Predictive Value of Prognostic Nutritional Index and Albumin/Creatinine Ratio in Hyperemesis Gravidarum

Aim:This study aimed to evaluate the predictive value of the Prognostic Nutritional Index (PNI) and Albumin/Creatinine (A/C) ratio for prolonged hospitalization in patients with hyperemesis gravidarum (HG).Materials and Methods:This retrospective cohort study was conducted at the Perinatology Department of A.B.C. Hospital between January 2020 and December 2024. Medical records of 228 women diagnosed with HG during the first or early second trimester were analyzed. Demographic, clinical, and laboratory data—including serum albumin, creatinine, and lymphocyte counts—were collected to calculate derived indices such as PNI, A/C ratio, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII). Prolonged hospitalization was defined as ≥ 72 hours. Statistical analyses included ROC curve assessment and multivariate logistic regression.Results:Patients with prolonged hospital stay had significantly lower PNI (44.8 ± 5.3 vs 47.9 ± 5.4, p < 0.001) and A/C ratio values (5.27 ± 1.03 vs 5.81 ± 1.08, p = 0.003). ROC analysis revealed that both indices were significant predictors of prolonged hospitalization, with optimal cut-offs of 46.8 for PNI (AUC = 0.79) and 5.45 for A/C ratio (AUC = 0.70). Multivariate regression identified low sodium, positive ketonuria, decreased PNI, and reduced A/C ratio as independent predictors. Conclusion:Lower PNI and A/C ratio values are independently associated with prolonged hospitalization in HG, reflecting nutritional depletion and systemic inflammation. These accessible, cost-effective indices may serve as valuable tools for early risk stratification and individualized management of affected patients.