pregnancies at high risk of HG.