Relationship between combined systemic inflammatory indices with presence and severity of hyperemesis gravidarum.

OBJECTIVE: Our study aims to determine the levels of systemic inflammation markers and the combined systemic inflammation indices in hyperemesis gravidarum (HG) patients and to investigate the association between the severity of the disease. PATIENTS AND METHODS: The study population consisted of 83 pregnant women with HG and 100 healthy pregnant women matched for gestational age as a control group. We grouped the HG patients according to the Modified Pregnancy Unique Quantification of Emesis/Nausea (PUQE) scoring system as mild, moderate, and severe. We calculated the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), MPV-to-lymphocyte ratio (MPVLR), RDW-to-platelet ratio (RPR), Systemic immune-inflammation index (SII), Systemic Inflammation Response Index (SIRI), and Aggregate Systemic Inflammation Index (AISI). RESULTS: NLR, PLR, SII, SIRI, and AISI levels were significantly higher in the HG group. These indices tended to increase as the severity of the disease increased. We found NLR, PLR, SII, SIRI, and AISI indices as the independent risk factors for the presence and severity of HG. The SIRI index, which has the highest area under the curve (AUC), sensitivity, and specificity values, was determined as the most powerful diagnostic tool in the diagnostic evaluation of the presence (AUC: 0.695; p < 0.001; sensitivity: 54%; specificity: 75%; cut-off: 3.14) and severity (AUC: 0.785; p < 0.001, sensitivity: 82%; specificity: 68%; cut-off: 2.74) of HG. CONCLUSIONS: Our study results showed that combined systemic inflammatory indices (NLR, PLR, SII, SIRI, and AISI) are associated and correlated with the presence and severity of HG. These indices are independent risk factors for the presence and severity of HG. Combined systemic inflammatory indices are diagnostic in determining the severity of HG. The SIRI index has the best diagnostic power for both the diagnosis of HG and the determination of the severity of HG.

Is there relationship between social support, psychological distress, mood disorders and emesis gravidarum?

OBJECTIVE: Emesis Gravidarum (EG) is common medical condition in pregnancy with significant negatively effects on daily social life, physical and psychological health. In this study, relationship of social support, psychological distress and mood disorders on EG were investigated. METHODS: The pregnant women with mild EG were accepted as control group and moderate and severe EG were accepted as patient group. All patients completed sociodemographic data collection form, Pregnancy-Unique Quantification of Emesis and Nausea scale (PUQE-24), Symptom Check List questionnaire (SCL-90 R), Spielberger state-trait anxiety inventory (STAI), Beck depression inventory (BDI) and Multidimensional Scale of Perceived Social Support (MSPSS). STAI, BDI, MSPSS and GSI (global symptom index) scores of the patients and control groups were compared. RESULTS: Statistically significant differences were found between the patients and control group on STAI score, BDI score and GSI scores. No statistically significant were found between the patients and control group on MSPSS score. CONCLUSION: Social support does not prevent patients from EG. But, there is a clear relationship between EG and psychological distress. Thus, psychiatric evaluation should be done in patients with EG. Obstetricians should encourage their patients to have psychiatric support. Further studies on relationship of psychosocial factors and EG are needed.