The Predictive Significance of Platelet-to-Lymphocyte Ratio for Miscarriage: A Systematic Review and Meta-Analysis

Overview

Journal Immun Inflamm Dis

Date 2025 Jan 8

PMID 39778007

Authors

Xiaoyi Wang

Yanfang Zhao

Yangyang Fan

Yun Liu

Affiliations

Soon will be listed here.

Abstract

Background: Miscarriage is a common complication of pregnancy, and its underlying pathophysiologic mechanisms remains unclear. The platelet-to-lymphocyte ratio (PLR), a prothrombotic and inflammatory marker, has been controversially discussed as a potential predictor of miscarriage. This systematic review and meta-analysis aimed to assess the predictive significance of the PLR in women with miscarriage compared to healthy pregnancies.

Material And Methods: Relevant studies were systematically searched in PubMed, Embase, Web of Sciencey, and Cochrane Library up to December 31, 2023. A systematic review and meta-analysis following PRISMA guidelines was conducted. Articles were identified, screened, and evaluated for quality to determine the predictive value of PLR for miscarriage.

Results: Fourteen eligible articles, comprising a total of 3745 patients, were included in the meta-analysis. The pooled analysis found comparable PLR levels between miscarriage and non-miscarriage groups (SMD = 0.25; 95% Confidence Interval (CI): -0.05 to 0.54). Subgroup analysis revealed significant differences in PLR levels in the missed miscarriage group (SMD = 0.29; 95% CI: 0.01-0.56). and in studies with sample sizes smaller than 200 (SMD = 0.31; 95% CI: 0.05-0.56). Other subgroups did not exhibit significant differences. Subgroup analysis of PLR levels and miscarriage risk demonstrated no significant differences across all subgroups.

Conclusion: PLR is not a reliable predictor of miscarriage in general. However, for missed miscarriage cases, elevated PLR levels may serve as a practical and cost-effective marker for prediction.

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