Fetal growth restriction (FGR) occurs in about 10 % of pregnancies and is characterized by fetal growth below the expected range for gestational age at any stage of pregnancy [1]. In addition to its association with stillbirth, perinatal morbidity and mortality, FGR may also be linked to long-term health outcomes in childhood and adulthood, such as neurodevelopmental delay, dyslipidemia, increased risk of cardiovascular disease, metabolic syndrome and diabetes [2,3]. Many factors may contribute to the etiopathogenesis, including genetic syndromes, chromosomal aberrations, environmental influences and perinatal infections; however, impaired uteroplacental circulation leading to placental insufficiency is the primary cause in a large number of cases [4].

Depending on the gestational age at diagnosis, FGR can be divided into two categories: early-onset (<32 weeks) and late-onset (≥32 weeks) FGR [5]. In recent years, some studies on FGR have suggested that early-onset and late-onset FGR without congenital fetal anomalies represent the same disease, occurring at different stages and/or with varying severity, rather than being distinct conditions with different pathophysiological mechanisms [5,6]. Because FGR may have serious consequences for the offspring, its prediction, early detection and appropriate management are essential components of prenatal care.

During embryo implantation, a local inflammatory process is triggered at the implantation site, which plays an important role in maintaining further trophoblastic invasion, differentiation, placental development and spiral arteriolar remodeling [7]. Additionally increasing evidence indicates that an abnormal immune response plays an important role in preeclampsia and FGR, which share a common pathogenesis of inadequate placentation [8,9]. Currently, there are no markers or methods used in clinical practice for the early prediction of FGR. However, angiogenic and antiangiogenic markers such as soluble fms-like tyrosine kinase 1 (sFlt-1), placental growth factor (PlGF), vascular endothelial growth factor (VEGF) and uterine artery Doppler have been studied for the early prediction of preeclampsia in high-risk groups, with inconsistent results [[10], [11], [12]].

As many of these biomarkers cannot be used universally due to their high cost and the difficulty of integrating them into clinical practice, inflammatory markers calculated from the components of complete blood count (CBC), a low-cost general laboratory test, appear to be more applicable for predicting diseases and/or their prognosis where altered inflammation plays a crucial role in the early stages of pathogenesis. On this basis, we aimed to investigate the association of inflammatory indices such as neutrophil-to-lymphocyte ratio (NLR), systemic immune inflammation index (SII), systemic inflammatory response index (SIRI) and pan-immune inflammation value (PIV) using CBC results obtained during the 11–14-week aneuploidy screening, with the prediction of pregnancies at high risk for idiopathic late-onset FGR.