{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T12:15:17Z","timestamp":1788437717454,"version":"build-2803163510"},"reference-count":25,"publisher":"IMR Press","issue":"8","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br. J. Hosp. Med. (Lond)"],"abstract":"<jats:p>Aims\/Background:Recurrent spontaneous abortion (RSA) may contribute to intrauterine adhesions and lead to female infertility. This study aims to analyze serum lactate dehydrogenase (LDH) levels and immune-inflammatory markers in patients with recurrent abortion and to evaluate their diagnostic value in RSA.Methods:A total of 120 patients with RSA admitted between January 2023 and December 2024 were included as the study group, and 80 pregnant women with normal prenatal examination findings during the same period were selected as controls. Serum and hematological assays were performed in both groups, and levels of LDH, immune-inflammatory markers, autoimmune antibodies, and lymphocyte subsets were compared. Factors associated with RSA were analyzed using logistic regression, and the diagnostic performance of each index was assessed using a receiver operating characteristic (ROC) curve.Results:Compared with the control group, serum LDH levels, immune-inflammatory markers [interleukin (IL)-6, IL-10, and interferon gamma (IFN-\u03b3)], antiphospholipid antibodies, and T lymphocyte subsets were significantly different in the RSA group (p &lt; 0.05). Serum LDH, IFN-\u03b3, antiphospholipid antibodies (APA) positive rate and cluster of differentiation (CD)4+ T-cell levels were significantly higher in the RSA group than in controls (p &lt; 0.05), whereas IL-6, IL-10, and CD8+ T-cell levels were significantly lower (p &lt; 0.05). Binary logistic regression analysis showed that elevated serum LDH, reduced IL-6 level, increased proportion of CD4+ cells, and decreased proportion of CD8+ cells were independent risk factors for recurrent abortion in RSA patients (all p &lt; 0.05). ROC curve analysis showed that the combined detection of serum LDH, IL-6, CD4+, and CD8+ yielded an area under the curve (AUC) of 0.908, with a sensitivity of 0.875 and specificity of 0.823. The combined model demonstrated superior diagnostic performance compared with individual markers.Conclusion:Combined assessment of serum LDH and selected immune-inflammatory markers (IL-6, CD4+, CD8+) shows good predictive and diagnostic value for RSA and may facilitate early identification of high-risk patients in clinical practice.<\/jats:p>","DOI":"10.31083\/bjhm56970","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T11:29:22Z","timestamp":1788434962000},"source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Performance of Serum Lactate Dehydrogenase and Immune-Inflammatory Markers in Recurrent Spontaneous Abortion: A Retrospective Study"],"prefix":"10.31083","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-6673-0434","authenticated-orcid":true,"given":"Jianfeng","family":"Wen","sequence":"first","affiliation":[{"name":"Department of Gynaecology, Yongkang Women and Children\u2019s Health Hospital, 321300 Jinhua, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjun","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Gynaecology, Yongkang Women and Children\u2019s Health Hospital, 321300 Jinhua, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanshan","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Gynaecology, Yongkang Women and Children\u2019s Health Hospital, 321300 Jinhua, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengnan","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Gynaecology, Yongkang Women and Children\u2019s Health Hospital, 321300 Jinhua, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingmei","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Gynaecology, Yongkang Women and Children\u2019s Health Hospital, 321300 Jinhua, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Deng T, Liao X, Zhu S. Recent Advances in Treatment of Recurrent Spontaneous Abortion. Obstetrical & Gynecological Survey. 2022; 77: 355\u2013366.","DOI":"10.1097\/OGX.0000000000001033"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Li D, Zheng L, Zhao D, Xu Y, Wang Y. The Role of Immune Cells in Recurrent Spontaneous Abortion. Reproductive Sciences. 2021; 28: 3303\u20133315.","DOI":"10.1007\/s43032-021-00599-y"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Wu A, Zhao Y, Yu R, Zhou J, Tuo Y. Untargeted metabolomics analysis reveals the metabolic disturbances and exacerbation of oxidative stress in recurrent spontaneous abortion. PloS One. 2023; 18: e0296122.","DOI":"10.1371\/journal.pone.0296122"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Albright CM, Ali TN, Lopes V, Rouse DJ, Anderson BL. Lactic acid measurement to identify risk of morbidity from sepsis in pregnancy. American Journal of Perinatology. 2015; 32: 481\u2013486.","DOI":"10.1055\/s-0034-1395477"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Tang C, Hu W. Non-coding RNA regulates the immune microenvironment in recurrent spontaneous abortion (RSA): new insights into immune mechanisms\u2020. Biology of Reproduction. 2024; 110: 220\u2013229.","DOI":"10.1093\/biolre\/ioad157"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Talukdar A, Sharma KA, Rai R, Deka D, Rao DN. Effect of Coenzyme Q10 on Th1\/Th2 Paradigm in Females with Idiopathic Recurrent Pregnancy Loss. American Journal of Reproductive Immunology. 2015; 74: 169\u2013180.","DOI":"10.1111\/aji.12376"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Kanellopoulos-Langevin C, Caucheteux SM, Verbeke P, Ojcius DM. Tolerance of the fetus by the maternal immune system: role of inflammatory mediators at the feto-maternal interface. Reproductive Biology and Endocrinology. 2003; 1: 121.","DOI":"10.1186\/1477-7827-1-121"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Ye L, Jiang Y, Zhang M. Crosstalk between glucose metabolism, lactate production and immune response modulation. Cytokine & Growth Factor Reviews. 2022; 68: 81\u201392.","DOI":"10.1016\/j.cytogfr.2022.11.001"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Obstetrics Subgroup, Chinese Society of Obstetrics and Gynecology, Chinese Medical Association; Chinese Expert Consensus Group on Diagnosis and Management of Recurrent Spontaneous Abortion. Chinese expert consensus on diagnosis and management of recurrent spontaneous abortion (2022). Chinese Journal of Obstetrics and Gynecology. 2022; 57: 653\u2013667.  (In Chinese)","DOI":"10.3760\/cma.j.cn112141-20220421-00259"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). Journal of Thrombosis and Haemostasis. 2006; 4: 295\u2013306.","DOI":"10.1111\/j.1538-7836.2006.01753.x"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Jauniaux E, Poston L, Burton GJ. Placental-related diseases of pregnancy: Involvement of oxidative stress and implications in human evolution. Human Reproduction Update. 2006; 12: 747\u2013755.","DOI":"10.1093\/humupd\/dml016"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Tian P, Xu Z, Guo J, Zhao J, Chen W, Huang W, et al. Hypoxia causes trophoblast cell ferroptosis to induce miscarriage through lnc-HZ06\/HIF1\u03b1-SUMO\/NCOA4 axis. Redox Biology. 2024; 70: 103073.","DOI":"10.1016\/j.redox.2024.103073"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Huang X, Lin Z, Zheng ZM, Shi JL, Lu KY, Wang JR, et al. A Hypoxia-Decidual Macrophage Regulatory Axis in Normal Pregnancy and Spontaneous Miscarriage. International Journal of Molecular Sciences. 2024; 25: 9710.","DOI":"10.3390\/ijms25179710"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Alijotas-Reig J, Esteve-Valverde E, Anunciaci\u00f3n-Llunell A, Marques-Soares J, Pardos-Gea J, Mir\u00f3-Mur F. Pathogenesis, Diagnosis and Management of Obstetric Antiphospholipid Syndrome: A Comprehensive Review. Journal of Clinical Medicine. 2022; 11: 675.","DOI":"10.3390\/jcm11030675"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Gao L, Xu QH, Ma LN, Luo J, Muyayalo KP, Wang LL, et al. Trophoblast-derived Lactic Acid Orchestrates Decidual Macrophage Differentiation via SRC\/LDHA Signaling in Early Pregnancy. International Journal of Biological Sciences. 2022; 18: 599\u2013616.","DOI":"10.7150\/ijbs.67816"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"Chen X, Song QL, Ji R, Wang JY, Cao ML, Guo DY, et al. JPT2 Affects Trophoblast Functions and Macrophage Polarization and Metabolism, and Acts as a Potential Therapeutic Target for Recurrent Spontaneous Abortion. Advanced Science. 2024; 11: e2306359.","DOI":"10.1002\/advs.202306359"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"Tang C, Hu W. The role of Th17 and Treg cells in normal pregnancy and unexplained recurrent spontaneous abortion (URSA): New insights into immune mechanisms. Placenta. 2023; 142: 18\u201326.","DOI":"10.1016\/j.placenta.2023.08.065"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"Thellin O, Heinen E. Pregnancy and the immune system: between tolerance and rejection. Toxicology. 2003; 185: 179\u2013184.","DOI":"10.1016\/s0300-483x(02)00607-8"},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"Mousavi-Salehi A, Ghafourian M, Amari A, Zargar M. Evaluation of NKT Cell Percentage and Function and Its Relationship with Serum IFN-\u03b3 and Vitamin D Levels in Women with Recurrent Spontaneous Abortion and Recurrent Implantation Failure. Journal of Obstetrics and Gynaecology of India. 2024; 74: 391\u2013397.","DOI":"10.1007\/s13224-023-01894-1"},{"key":"ref20","doi-asserted-by":"publisher","unstructured":"Ma W, Gu Z, Lin Q, Cao M, Zhong J, Li X, et al. Integrative genetic and multi-omics analysis reveals the interleukin-6 receptor's role in recurrent spontaneous abortion. Frontiers in Immunology. 2025; 16: 1659251.","DOI":"10.3389\/fimmu.2025.1659251"},{"key":"ref21","doi-asserted-by":"publisher","unstructured":"Liu Y, Liu Y, Li X, Jiao X, Zhang R, Zhang J. Predictive value of serum \u03b2-hCG for early pregnancy outcomes among women with recurrent spontaneous abortion. International Journal of Gynaecology and Obstetrics. 2016; 135: 16\u201321.","DOI":"10.1016\/j.ijgo.2016.03.007"},{"key":"ref22","doi-asserted-by":"publisher","unstructured":"Ban Y, Chang Y, Dong B, Kong B, Qu X. Indoleamine 2,3-dioxygenase levels at the normal and recurrent spontaneous abortion fetal-maternal interface. The Journal of International Medical Research. 2013; 41: 1135\u20131149.","DOI":"10.1177\/0300060513487642"},{"key":"ref23","doi-asserted-by":"publisher","unstructured":"Cui L, Xu F, Xu C, Ding Y, Wang S, Du M. Circadian gene Rev-erb\u03b1 influenced by sleep conduces to pregnancy by promoting endometrial decidualization via IL-6-PR-C\/EBP\u03b2 axis. Journal of Biomedical Science. 2022; 29: 101.","DOI":"10.1186\/s12929-022-00884-1"},{"key":"ref24","doi-asserted-by":"publisher","unstructured":"Baroeva MD, Datieva FS, Popova LS, Tsallagova LV. Characteristics of circadian regulation in patients with miscarriage. Obstetrics and Gynecology. 2024; 5\u201311.","DOI":"10.18565\/aig.2024.95"},{"key":"ref25","doi-asserted-by":"crossref","unstructured":"Haldar C, Chowdhury JP. Chronodisruption and Loss of Female Reproductive Potential Due to Shift Work. In Wani KA, Naha N (eds.) Climate Change and Its Impact on Fertility and Life Forms (pp. 70\u201398). IGI Global Scientific Publishing: Hershey, PA. 2021.","DOI":"10.4018\/978-1-7998-4480-8.ch004"}],"container-title":["British Journal of Hospital Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.imrpress.com\/journal\/BJHM\/87\/8\/10.31083\/BJHM56970","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T11:29:48Z","timestamp":1788434988000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.imrpress.com\/journal\/BJHM\/87\/8\/10.31083\/BJHM56970"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,12]]},"references-count":25,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026]]}},"alternative-id":["S1750-8460(26)03486-0"],"URL":"https:\/\/doi.org\/10.31083\/bjhm56970","relation":{},"ISSN":["1750-8460","1759-7390"],"issn-type":[{"value":"1750-8460","type":"print"},{"value":"1759-7390","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,12]]},"article-number":"56970"}}