Effect of delivery mode on admission to neonatal intensive care unit in healthy singleton pregnancies.

Objective: The aim of this study was to evaluate the short-term results of perinatal health in vaginal and cesarean deliveries and the indications for admission to the neonatal intensive care unit (NICU) in terms of healthy singleton pregnancies. Materials and Methods: In this study, 300 pregnant women who gave birth in our tertiary hospital was included. The records of newborns admitted to the NICU of these pregnant women were reviewed between January 1, 2019 and January 1, 2021. Durations of newborn hospitalizations and problems encountered during admission were recorded. The results were statistically evaluated. Results: There was no significant difference between vaginal delivery and cesarean section groups in terms of the indications for admission to the NICU of term low-risk pregnant women (p=0.91, p=0.17). A higher admission in the NICU was found in the early term group. The early term group required more respiratory support compared to the full term group (p=0.02). When the groups were compared in terms of IV fluid treatment support, hypoglycemia or feeding difficulty, and jaundice requiring phototherapy, no significant difference was found. Conclusion: Withlimited data available for admission indications to the NICU of newborns born from term pregnancies, we found that the mode of delivery affects hospitalization indications of newborns, need for support, and Apgar scores. Early term delivery is associated with higher rates of neonatal morbidity and admission to the NICU. Better maternal care and prevention of factors that may lead to preterm birth will provide the prevention and management of these problems.

Comparison of hematological parameters and perinatal outcomes between COVID-19 pregnancies and healthy pregnancy cohort.

OBJECTIVES: To evaluate the relationship between Coronavirus Disease 2019 (COVID-19) in pregnancy and adverse perinatal outcomes. The secondary aim is to analyze the diagnostic value of hematologic parameters in COVID-19 complicated pregnancies. METHODS: The current study is conducted in a high volume tertiary obstetrics center burdened by COVID-19 pandemics, in Turkey. In this cohort study, perinatal outcomes and complete blood count indices performed at the time of admission of 39 pregnancies (Study group) complicated by COVID-19 were compared with 69 uncomplicated pregnancies (Control group). RESULTS: There was no significant difference between the obstetric and neonatal outcomes of pregnancies with COVID-19 compared to data of healthy pregnancies, except the increased C-section rate (p=0.026). Monocyte count, red cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR), and monocyte/lymphocyte ratio (MLR) were significantly increased (p<0.0001, p=0.009, p=0.043, p<0.0001, respectively) whereas the MPV and plateletcrit were significantly decreased (p=0.001, p=0.008) in pregnants with COVID-19. ROC analysis revealed that the optimal cut-off value for MLR was 0.354 which indicated 96.7% specificity and 59.5% sensitivity in diagnosis of pregnant women with COVID-19. A strong positive correlation was found between the MLR and the presence of cough symptom (r=41.4, p=<0.0001). CONCLUSIONS: The study revealed that, pregnancies complicated by COVID-19 is not related with adverse perinatal outcomes. MLR may serve as a supportive diagnostic parameter together with the Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) in assessment of COVID-19 in pregnant cohort.

The Relationship Between Breast Density, Bone Mineral Density, and Metabolic Syndrome Among Postmenopausal Turkish Women.

The relationship between metabolic syndrome (MetS) and menopause remains unclear. The effects of MetS on breast and bone density in this group of women are also not fully elucidated. Herein, we aimed to investigate the relationship between components of the MetS, mammographic breast density (MBD), and vertebral/femoral bone mineral density (BMD) in postmenopausal Turkish women. The study group consisted of postmenopausal women with MetS whereas controls postmenopausal women without MetS. All consecutive women who applied to our center for routine postmenopausal follow up and met the inclusion criteria, between July 2013 and October 2015 were included in the study. Menopause was defined as the cessation of menstruation for at least 1 year, and we used the definition of the MetS suggested by a joint interim statement. BMD of the spine and femur was measured by dual energy X-ray absorptiometry. The medical records of 390 postmenopausal were retrospectively reviewed. No significant differences were observed between the groups in terms of age, menopause type, and menopause duration (p > 0.05). Decreased MBD (for grade 1-2 and 3-4 densities) was associated with increased MetS risk (p = 0.017). Total femoral BMD, total lumber BMD, femoral neck BMD were significantly higher in postmenopausal women with MetS (p < 0,005). This study is the first report focusing on the relationship between MetS and breast/bone density. According to the results of our study, the presence of MetS in postmenopausal periods has a positive effect on both MBD and BMD.

Prediction of gestational diabetes mellitus in the first trimester: comparison of maternal fetuin-A, N-terminal proatrial natriuretic peptide, high-sensitivity C-reactive protein, and fasting glucose levels.

OBJECTIVE: We investigated the utility of maternal fetuin-A, N-terminal proatrial natriuretic peptide (pro-ANP), high-sensitivity C-reactive protein (hs-CRP), and fasting glucose levels at 11-14 gestation weeks for predicting pregnancies complicated by gestational diabetes mellitus (GDM). SUBJECTS AND METHODS: This prospective cohort study included 327 low-risk pregnant women who completed antenatal follow-up at a tertiary research hospital between January and April 2014. Maternal blood samples were collected between 11-14 gestational weeks in the first trimester of pregnancy and then stored at -80 °C until further analyses. During follow-up, 29 (8.8%) women developed GDM. The study population was compared 1:2 with age- and body mass index-matched pregnant women who did not develop GDM (n = 59). Fasting plasma glucose (FPG) levels and serum fetuin-A, pro-ANP, and hs-CRP levels were measured using automated immunoassay systems. RESULTS: There was a significant negative correlation between fetuin-A and hs-CRP (CC = -0.21, p = 0.047) and a positive correlation between FPG and hs-CRP (CC = 0.251, p = 0.018). The areas under the receiver operating characteristic curve for diagnosing GDM were 0.337 (p = 0.013), 0.702 (p = 0.002), and 0.738 (p < 0.001) for fetuin-A, hs-CRP, and FPG, respectively. The optimal cut-off values were > 4.65, < 166, and > 88.5 mg/dL for maternal hs-CRP, fetuin-A, and FPG, respectively. CONCLUSION: Reduced fetuin-A, elevated hs-CRP, and FPG levels in women in the first trimester can be used for the early detection of GDM. Further research is needed before accepting these biomarkers as valid screening tests for GDM.

Prediction of gestational diabetes mellitus in the first trimester: comparison of maternal fetuin-A, N-terminal proatrial natriuretic peptide, high-sensitivity C-reactive protein, and fasting glucose levels

ABSTRACT Objective We investigated the utility of maternal fetuin-A, N-terminal proatrial natriuretic peptide (pro-ANP), high-sensitivity C-reactive protein (hs-CRP), and fasting glucose levels at 11-14 gestation weeks for predicting pregnancies complicated by gestational diabetes mellitus (GDM). Subjects and methods This prospective cohort study included 327 low-risk pregnant women who completed antenatal follow-up at a tertiary research hospital between January and April 2014. Maternal blood samples were collected between 11-14 gestational weeks in the first trimester of pregnancy and then stored at -80 °C until further analyses. During follow-up, 29 (8.8%) women developed GDM. The study population was compared 1:2 with age- and body mass index-matched pregnant women who did not develop GDM (n = 59). Fasting plasma glucose (FPG) levels and serum fetuin-A, pro-ANP, and hs-CRP levels were measured using automated immunoassay systems. Results There was a significant negative correlation between fetuin-A and hs-CRP (CC = -0.21, p = 0.047) and a positive correlation between FPG and hs-CRP (CC = 0.251, p = 0.018). The areas under the receiver operating characteristic curve for diagnosing GDM were 0.337 (p = 0.013), 0.702 (p = 0.002), and 0.738 (p < 0.001) for fetuin-A, hs-CRP, and FPG, respectively. The optimal cut-off values were > 4.65, < 166, and > 88.5 mg/dL for maternal hs-CRP, fetuin-A, and FPG, respectively. Conclusion Reduced fetuin-A, elevated hs-CRP, and FPG levels in women in the first trimester can be used for the early detection of GDM. Further research is needed before accepting these biomarkers as valid screening tests for GDM.

The role of oxidative stress markers in development of endometrial polyp.

OBJECTIVE: To evaluate the association of the oxidative stress markers in patients with endometrial polyp. METHODS: A total of forty nine patients between 28-47 years of ages who have a suspect evidence of endometrial polyp on transvaginal sonography were enrolled for the study. Hysterosonography was applied all of the patients and patients then were divided into two groups in terms of their hysteroscopic findings. Group 1(control group, n=27) defined who has no endometrial pathology and group 2 (study group, n=22) defined has one or more endometrial polyp on hysteroscopy with guided biopsy. The diagnosis was established by histopathological examination polyps. The parameters compared between groups were; age, body mass index, catalase (CAT), xsantine oxidase (XO), malondialdehyde (MDA) levels. RESULTS: There were no statistically significant differences between groups in terms of age and BMI. Catalase, xsantine oxidase and malondialdehyde levels were statically significantly different between the groups (p < 0,05). The mean of polyp diameter size were 17.95 ±0.45 mm and the number of the polyp per patient was 1.54 ± 0.67. CONCLUSION: According to our study, serum catalase, xsantine oxidase and malondialdehyde levels may be discriminative parameters for patients with endometrial polyp.

Effect of reproductive history, lactation, first pregnancy age and dietary habits on bone mineral density in natural postmenopausal women.

AIM: The aim of this study was to investigate the possible risk factors related with osteoporosis in women with spontaneous menopause. METHODS: Five hundred and one postmenopausal women were divided into three groups as normal, osteopenic and osteoporotic according to their bone mineral density (BMD). By face-to-face interview, parity, age at menarche, age at menopause, duration of fertility, duration of menopause, first pregnancy age, total lactation period, exercise, smoking were assessed. Women with menopause age before 40 years, surgical menopause, who had any anti-osteoporosis treatment, hormone replacement therapy at the time of BMD measurement and corticosteroid use longer than 6 months were excluded from the study. RESULTS: Among 501 postmenopausal women, 107 women were classified as normal, 170 as osteopenic and 224 as osteoporotic. Among demographic features of patients, there was statistically significant difference between the groups in age, BMI and parity (p < 0.001, p < 0.0001 and p = 0.002, respectively). There were statistically significant differences between the groups in case of age at menopause, duration of fertility and duration of menopause (p = 0.013, p = 0.013 and p < 0.0001, respectively). In the multivariate logistic regression analysis, BMI over 32 and fertility duration over 33 years had a statistically significant protective effect against osteoporosis (OR 0.42, CI 95 % 0.27-0.66; OR 0.36, CI 95 % 0.24-0.56, respectively), but age was positively correlated with osteoporosis (OR 1.13, CI 95 % 1.01-1.17) CONCLUSIONS: Duration of fertility (years of menstruation) longer than 33 years and body mass index higher than 32 seem to protect against postmenopausal osteoporosis. Age is also an independent risk factor for postmenopausal osteoporosis.

Effect of povidone iodine on thyroid functions and urine iodine levels in caesarean operations.

OBJECTIVE: In the present study, the effects of povidone iodine (PI) used during Caesarean operations on maternal thyroid hormones and urine iodine levels in the infant and the mother were investigated. DESIGN: Twenty-seven patients were allocated to the PI group I (Gr I), and 28 to the non-PI group (Group II). Maternal preoperative and 24th-h postoperative free T3 (fT3), freeT4 (fT4), TSH, and urine iodine levels were determined, as well as infant urine iodine values. RESULTS: In both groups, fT3 levels before and after the operation were found to be reduced (p < 0.01, p = 0.01, respectively). However, the decrease in fT3 was approximately 1.5-fold higher in Gr I than in Gr II. TSH levels increased significantly in Gr I (p = 0.005). The urine iodine levels of the mothers increased 25% in Gr I, but only 2% in Gr II. CONCLUSIONS: The absorption of PI by the skin was found to lead to changes in fT3, TSH, and urine iodine excretion values in the mothers. The findings of this study of Caesarean operations, which have a short duration, might be a signal to be careful of thyroid hormone effects in operations lasting longer.

Urinary incontinence in women and its relation with pregnancy, mode of delivery, connective tissue disease and other factors.

OBJECTIVES: The aim of this study was to determine the relationship between urinary incontinence (UI) and parameters such as pregnancy, mode of delivery and other factors. MATERIAL AND METHODS: The study was based on a questionnaire administered to 761 patients. After their age, menopausal status, number of pregnancies, number of deliveries and history of connective tissue disease (CTD) were recorded, the data were analyzed using a chi2 test. RESULTS: In patients who are post-menopausal and over 40, both stress incontinence (SI) and urge incontinence (URI) were found to be significantly higher. It was also established that both SI and URI increased with the number of pregnancies. As the number of normal vaginal deliveries increased, the rate of both SI and URI increased, while increases in the number of cesarean sections affected neither SI nor URI. Among women who had had abortions, the rate of SI was higher, and it increased as the number of abortions increase. Neither the occurrence of abortions nor increased numbers of abortions influenced the rate of URI. In patients with CTD, both SI and URI increase. CONCLUSIONS: Urinary incontinence in women seems to be influenced by the mode of delivery, menopause, age and CTD.

Sialic acid levels in the blood in pregnant women with impaired glucose tolerance test.

PURPOSE: Gestational diabetes (GDM) is a metabolic disease characterized by the impairment of glucose tolerance during pregnancy. Sialic acid (SA) is a component of glycolipid and glycoproteins found in hormone and enzymes in serum and tissues and high serum SA levels are observed in diabetic patients. METHODS: Serum SA levels were investigated in three groups, namely 61 normal pregnant women with normal 50 gr glucose loading test (group 1: gr 1), 36 patients with high 50 gr test values and normal 100 gr test (group 2: gr 2: group with impaired glucose tolerance test, IGT), and 8 patients with diagnosis of GDM (group 3:gr 3). RESULTS: According to Kruskal-Wallis test, significant difference was observed in SA levels between gr1 and gr2-gr3 (p = 0.001). Difference was observed between groups with respect to age (p < 0.001), the number of pregnancies (p = 0.001), BMI (p = 0.001), and diabetes history in the family (p = 0.001) (Table 1). Table 1 Summary of results and statistical relationship Variable Group 1 (n = 61) Group 2 (n = 36) Group 3 (n = 8) p Age 24 (18-38) 28 (19-38) 31 (20-38) <0.001 Pregnancy week 26 (24-29) 26 (24-32) 26,5 (24-29) 0.126 Pregnancy number 2 (0-6) 2 (1-5) 3.5 (1-5) <0.001 BMI 23.7 (17.9-38.2) 27.6 (17.04-41.14) 30.8 (21.9-43.8) <0.001 Weight taken 7 (1-13) 6 (2-12) 6 (4-10) 0.954 Sialic acids 2.66 (1.2-4.59) 3.22 (2.34-5.04) 3.05 (2.67-3.49) <0.001 Fetal weight 3,380 (2,310-4,290) 3,400 (2,650-4,600) 3,655 (3,270-3,960) 0.092 Smoking 5 (%8.2) 2 (%5.6) 0 (%0) 1 Family history 22 (%36.1) 10 (%27.8) 8 (%100) <0.001. CONCLUSION: Our study demonstrated that SA values are increased in GDM and IGT groups, which demonstrates that inflammatory disorders may occur also in IGT group, which is considered like normal pregnancy, and that this group may be considered in the same way as GDM.

Striae gravidarum, vitamin C and other related factors.

BACKGROUND: Striae gravidarum, a clinical condition commonly seen in pregnant women, produces serious cosmetic problems and may lead to psychological problems. AIM: The present study investigated whether there was any relation between the presence of striae in primigravid pregnant women and blood vitamin C levels, and factors thought to contribute to the formation of striae such as family history, weight gained during pregnancy, smoking status, abdominal and thigh circumference, and age. METHODS: Overall, 69 primigravid women attending routine antenatal follow-up and, using prophylactic iron and vitamin preparations, underwent investigation. All were pregnant 36 or more weeks. Scoring was based on striae examination and whether striae were present. The relation between the presence of striae, vitamin C blood levels, and other factors was investigated. RESULTS AND CONCLUSIONS: Multiple logistic regression analysis showed a significant relation between the presence of striae and blood vitamin C levels (p = 0.046) and between the presence of striae and family history (p = 0.023). No significant relation was found between the presence of striae and age, weight gained during pregnancy, abdominal and thigh circumference, or smoking status. It was concluded that further, more comprehensive studies on the issue are required.