Association and Discriminative Performance of the Infection Discrimination Index Versus Neutrophil-to-Lymphocyte Ratio in Preterm Premature Rupture of Membranes: A Retrospective Case– Control Study
نویسندگان
1 Basic Medical Science Department, College of Medicine, Prince Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
2 Department of Basic Dental Sciences, Faculty of Dentistry, Al-Ahliyya Amman University, Amman, Jordan
3 Department of Basic Dental Sciences, Faculty of Dentistry, Al-Ahliyya Amman University, Amman, Jordan
4 Basic Medical Sciences Department, College of Medicine, University of Jeddah, Jeddah, Saudi Arabia
5 Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
6 Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
7 Public Health Department, London School of Hygiene and Tropical Medicine (LSHTM), University of London, London, UK
8 Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
9 Obstetrics and Gynecology Department, King Fahad Hospital, Al-Baha Health Cluster, Al-Baha, Saudi Arabia
10 Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
11 Basic Medical Sciences Department, College of Medicine, University of Jeddah, Jeddah, Saudi Arabia
12 Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
13 Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
14 Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
15 Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
16 Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
17 Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
18 Pediatrics Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
doi
10.48309/jmcs.2026.571197.2918چکیده
Preterm prelabor rupture of membranes (PPROM) before 37 weeks’ gestation is a major cause of maternal and neonatal morbidity and mortality. Complete blood count–derived inflammatory indices, including the neutrophil-to-lymphocyte ratio (NLR) and the infection discrimination index (IDI), may help identify women at risk. To compare the association and discriminative performance of NLR and IDI for distinguishing women with established PPROM from term controls. In this case–control study, 156 women with PPROM at 22–34 weeks’ gestation and 942 term controls (≥37 weeks) without PPROM were enrolled. Neutrophil, lymphocyte, and monocyte counts were obtained, and NLR and IDI were calculated. Receiver operating characteristic (ROC) analysis assessed discrimination of PPROM. Neutrophil and monocyte counts, NLR, and IDI were higher in the PPROM group than controls (all p < 0.0001). IDI showed better discrimination than NLR: IDI >2.96 yielded 81.41% sensitivity and 71.02% specificity (AUC = 0.82), versus NLR >5.42 with 73.08% sensitivity and 68.05% specificity (AUC = 0.77); the AUC difference was significant (p = 0.0499). Both NLR and IDI were elevated in PPROM, and IDI showed better discrimination than NLR in this case–control cohort. Prospective studies among women evaluated for suspected PPROM are needed to determine real-world diagnostic performance.
