Impact of Mediterranean diet in lowering risk of gestational diabetes mellitus: A cross-sectional study.

INTRODUCTION AND OBJECTIVES: The prevalence of gestational diabetes is increasing, and the Mediterranean diet is highly recommended for health. The objective of this study is to determine the relationship between adherence to the Mediterranean diet and gestational diabetes mellitus (GDM). MATERIALS AND METHODS: In this cross-sectional study the presence of GDM is the dependent variable, and socio-demographic and anthropometric characteristics and adherence to the Mediterranean diet are the independent variables in this study, which was carried out in pregnant women who were 24-28 weeks pregnant and had Oral Glucose Tolerance Test (OGTT). Adherence to the Mediterranean diet was evaluated with the Mediterranean Diet Adherence Scale (MEDAS). Data were collected through face-to-face interviews, weight and height measurements of the pregnant women were made, and the diagnosis of GDM was made with OGTT. RESULTS: Two hundred and seven pregnant women participated in the study and 85 of them (41.1%) were diagnosed as GDM. According to Logistic Regression models, age (OR: 1.088, 95% CI: 1.031-1.149) and infertility treatment (OR: 4.570, 95% CI: 1.443-14.474) significantly increased the occurrence of GDM, while adherence to the Mediterranean diet (OR: 0.683, 95% CI: 0.568-0.820) significantly reduced the risk. CONCLUSIONS: Nearly two-fifths of pregnant women were diagnosed with GDM while only one-fourth complied with a Mediterranean diet. The increase in the frequency of GDM should be carefully monitored. It may be useful to detect risky pregnant women at the time of the first diagnosis, to measure their glucose levels, and to give suggestions about the Mediterranean diet in the early period.

Indications, risk factors, and outcomes of emergency peripartum hysterectomy: A 7-year retrospective study at a tertiary center in Turkey.

Objective: To determine the incidence, indications, the risk factors, complications, maternal morbidity and mortality of emergency peripartum hysterectomy (EPH), and perinatal outcomes at a tertiary hospital, Turkey. Methods: We analyzed 71 cases of EPH from 2012 to 2019 at a tertiary hospital in a retrospective study. There were 142 control patients. Results: There were 71 EPH out of 69,504 deliveries, for an overall incidence of 1.02 per 1000 births. The main indication for peripartum hysterectomy was abnormal placentation (67.6%), followed by uterine atony (28.1%), and uterine rupture (4.2%). Cesarean section (CS) and previous CS are major risk indicators for EPH. Other risk indicators are advanced maternal age (≥ 35 years) and multiparity. All patients with abnormal placentation had a previous CS. 93% of EPH were performed during and/or after CS, and 7% after vaginal delivery. 69% of EPH were made in total and 31% were subtotal. The three most common maternal morbidity included: wound infection and febrile morbidity (26.7%), bladder injury (16.9%), and disseminated intravascular coagulopathy (11.2%). There were no maternal deaths but perinatal mortality was 4%. Conclusion: The most common indication for EPH was abnormal placentation. Also, CS and previous CS are major risk factors of EPH. Other risk factors for EPH are advanced maternal age (≥ 35 years) and multiparity. Moreover, all unnecessary CS should be avoided.

Ansiedad y depresión posparto a largo plazo de las madres con COVID-19 durante el embarazo

La pandemia de COVID-19 se asocia con resultados mentales negativos en el período posparto temprano. Objetivo. Evaluar la salud mental posparto a largo plazo de las mujeres infectadas con COVID-19 durante el embarazo. Métodos. Estudio transversal en 101 gestantes que dieron a luz en un centro terciario durante la pandemia de COVID-19, entre el 31 de marzo de 2020 y el 30 de noviembre de 2021. Se clasificó a las gestantes en 2 grupos como COVID-19 positivo (grupo de estudio, n=52) y COVID-19 negativo (grupo control, n=49). Se recogieron datos sociodemográficos y obstétricos mediante un cuestionario en los períodos posparto temprano (≤6 meses) y tardío (6 a 18 meses). Se calculó la puntuación del Inventario de Depresión de Beck (IDB) y del Inventario de Ansiedad de Beck (IAB) mediante el análisis de los datos de las participantes. Resultados. La puntuación media del IDB y la tasa de depresión (puntuación del IDB >13) en las pacientes con COVID-19 positivo fueron mayores en el período posparto temprano que en el tardío. Según el análisis de regresión lineal multivariante, existió una correlación significativa entre la puntuación IDB de las pacientes con COVID-19 y el nivel educativo y la situación laboral. Según el mismo análisis, existió una correlación significativa entre la puntuación del IAB de los pacientes con COVID-19 y el apoyo del cónyuge, la relación marital y las enfermedades relacionadas con el nacimiento. Se encontró que las pacientes con COVID-19 positivo y COVID-19 negativo tenían puntuaciones IDB e IAB similares en los periodos postparto temprano (≤6 meses) y tardío (6-18 meses). Además, las tasas de ansiedad y depresión fueron similares en ambos grupos en los mismos períodos posparto. Conclusión. En nuestro estudio, la infección por COVID-19 en el embarazo no tuvo un impacto adicional significativo en la salud mental materna en el posparto a largo plazo.

The COVID-19 pandemic is associated with negative mental outcomes in the early postpartum period. Objective: To assess the long-term postpartum mental health of women infected with COVID-19 during pregnancy. Methods: Cross-sectional study in 101 pregnant women who gave birth in a tertiary center during the COVID-19 pandemic, between March 31, 2020, and November 30, 2021. The pregnant women were classified into 2 groups as COVID-19 positive (study group, n=52) and COVID-19 negative (control group, n=49). Sociodemographic and obstetric data were collected by questionnaire in the early (≤6 months) and late (6-18 months) postpartum periods. Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) scores were calculated by analysis of the participants' data. Results: The mean BDI score and the rate of depression (BDI score >13) in COVID-19 positive patients were higher in the early postpartum period than in the late postpartum period. According to multivariate linear regression analysis, there was a significant correlation between the BDI score of COVID-19 patients and educational level and employment status. According to the same analysis, there was a significant correlation between the BAI score of COVID-19 patients and spousal support, marital relationship, and birthrelated diseases. We found that COVID-19 positive and COVID-19 negative patients had similar BDI and BAI scores in the early (≤6 months) and late (6-18 months) postpartum periods. In addition, rates of anxiety and depression were similar in both groups at the same postpartum periods. Conclusion: In our study, COVID-19 infection in pregnancy had no significant additional impact on long-term postpartum maternal mental health.

Comparison of Maternal, Perinatal, and Neonatal Outcomes of Asymptomatic and Symptomatic Pregnant Women with Coronavirus Disease-2019.

Objective: This study aimed to compare the postpartum outcomes of asymptomatic and symptomatic patients with coronavirus disease-2019 (COVID-19). Methods: This retrospective cohort study included pregnant women with COVID-19. Pregnant women were categorized into two sets as asymptomatic and symptomatic according to their clinics at the time of application. COVID-19 was diagnosed using the real-time reverse transcriptase-polymerase chain reaction on the oropharyngeal and nasopharyngeal swabs. Asymptomatic and symptomatic patients were compared in terms of maternal and perinatal outcomes. Results: Our study population consisted of 20 asymptomatic and 41 symptomatic patients with laboratory-confirmed COVID-19. The rate of primary cesarean section was more than twice in the symptomatic group (51.2%) than that of the asymptomatic group (20%) (p=0.019). Both groups are quite similar in terms of maternal [respiratory support, COVID-19- related treatment, and intensive care unit (ICU) admission], perinatal (preterm delivery, preterm premature rupture of membrane, preeclampsia, and mode of delivery), and neonatal outcomes [birth weight, Apgar scores, neonatal ICU (NICU) admission]. The rate of total cesarean section in the asymptomatic group (75%) was statistically similar to the symptomatic group (83%) (p=0.464). The NICU admission rate was found to be similar in the asymptomatic (54.2%) and symptomatic groups (50%) (p=0.858). However, NICU admissions were more frequent in the symptomatic group due to respiratory distress (p=0.032). The breastfeeding rate is higher in the asymptomatic pregnant group as expected (p=0.015). Additionally, the ferritin level was significantly lower in the asymptomatic group (p=0.006). Conclusions: The rate of primary cesarean section is quite high in symptomatic patients with COVID-19. Additionally, the total cesarean section rate was extremely high in both groups. We expected more adverse outcomes in symptomatic patients; however, we found similar maternal, perinatal, and neonatal outcomes between both groups.