{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:38:15Z","timestamp":1792809495052,"version":"4.5.0"},"reference-count":44,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:00:00Z","timestamp":1792713600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:00:00Z","timestamp":1792713600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Paediatric Perinatal Epid"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Systemic inflammation may affect female reproductive function, but there is relatively little epidemiological evidence regarding the association between pre\u2010pregnancy inflammatory status and fertility. We explore the association between the pre\u2010pregnancy Systemic Inflammation Response Index (SIRI) and the time to pregnancy (TTP) in couples trying to conceive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This study included 1739 couples from the National Free Preconception Check\u2010up Project (NFPCP) in Guangzhou. SIRI was calculated as neutrophil count\u2009\u00d7\u2009monocyte count\/lymphocyte count from routine complete blood count (CBC) at baseline. Quartile and continuous variable analysis of SIRI was performed, and restricted cubic spline functions were used to evaluate the dose\u2013response relationship. The associations were adjusted for demographic, behavioural, and lifestyle factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the NFPCP preconception couple cohort, 1182 pregnancy events were observed. In categorical analyses, women in the highest quartile of SIRI (Q4: 0.99, 5.58) had lower fecundability than those in Q2 (FR, 0.79; 95% CI 0.63, 0.98), indicating a longer TTP. The inverse association became more apparent at SIRI levels above approximately 0.89 in spline\u2010based analyses. Sensitivity analyses yielded comparable effect estimates after restricting the analysis to live birth outcomes and excluding women with chronic inflammatory conditions, fertility\u2010related disorders, or antibiotic use, supporting the robustness of the observed association.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher preconception SIRI was associated with longer TTP, and the association remained generally consistent across adjusted and sensitivity analyses. SIRI may have potential value in preconception risk stratification, but further studies are required to confirm its clinical relevance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ppe.70208","type":"journal-article","created":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:51:08Z","timestamp":1792806668000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Preconception Systemic Inflammation Response Index and Time\u2010to\u2010Pregnancy"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1598-1273","authenticated-orcid":false,"given":"Yuxian","family":"Zhang","sequence":"first","affiliation":[{"name":"Health Department Baiyun Branch of the Third Affiliated Hospital of Guangzhou Medical University (Guangzhou Baiyun District Maternal and Child Health Hospital)  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2032-2095","authenticated-orcid":false,"given":"Dongling","family":"Gu","sequence":"additional","affiliation":[{"name":"Health Department Baiyun Branch of the Third Affiliated Hospital of Guangzhou Medical University (Guangzhou Baiyun District Maternal and Child Health Hospital)  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5532-1029","authenticated-orcid":false,"given":"Yanyuan","family":"Xie","sequence":"additional","affiliation":[{"name":"Health Department Baiyun Branch of the Third Affiliated Hospital of Guangzhou Medical University (Guangzhou Baiyun District Maternal and Child Health Hospital)  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3106-2318","authenticated-orcid":false,"given":"Dayong","family":"Zha","sequence":"additional","affiliation":[{"name":"Health Department Baiyun Branch of the Third Affiliated Hospital of Guangzhou Medical University (Guangzhou Baiyun District Maternal and Child Health Hospital)  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3004-6039","authenticated-orcid":false,"given":"Jianwei","family":"Zhao","sequence":"additional","affiliation":[{"name":"Health Department Baiyun Branch of the Third Affiliated Hospital of Guangzhou Medical University (Guangzhou Baiyun District Maternal and Child Health Hospital)  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Public Health and Hospital Infection Baiyun Branch of the Third Affiliated Hospital of Guangzhou Medical University (Guangzhou Baiyun District Maternal and Child Health Hospital)  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6652-030X","authenticated-orcid":false,"given":"Yanyan","family":"Fu","sequence":"additional","affiliation":[{"name":"Health Department Baiyun Branch of the Third Affiliated Hospital of Guangzhou Medical University (Guangzhou Baiyun District Maternal and Child Health Hospital)  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7398-2461","authenticated-orcid":false,"given":"Bing","family":"Li","sequence":"additional","affiliation":[{"name":"Maternal and Child Health Research Institute Guangdong Women and Children Hospital  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,23]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"2057","DOI":"10.1016\/S0140-6736(24)00550-6","article-title":"Global Fertility in 204 Countries and Territories, 1950\u20102021, With Forecasts to 2100: A Comprehensive Demographic Analysis for the Global Burden of Disease Study 2021","volume":"403","year":"2024","journal-title":"Lancet"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"593","DOI":"10.46234\/ccdcw2021.158","article-title":"Trends and Challenges for Population and Health During Population Aging\u2014China, 2015\u20102050","volume":"3","author":"Luo Y.","year":"2021","journal-title":"China CDC Weekly"},{"key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1186\/s12889-024-17699-4","article-title":"Inflammatory Markers Are Associated With Infertility Prevalence: A 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A.","year":"2011","journal-title":"Blood"}],"container-title":["Paediatric and Perinatal Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ppe.70208","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ppe.70208","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ppe.70208","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:51:13Z","timestamp":1792806673000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ppe.70208"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,23]]},"references-count":44,"alternative-id":["10.1111\/ppe.70208"],"URL":"https:\/\/doi.org\/10.1111\/ppe.70208","archive":["Portico"],"relation":{},"ISSN":["0269-5022","1365-3016"],"issn-type":[{"value":"0269-5022","type":"print"},{"value":"1365-3016","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,23]]},"assertion":[{"value":"2026-03-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ppe.70208"}}