RESUMO
We aimed to investigate whether proteinuria in the first trimester of pregnancy in Familial Mediterranean fever (FMF) patients has an impact on pregnancy outcome and perinatal and neonatal outcome of pregnancies. A total of 66 pregnant with FMF were compared with healthy controls at the same gestational weeks. Patients with FMF had a higher antenatal hospitalisation rate (34.8% vs. 6.1%, respectively, p < .01) and higher rate of 2 or more miscarriages. FMF patients with or without obstetric complications also had a similar amount of 24-h urine proteinuria in the first trimester. Patients on colchicine therapy during pregnancy had more frequent attacks in pregnancy (59.3% vs. 18.2%, respectively, p: .012). The rates of preeclampsia, preterm delivery, foetal anomalies, small for gestation age neonates and primary caesarean rate were similar between groups. In conclusion; FMF had no significant impact on pregnancy. Neither attacks in pregnancy nor basal proteinuria were associated with adverse outcomes.Impact statementWhat is already known on this subject? Familial Mediterranean fever (FMF) is an autosomal recessive disease characterised by inflammation of the serosal, synovial and cutaneous tissues with recurrent attacks. One of the most serious complications of FMF is amyloidosis that can cause end-stage renal disease. Outcomes of FMF on pregnancy have been analysed by only few studies. Amyloidosis based on the initial renal function may adversely affect pregnancies. It has been reported that FMF patients with renal amyloidosis may suffer pregnancy complications to a greater extent.What do the results of this study add? There have been few studies on the correlation between FMF, proteinuria and pregnancy outcomes. In our study we found that FMF had no significant impact on pregnancy. Neither attacks in pregnancy nor basal proteinuria were associated with adverse outcomes.What are the implications of these findings for clinical practice and/or further research? Our study suggested that FMF had no relationship between pregnancy outcomes. However, our study population is relatively small. It will contribute to comprehensive studies involving a larger population. Future studies should be performed to investigate the effects of basal proteinuria in pregnancy with FMF.
Assuntos
Febre Familiar do Mediterrâneo/complicações , Complicações na Gravidez/epidemiologia , Resultado da Gravidez/epidemiologia , Primeiro Trimestre da Gravidez/urina , Proteinúria/complicações , Adulto , Amiloidose/complicações , Amiloidose/congênito , Estudos de Casos e Controles , Cesárea/estatística & dados numéricos , Colchicina/uso terapêutico , Anormalidades Congênitas , Febre Familiar do Mediterrâneo/urina , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Nefropatias/complicações , Nefropatias/congênito , Pré-Eclâmpsia/epidemiologia , Pré-Eclâmpsia/etiologia , Gravidez , Complicações na Gravidez/urina , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/etiologia , Proteinúria/congênitoRESUMO
OBJECTIVE: The association between inflammation and threatened preterm labor (TPL) is well known. The aim of this study was to investigate a possible relation between TPL and new defined systemic inflammatory markers, neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR) and platelet to lymphocyte ratio (PLR). PATIENTS AND METHODS: Fifty-three healthy pregnant women as the control group and 55 pregnant women diagnosed with TPL as the study group were included in this prospective controlled study. The study group was divided into two groups according to the gestational age at delivery: pregnant with TPL who delivered < 37 weeks and pregnant with TPL who delivered ≥ 37 weeks. The clinical and laboratory data were compared among the groups. RESULTS: LMR was found to be significantly higher in patients complicated with TPL who delivered prematurely when compared to the women whose pregnancies continued to term (p = 0.02). Furthermore, a significant negative correlation was also observed between the gestational week at delivery and LMR in women who delivered < 37 weeks. DISCUSSION: We demonstrated that LMR was significantly increased in pregnant women with preterm birth and threatened preterm labor than healthy subjects. CONCLUSIONS: Although increased LMR levels were demonstrated to be associated with preterm birth and threatened preterm labor to be able to extrapolate these findings into clinical daily practice, further studies are needed.