Abstract
Introduction: Gestational diabetes mellitus (GDM) is among the most common complications during pregnancy, and inflammatory indices, including systemic immune-inflammation (SII) index and systemic inflammation response index (SIRI), appear to be able to forecast GDM. Accordingly, in the present study, our goal was to examine the association between high levels of SII and SIRI indices and the risk of gestational diabetes.
Materials and Methods: Databases Web of Science, Cochrane, Scopus, PubMed, Embase, and Google Scholar Search Engine were used for articles published until August 7, 2025. Data was analyzed using STATA 14. Tests with p-values lower than 0.05 were considered statistically significant.
Results: High SII index levels increased the risk of GDM (OR=1.52, 95% CI: 1.25, 1.86), as the second (OR=1.11, 95% CI: 1.03, 1.19) and fourth (OR=1.31, 95% CI: 1.03, 1.66) quartiles increased the risk of GDM. Furthermore, high SII index levels in the USA and the cross-sectional study had no statistically significant association with GDM (OR=0.98, 95% CI: 0.59, 1.62). However, in China and cohort studies, high SII index levels increased the risk of GDM (OR=1.60, 95% CI: 1.30, 1.98). Additionally, high SIRI index levels increased the risk of GDM (OR=1.37, 95% CI: 1.17, 1.62), whereas high SIRI index levels in the USA and the cross-sectional study lowered the risk of GDM (OR=0.72, 95% CI: 0.53, 0.99). However, in China and cohort studies, high SIRI index levels increased the risk of GDM (OR=1.47, 95%CI: 1.24, 1.74).
Conclusion: High SII (52%) and SIRI (37%) indexes significantly increased the risk of GDM. Hence, individuals at risk of GDM can be identified and controlled through the evaluation and screening of the mentioned indices in pregnant women.
Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (ID: CRD420251128749) and Research Registry (UIN: reviewregistry2038) websites.