Diagnostic Performance of Serum Lactate Dehydrogenase and Immune-Inflammatory Markers in Recurrent Spontaneous Abortion: A Retrospective Study.

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-γ)], antiphospholipid antibodies, and T lymphocyte subsets were significantly different in the RSA group (p < 0.05). Serum LDH, IFN-γ, 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 < 0.05), whereas IL-6, IL-10, and CD8+ T-cell levels were significantly lower (p < 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 < 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.