The value of the second trimester glucose-to-lymphocyte ratio in predicting fetal loss at late preterm and term pregnancies

INTRODUCTION: This study aimed to determine whether the second-trimester glucose-to-lymphocyte ratio (GLR) can predict intrauterine fetal demise (IUFD) at late preterm and term gestations.
METHODS: A retrospective cross-sectional design was employed. Pregnant women aged 18–45 who delivered at our tertiary hospital between January 2023 and December 2024 were screened. Those diagnosed with IUFD at or beyond 34 weeks of gestation comprised the case group, while two healthy pregnant women of similar age and body mass index for each case served as the control group. Laboratory parameters from the 20th–24th weeks, including hemoglobin, white blood cell (WBC) count, neutrophil count, lymphocyte count, random blood glucose, and GLR, were analyzed.
RESULTS: Data from 105 patients (35 IUFD, 70 controls) were included. The IUFD group had significantly lower WBC, neutrophil, and lymphocyte counts but higher glucose and GLR than controls (p<0.01). Receiver operating characteristic analysis showed an area under the curve of 0.876 (p<0.01) for GLR, with 80% sensitivity and 79% specificity at a cutoff of 0.604.
DISCUSSION AND CONCLUSION: Elevated GLR in the second trimester may reflect subclinical inflammation and serve as a practical, cost-effective predictor of IUFD. Further large-scale studies are warranted to validate these findings.