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Ozer Bekmez B, Kanmaz Kutman HG, Oguz Y, Uygur D, Elbayiyev S, Canpolat FE, Oguz SS, Tayman C. Antenatal Neuroprotective Magnesium Sulfate in Very Preterm Infants and Its Association With Feeding Intolerance. J Pediatr Gastroenterol Nutr 2023; 77:597-602. [PMID: 37580867 DOI: 10.1097/mpg.0000000000003912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
INTRODUCTION/OBJECTIVE Magnesium sulfate (MgSO 4 ) treatment is widely used for fetal neuroprotection despite the controversy concerning the side effects. There is limited data regarding the impact of various cumulative maternal doses and neonatal serum magnesium (Mg) levels on short-term neonatal morbidity and mortality. We opted to carry out a study to determine the impact of neonatal serum Mg levels on neonatal outcomes. METHOD We conducted this prospective observational study between 2017 and 2021. Antenatal MgSO 4 was used for neuroprotective purpose only during the study period. Inborn preterm infants delivered between 23 and 31 6/7 weeks of gestation were enrolled consecutively. Babies who underwent advanced resuscitation in the delivery room, inotropic treatment due to hemodynamic instability in the first 7 days of life, >12 hours since the discontinuation of maternal MgSO 4 treatment, severe anemia, and major congenital/chromosomal anomalies were excluded from the study. The subgroup of babies with serum Mg level at the 6th hour of life underwent an analysis. A neonatal Mg concentration of 2.5 mg/dL was used to classify MgSO 4 -exposed patients into 2 groups (<2.5 mg/dL and ≥2.5 mg/dL). Another analysis was performed between babies whose mothers were exposed to MgSO 4 and those not exposed. Finally, the groups' neonatal outcomes were compared. RESULTS Of the 584 babies, 310 received antenatal MgSO 4 . The birth weights were significantly lower in the MgSO 4 exposed group (1113 ± 361 g vs 1202 ± 388 g, P = 0.005). Antenatal corticosteroid usage and intrauterine growth restriction were also noted to be higher. The MgSO 4 group was more likely to have bronchopulmonary dysplasia, prolonged invasive ventilation, necrotizing enterocolitis, delayed enteral nutrition, and feeding intolerance ( P < 0.05). MgSO 4 treatment was shown as an independent risk factor for feeding intolerance when corrected for confounders (odds ratio 2.13, 95% confidence interval: 1.4-3.1, P = 0.001). Furthermore, serum Mg level significantly correlated with feeding intolerance ( r = 0.21, P = 0.002). CONCLUSION This study highlighted the effect of MgSO 4 treatment and the potential superiority of serum Mg level as a predictor of immediate neonatal outcomes, particularly delayed enteral nutrition and feeding intolerance. Further studies are warranted to ascertain the optimal serum Mg concentration of preterm infants in early life to provide maximum benefit with minimal side effects.
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MESH Headings
- Female
- Humans
- Infant, Newborn
- Pregnancy
- Fetal Growth Retardation/drug therapy
- Infant, Newborn, Diseases/drug therapy
- Infant, Premature
- Infant, Premature, Diseases/drug therapy
- Infant, Premature, Diseases/prevention & control
- Infant, Premature, Diseases/chemically induced
- Magnesium Sulfate/therapeutic use
- Neuroprotection
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Affiliation(s)
- Buse Ozer Bekmez
- From the Division of Neonatology, Department of Pediatrics, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Hayriye Gozde Kanmaz Kutman
- From the Division of Neonatology, Department of Pediatrics, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Yuksel Oguz
- the Department of Obstetrics and Gynecology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Dilek Uygur
- the Department of Obstetrics and Gynecology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Sarkhan Elbayiyev
- From the Division of Neonatology, Department of Pediatrics, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Fuat Emre Canpolat
- From the Division of Neonatology, Department of Pediatrics, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Serife Suna Oguz
- From the Division of Neonatology, Department of Pediatrics, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Cuneyt Tayman
- From the Division of Neonatology, Department of Pediatrics, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
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Abstract
BACKGROUND AND AIM Zinc and copper are essential trace elements for cell growth and proliferation. Their deficiency may contribute to intrauterine growth restriction (IUGR). We aimed to determine the zinc and copper status of maternal serum and placenta samples of pregnant women with fetal IUGR and age-matched pregnant women without IUGR. METHOD Serum and placenta samples obtained from 37 IUGR and 21 healthy pregnant women were analyzed at delivery. RESULTS Placenta zinc concentrations and placenta zinc/copper ratio were significantly lower in the IUGR group compared to controls (p < 0.05). Placenta zinc concentrations correlated with birth weight (p: 0.01, r: 0.31). Maternal levels of zinc and copper were similar between pregnant women with IUGR and controls. CONCLUSIONS Lower placental zinc and zinc/copper ratio levels in pregnancies with IUGR may indicate that placenta zinc and placental zinc/copper status might be involved in IUGR.
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Affiliation(s)
- Özge Yücel Çelik
- Etlik Zubeyde Hanim Kadin Hastaliklari Egitim ve Arastirma Hastanesi, Ankara, Turkey
| | - Sevginur Akdas
- Interdisciplinary Food, Metabolism and Clinical Nutrition Department, Ankara University, Ankara, Turkey
| | - Aykan Yucel
- Ankara City Hospital, Republic of Turkey Ministry of Health, Cankaya, Turkey
| | - Burcu Kesikli
- Pathophysiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Nuray Yazihan
- Interdisciplinary Food, Metabolism and Clinical Nutrition Department, Ankara University, Ankara, Turkey.,Department of Pathophysiology, Ankara University Faculty of Medicine, Internal Medicine, Ankara, Turkey
| | - Dilek Uygur
- Ankara City Hospital, Republic of Turkey Ministry of Health, Cankaya, Turkey
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Ozer Bekmez B, Oğuz Y, Kutman HGK, Uygur D, Canpolat FE, Oğuz SS, Tayman C. The Effect of Antenatal Neuroprotective Magnesium Sulfate Treatment on Cerebral Oxygenation in Preterm Infants. Am J Perinatol 2021; 38:e64-e70. [PMID: 32143226 DOI: 10.1055/s-0040-1705148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Antenatal magnesium sulfate (MgSO4) treatment is associated with reduced risk of cerebral palsy in preterm infants. We aimed to investigate whether this treatment leads to any alterations on cerebral hemodynamics which could be detected by near-infrared spectroscopy (NIRS) readings in early postnatal life. STUDY DESIGN Infants with gestational ages (GAs) ≤ 32 weeks were divided into two groups regarding their exposure to antenatal neuroprotective MgSO4 treatment or not. NIRS monitoring was performed to all infants, and readings were recorded for 2 hours each day during the first 3 days of life. The primary aim was to compare regional cerebral oxygen saturation (rcSO2) and cerebral fractional tissue oxygen extraction (cFTOE) between the groups. RESULTS Sixty-six infants were exposed to antenatal MgSO4, while 64 of them did not. GA and birth weight were significantly lower in the treatment group (p < 0.01). No difference was observed in rcSO2 and cFTOE levels in the first, second, and the third days of life (p > 0.05). An insignificant reduction in severe intraventricular hemorrhage rates was observed (8 vs. 15%, p = 0.24). CONCLUSION We could not demonstrate any effect on cerebral oxygenation of preterm infants in early postnatal life that could be attributed to antenatal neuroprotective MgSO4 treatment. Future studies are warranted to clarify the exact underlying mechanisms of neuroprotection.
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Affiliation(s)
- Buse Ozer Bekmez
- Division of Neonatology, Zekai Tahir Burak Women's Health Education and Research Hospital, Altındağ, Ankara, Turkey
| | - Yüksel Oğuz
- Division of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital, Altındağ, Ankara, Turkey
| | - Hayriye Gözde Kanmaz Kutman
- Division of Neonatology, Zekai Tahir Burak Women's Health Education and Research Hospital, Altındağ, Ankara, Turkey
| | - Dilek Uygur
- Division of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital, Altındağ, Ankara, Turkey
| | - Fuat Emre Canpolat
- Division of Neonatology, Zekai Tahir Burak Women's Health Education and Research Hospital, Altındağ, Ankara, Turkey
| | - Serife Suna Oğuz
- Division of Neonatology, Zekai Tahir Burak Women's Health Education and Research Hospital, Altındağ, Ankara, Turkey
| | - Cüneyt Tayman
- Division of Neonatology, Zekai Tahir Burak Women's Health Education and Research Hospital, Altındağ, Ankara, Turkey
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Ergani SY, Orgul G, Tolunay HE, Arici M, Yucel A, Uygur D. Gitelman Syndrome in Pregnancy: A Clinical Challenge. Z Geburtshilfe Neonatol 2021; 225:526-528. [PMID: 34126642 DOI: 10.1055/a-1498-2940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Disease progress may be affected by pregnancy-related changes, and underlying conditions may also affekt pregnancy outcomes in women with Gitelman syndrome (GS). Case presentation A 35-year-old woman with GS (gravida 2 para 1) was referred to our hospital to start routine antenatal care follow-up at 6 weeks of gestation. At the age of 31, she had been diagnosed with GS after her first uneventful pregnancy. Upon early admission, her serum Mg+level was 0.51 mmol/L and her serum K+level 2.7 mmol/L with normal kidney function tests. She was already taking oral combined potassium citrate and potassium bicarbonate supplementation once a day before pregnancy. At the eighth gestational week, the medication was changed to an oral potassium color sachet of 1.5 gram per day until labor because of the insufficient dosage to maintain optimum potassium levels. She was also taking 365 milligrams of oral magnesium oxide twice a day before and during pregnancy. In the third trimester of the pregnancy, her serum Mg+level was 0.48 mmol/L and serum K+level 2.8 mmol/L. Because of the previous uterine surgery history, she underwent an elective cesarean operation at 39 weeks' gestation under spinal anesthesia and delivered a healthy 3090-gram female infant. CONCLUSION Increased need for potassium and magnesium supplementation should be the critical considerations when managing pregnant patients with GS.
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Affiliation(s)
- Seval Yilmaz Ergani
- Perinatology, Ankara Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Turkey
| | - Gokcen Orgul
- Division of Perinatology, Department of Obstetrics and Gynecology, Hacettepe Universitesi Tip Fakultesi, Altindag, Turkey
| | - Harun Egemen Tolunay
- Perinatology, Ankara Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Turkey
| | - Mustafa Arici
- Division of Nephrology, Department of Internal Medicine, Hacettepe Universitesi Tip Fakultesi, Altindag, Turkey
| | - Aykan Yucel
- Perinatology, Ankara City Hospital, Cankaya, Turkey
| | - Dilek Uygur
- Perinatology, Ankara City Hospital, Cankaya, Turkey
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Abstract
Preeclampsia (PE) may represent an inflammatory process. Endocan (ESM-1) is a marker of endothelial inflammation. We compared plasma endocan levels between PE and control groups and between early and late-onset PE. Study design: Maternal plasma endocan levels were measured in 41 preeclampsia (PE) pregnancies - 25 early-onset (<34 weeks); 16 late-onset (≥34 weeks), and 37 non-complicated pregnancies (22 matched with early-onset PE, 15 with late onset). Results: There was no significant differences between plasma endocan levels of patients with PE and control group (468.8(IQR: 169.7)ng/L vs 462.4(IQR: 321.1)ng/L, p > 0.05), between early and late-onset PE (458.8(221.8)ng/L vs 469.8(122.6)ng/L, p > 0.05), between early-onset PE and corresponding control group (458.8(221.8)ng/L vs 506.2(1481.9)ng/L, p > 0.05), or late-onset PE and corresponding control group (469.8(122.6)ng/L vs 451.0(85.1)ng/L, p > 0.05). Conclusion: There was no significant difference between endocan levels of early or late-onset PE compared with their corresponding control groups, nor between early and late-onset preeclampsia groups.
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Affiliation(s)
| | - Cem Yasar Sanhal
- Gynecology and Obstetrics, Akdeniz University School of Medicine, Antalya, Turkey
| | - Dilek Uygur
- Etlik Zübeyde Hanım Women's Health and Research Hospital, Ankara, Turkey
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Ozgu-Erdinc AS, Oskovi-Kaplan ZA, Erkenekli K, Yilmaz N, Engin-Ustun Y, Yücel A, Uygur D. Do fetuin-A/apha2-Heremans Schmid-glycoprotein levels have an association with recurrent pregnancy loss? J Matern Fetal Neonatal Med 2021; 35:6942-6945. [PMID: 34024228 DOI: 10.1080/14767058.2021.1931675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Fetuin-A is a hepatokine which is previously found related to fertility and pregnancy outcomes. We aimed to investigate if recurrent pregnancy loss (RPL) is associated with increased fetuin-A levels. MATERIALS AND METHODS Serum fetuin-A concentrations were measured and compared in 30 non-pregnant women with a history of unexplained recurrent miscarriage, 29 women who had a history of unexplained recurrent miscarriage and were admitted to our clinic due to miscarriage during the study period and 30 fertile women who have no history of miscarriage or any other pregnancy complications with at least two previous healthy children. RESULTS The median serum fetuin-A levels of group I, II, and III were 59.45, 62.73, and 44.52, respectively (p=.065). Serum fetuin-A levels significantly increased in group II compared to group III (p=.011). No significant differences in the levels of fetuin-A of group I compared to either group II (p=.433) or group III (p=.268). CONCLUSIONS The etiology of RPL is still a subject that is not clarified. Fetuin-A levels may have a relationship with RPL.
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Affiliation(s)
- A Seval Ozgu-Erdinc
- Department of Obstetrics and Gynecology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Z Asli Oskovi-Kaplan
- Department of Obstetrics and Gynecology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | | | - Nafiye Yilmaz
- Department of Obstetrics and Gynecology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Yaprak Engin-Ustun
- Department of Obstetrics and Gynecology, Etlik Zübeyde Hanım Womens' Health Education and Research Hospital, Ankara, Turkey
| | - Aykan Yücel
- Department of Obstetrics and Gynecology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Dilek Uygur
- Department of Obstetrics and Gynecology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
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Eroğlu H, Tonyalı NV, Orgul G, Biriken D, Yucel A, Yazihan N, Uygur D. Is ProBNP a New Marker for Predicting Intrauterine Growth Restriction? Z Geburtshilfe Neonatol 2021; 225:125-128. [PMID: 33694150 DOI: 10.1055/a-1382-8787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To evaluate the usability of first-trimester maternal serum ProBNP levels in the prediction of intrauterine growth restriction (IUGR). Methods In this prospective study, blood samples taken from 500 women who applied to our polyclinic for routine serum aneuploidy screening between the 11-14th gestational weeks were centrifuged. The obtained plasma samples were placed in Eppendorf tubes and stored at -80+°C. For the final analysis, first-trimester maternal serum ProBNP levels of 32 women diagnosed with postpartum IUGR and 32 healthy women randomly selected as the control group were compared. FGR was defined as estimated fetal weight below the 10th percentile for the gestational age. RESULTS The mean ProBNP levels were statistically and significantly higher in the women with intrauterine growth restriction (113.73±94.69 vs. 58.33±47.70 pg/mL, p<0.01). At a cut-off level of 50.93, ProBNP accurately predicted occurrence of IUGR (AUC+= 0.794 (95% confidence interval 0.679-0.910), p+= 0.001) with sensitivity and specificity rates of 78.1 and 69.0%, respectively. Conclusion First-trimester serum ProBNP level was significantly higher in women who developed IUGR compared to healthy controls. First-trimester ProBNP level can be used as a potential marker to predict the development of IUGR in pregnant women.
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Affiliation(s)
- Hasan Eroğlu
- Department of Perinatology, Etlik Lady Zübeyde Gynaecology Education and Research Hospital, Ankara, Turkey
| | - Nazan Vanlı Tonyalı
- Department of Perinatology, Etlik Lady Zübeyde Gynaecology Education and Research Hospital, Ankara, Turkey
| | - Gokcen Orgul
- Department of Perinatology, Etlik Lady Zübeyde Gynaecology Education and Research Hospital, Ankara, Turkey
| | - Derya Biriken
- Microbiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Aykan Yucel
- Department of Perinatology, Etlik Lady Zübeyde Gynaecology Education and Research Hospital, Ankara, Turkey
| | - Nuray Yazihan
- Ankara University, Faculty of Medicine, Pathophysiology Department
| | - Dilek Uygur
- Department of Perinatology, Etlik Lady Zübeyde Gynaecology Education and Research Hospital, Ankara, Turkey
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Anuk AT, Tanacan A, Yetiskin FDY, Buyuk GN, Senel SA, Keskin HL, Moraloglu O, Uygur D. Doppler assessment of the fetus in pregnant women recovered from COVID-19. J Obstet Gynaecol Res 2021; 47:1757-1762. [PMID: 33650296 PMCID: PMC8014281 DOI: 10.1111/jog.14726] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/11/2021] [Accepted: 02/11/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the maternal-fetal Doppler patterns in pregnant women recovered from COVID-19. METHODS This prospective case-control study was conducted in Ankara City Hospital between July 1, 2020 and August 30, 2020. Thirty pregnant women who were diagnosed with COVID-19 and completed the quarantine process were compared with 40 healthy pregnant women in terms of the fetal Doppler parameters. All pregnant women diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection were followed up in our clinic and their diagnoses have been confirmed in nasopharyngeal and oropharyngeal samples by quantitative real time reverse transcriptase polymerase chain reaction (RT-PCR) method. Doppler ultrasonographic assessment of the uterine arteries (UtA) and middle cerebral artery (MCA) were used in addition to umbilical artery (UA) Doppler between 23 and 40 weeks of gestation. Also, cerebroplacental ratio (CPR) was calculated according to gestational age. RESULTS The pulsatility and resistance indices of umbilical and UtA showed a significant increase in pregnant women in the study group compared to the control group (p < 0.05). Multivariable logistic regression analysis revealed that pulsatility and resistance indices of the mean UtA were independently associated with disease (OR > 1000, 95%CI 9.77 to >1000, p = 0.009; OR 0,000 95%CI 0,000-0,944, p = 0,049), respectively. Medical treatment was given to 16/30 (53%) of pregnant women diagnosed with COVID-19. CONCLUSION In conclusion, uterine artery Doppler indices in the third trimester may have clinical value in pregnant women recovered from COVID-19.
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Affiliation(s)
- Ali T Anuk
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Cankaya, Turkey
| | - Atakan Tanacan
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Cankaya, Turkey
| | - Fatma D Y Yetiskin
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Cankaya, Turkey
| | - Gul N Buyuk
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Cankaya, Turkey
| | - Selvi A Senel
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Cankaya, Turkey
| | - Huseyin L Keskin
- University of Health Sciences, Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ozlem Moraloglu
- University of Health Sciences, Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Dilek Uygur
- University of Health Sciences, Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
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Korkut S, Oğuz Y, Bozkaya D, Türkmen GG, Kara Ö, Uygur D, Oğuz ŞS. Evaluation of the Effects of Delayed Cord Clamping in Infants of Diabetic Mothers. Am J Perinatol 2021; 38:242-247. [PMID: 31563135 DOI: 10.1055/s-0039-1695799] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE This study aimed to investigate the effect of delayed cord clamping (DCC) in infants of diabetic mothers. STUDY DESIGN Women who had diabetes throughout their pregnancy and gave birth at 37 weeks of gestation or later were included in the study along with their babies. Early cord clamping was performed as soon as possible after birth, while DCC was performed by clamping 60 second after birth. The two groups were compared in terms of venous hematocrit (htc) levels and rates of hypoglycemia, jaundice requiring phototherapy, and respiratory distress. RESULTS Venous htc levels at postnatal 6 and 24 hours were significantly higher in the DCC group (p = 0.0001). Polycythemia rates were higher in the DCC group at both 6 and 24 hours, but partial exchange transfusion (PET) was not needed in either group. There were no differences between the groups with regard to the rates of hypoglycemia or jaundice requiring phototherapy. Rate of admission to the neonatal intensive care unit (NICU) was lower in the DCC group. CONCLUSION Although DCC increased the rate of polycythemia, it did not result in PET requirement. Moreover, DCC reduced the severity of respiratory distress and the rate of admission to NICU due to respiratory distress.
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Affiliation(s)
- Sabriye Korkut
- Department of Neonatology, University of Health Sciences, Faculty of Medicine, Zekai Tahir Burak Women's Helath Training and Research Hospital, Ankara 06230, Turkey
| | - Yüksel Oğuz
- Department of Perinatology, University of Health Sciences, Faculty of Medicine, Zekai Tahir Burak Women's Helath Training and Research Hospital, Ankara, Turkey
| | - Davut Bozkaya
- Department of Neonatology, University of Health Sciences, Faculty of Medicine, Zekai Tahir Burak Women's Helath Training and Research Hospital, Ankara 06230, Turkey
| | - Gülenay Gençosmanoğlu Türkmen
- Department of Perinatology, University of Health Sciences, Faculty of Medicine, Zekai Tahir Burak Women's Helath Training and Research Hospital, Ankara, Turkey
| | - Özgür Kara
- Department of Perinatology, University of Health Sciences, Faculty of Medicine, Zekai Tahir Burak Women's Helath Training and Research Hospital, Ankara, Turkey
| | - Dilek Uygur
- Department of Perinatology, University of Health Sciences, Faculty of Medicine, Zekai Tahir Burak Women's Helath Training and Research Hospital, Ankara, Turkey
| | - Şerife Suna Oğuz
- Department of Neonatology, University of Health Sciences, Faculty of Medicine, Zekai Tahir Burak Women's Helath Training and Research Hospital, Ankara 06230, Turkey
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Işlek Seçen E, Desdicioglu R, Yeğin GF, Bal C, Erdinç AS, Uygur D, Keskin HL. Diagnostic Evaluation of Pregnant Women Presentıng with Pruritis and Retrospective Analysis of Pregnancy Outcomes. Ankara Med J 2021. [DOI: 10.5505/amj.2021.24022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abstract
Objectives: Intrauterine growth restriction (IUGR) is diagnosed when the estimated fetal weight remains below the 10th percentile of gestational age based on pathological restriction of growth and/or accompanying Doppler abnormalities. Endothelial dysfunction is a common pathogenetic pathway underlying IUGR etiology. Endocan (ESM-1) is a novel marker of endothelial dysfunction and inflammation found in the maternal circulation. This study was designed to compare plasma endocan levels between pregnancies complicated with IUGR and a control group.Study design: Forty-four pregnancies complicated with IUGR and 47 healthy pregnancies were included. Maternal plasma endocan levels were detected by ELISA. Parametric data was studied by Student's t-test. Mann-Whitney U-test was used in analyzing non-parametric data. Categorical variables underwent chi-square test. ROC analysis was performed to define the cutoff value of endocan in detecting IUGR. Spearman correlation test was performed.Results: Maternal plasma endocan level varied significantly between IUGR and healthy pregnancies and was 1.8 fold higher in the IUGR group (793.0 (IQR:544.4-1896.0) ng/L vs. 441.8 (IQR: 408.3-512.4) ng/L, p < .001). There was a weak negative correlation between endocan level and 5th and 10th minute APGAR Scores (r = -0.256; p = .015 and r = -0.215; p = .042, respectively), a weak positive correlation with umbilical artery pulsatility index, and a moderate negative correlation with cerebroplacental ratio (r = 0.394; p < .001 and r = -0.459; p < .001, respectively).Conclusions: There was a significant difference between endocan levels of IUGR and healthy pregnancies. Further studies might be designed to investigate the performance of endocan in predicting neonatal outcomes for pregnancies complicated with IUGR.
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Affiliation(s)
- Gokce Naz Kucukbas
- Department of Perinatology, Zekai Tahir Burak Women's Research and Tertiary Hospital, Ankara, Turkey
| | - Ozgur Kara
- Department of Perinatology, Zekai Tahir Burak Women's Research and Tertiary Hospital, Ankara, Turkey
| | - Deniz Yüce
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Dilek Uygur
- Department of Perinatology, Zekai Tahir Burak Women's Research and Tertiary Hospital, Ankara, Turkey
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Oskovi-Kaplan ZA, Erkenekli K, Oztas E, Esmer SB, Danisman N, Uygur D, Ozgu-Erdinc AS. Do Anti-Factor Xa Levels have any Impact on Pregnancy Outcome in Women with Previous Adverse Outcomes? Z Geburtshilfe Neonatol 2020; 224:355-359. [PMID: 32236912 DOI: 10.1055/a-1130-2017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Low-molecular-weight heparin (LMWH) is used during pregnancy in women diagnosed with thrombophilia for prevention of thromboembolic events and prevention of recurrent pregnancy loss. Prophylactic dosing does not always achieve target anti-FXa levels of 0.2-0.6 IU/ml. We aimed to determine if anti-FXa levels, measured in the first trimester, have an influence on pregnancy outcome. MATERIAL AND METHODS Eighty-one first-trimester women with a history of adverse pregnancy outcomes under LMWH therapy during pregnancy were enrolled in this study. Anti-FXa levels were measured in the first trimester, and fetal and maternal outcomes were recorded. RESULTS The mean age of women was 28±4 (19-40) and mean anti-FXa level 0.44±0.93 IU/ml. No bleeding or clotting complications were associated with LMWH administration. Anti-FXa levels did not have a relationship with gestational age at birth, fetal weight, type of delivery, cesarean indications, postpartum bleeding, APGAR scores, or admission to the neonatal intensive care unit (p>0.005). Anti-FXa levels were not correlated with live birth rates. CONCLUSION Anti-FXa levels did not have an influence on pregnancy and fetal outcomes. The effect of LMWH on pregnancy outcomes may not be due to anticoagulant activity but other mechanisms.
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Affiliation(s)
- Z Asli Oskovi-Kaplan
- Perinatology, Zekai Tahir Burak Health Practice Research Center, University of Health Sciences, Ankara, Turkey
| | - Kudret Erkenekli
- Perinatology, Zekai Tahir Burak Health Practice Research Center, University of Health Sciences, Ankara, Turkey
| | - Efser Oztas
- Perinatology, Zekai Tahir Burak Health Practice Research Center, University of Health Sciences, Ankara, Turkey
| | - Seda Bilir Esmer
- Perinatology, Zekai Tahir Burak Health Practice Research Center, University of Health Sciences, Ankara, Turkey
| | - Nuri Danisman
- Perinatology, Zekai Tahir Burak Health Practice Research Center, University of Health Sciences, Ankara, Turkey
| | - Dilek Uygur
- Perinatology, Zekai Tahir Burak Health Practice Research Center, University of Health Sciences, Ankara, Turkey
| | - A Seval Ozgu-Erdinc
- Perinatology, Zekai Tahir Burak Health Practice Research Center, University of Health Sciences, Ankara, Turkey
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Ozgu-Erdinc AS, Oskovi Kaplan ZA, Engin-Ustun Y, Yilmaz N, Yildirim G, Tokmak A, Erkenekli K, Erkaya S, Uygur D. There is No Association between Premature Ovarian Insufficiency and Levels of Fetuin-A/α2-Heremans-Schmid Glycoprotein. J Hum Reprod Sci 2019; 12:299-302. [PMID: 32038079 PMCID: PMC6937773 DOI: 10.4103/jhrs.jhrs_104_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 11/01/2019] [Indexed: 11/24/2022] Open
Abstract
Objective: Fetuin-A is a well-known negative acute-phase protein and has been used liberally to predict vascular disease. The aim of this study was to evaluate the association between serum human fetuin-A/alpha2-Heremans–Schmid glycoprotein levels and idiopathic premature ovarian insufficiency (POI). Methods: A total of 75 women were included in this case–control study between January 2013 and December 2013. Serum fetuin-A concentrations were measured in 36 women with idiopathic POI and 39 healthy women with regular cycles. Blood samples were drawn after a 12-h overnight fast and were kept at −80°C for subsequent assay. The serum levels of fetuin-A were assessed by commercial ELISA kits (BioVendor Laboratory Medicine Inc., Brno, Czech Republic) and serum concentration values were expressed as μg/ml. Results: The mean serum fetuin-A levels of idiopathic POI and control women were 229.02 ± 27.79 and 232.37 ± 65.56, respectively, with P = 0.771 (independent samples t-test). Our results showed no statistically significant difference between serum fetuin-A levels of idiopathic POI women and controls. Conclusion: The mean values of serum fetuin-A in idiopathic POI women were not significantly different from controls, which implies that there is no significant association between serum fetuin-A levels and idiopathic POI.
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Affiliation(s)
- A Seval Ozgu-Erdinc
- Ankara Dr. Zekai Tahir Burak Health Practice Research Center, University of Health Sciences, Ankara, Turkey
| | - Zeynep Asli Oskovi Kaplan
- Ankara Dr. Zekai Tahir Burak Health Practice Research Center, University of Health Sciences, Ankara, Turkey
| | - Yaprak Engin-Ustun
- Ankara Dr. Zekai Tahir Burak Health Practice Research Center, University of Health Sciences, Ankara, Turkey
| | - Nafiye Yilmaz
- Ankara Dr. Zekai Tahir Burak Health Practice Research Center, University of Health Sciences, Ankara, Turkey
| | - Gulcin Yildirim
- Ankara Dr. Zekai Tahir Burak Health Practice Research Center, University of Health Sciences, Ankara, Turkey
| | - Aytekin Tokmak
- Ankara Dr. Zekai Tahir Burak Health Practice Research Center, University of Health Sciences, Ankara, Turkey
| | - Kudret Erkenekli
- Ankara Dr. Zekai Tahir Burak Health Practice Research Center, University of Health Sciences, Ankara, Turkey
| | - Salim Erkaya
- Ankara Dr. Zekai Tahir Burak Health Practice Research Center, University of Health Sciences, Ankara, Turkey
| | - Dilek Uygur
- Ankara Dr. Zekai Tahir Burak Health Practice Research Center, University of Health Sciences, Ankara, Turkey
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Ozler S, Oztas E, Gumus Guler B, Erel O, Turhan Caglar A, Ergin M, Uygur D, Danisman N. Are serum levels of ADAMTS5, TAS and TOS at 24-28 gestational weeks associated with adverse perinatal outcomes in gestational diabetic women? J OBSTET GYNAECOL 2019; 40:619-625. [PMID: 31526197 DOI: 10.1080/01443615.2019.1634025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We aimed to determine the role of placental A Disintegrin and Metalloproteinase with thrombospondin motifs 5 (ADAMTS5), and maternal serum ADAMTS5, total antioxidant status (TAS), total oxidant status (TOS) and oxidative stress index (OSI) levels at 24-28th gestational weeks in GDM. This study included 57 patients, who had been diagnosed as having GDM at their 24-28th gestational week, and 29 controls. The maternal blood samples were collected at the 24-28th gestational week and ADAMTS5 was studied with the enzyme-linked immunosorbent assay (ELISA) method, whereas an automated colorimetric method was used to study TAS, TOS, and OSI. The level of ADAMTS5 in maternal serum of patients with GDM were significantly lower than the controls (p = .017); whereas TOS and OSI levels were significantly higher (p = .003 and p = .008). Multivariable logistic regression analysis revealed ADAMTS5 and TOS levels were independently associated with adverse perinatal outcomes (p = .004 and p = .018). We found that serum ADAMTS5 levels decreased and TOS level increased in GDM pregnant at 24-28th gestational weeks. In addition, we found that increased levels of serum ADAMTS5 and decreased TOS levels at 24-28th weeks were associated with adverse perinatal outcomes independent of the mode of treatment in GDM.Impact statementWhat is already known on this subject? Gestational diabetes mellitus (GDM) is one of the most common medical complications of pregnancy. The insulin resistance, which starts at the 24-28th gestational weeks, increases during gestation. GDM increases maternal complications like preeclampsia, cesarean rate, cardiovascular disease, obesity, and diabetes after pregnancy; and neonatal complications like macrosomia, hypoglycemia, hyperbilirubinemia, delivery trauma, shoulder dystocia, and adult-onset obesity, and diabetes.What the results of this study add? A significant relationship between ADAMTS5, TOS levels and adverse perinatal outcome. insulin resistance and was observed.What the implications are of these findings for clinical practice and/or further research? Based on this finding, we concluded that increased levels of oxidative stress and decreased ADAMTS5 levels are associated with GDM and predictive for adverse perinatal outcomes. The results of the present study were consistent with the previous reports and indicated that increased oxidative stress in GDM patients are related to adverse perinatal outcomes.
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Affiliation(s)
- Sibel Ozler
- Department of Perinatology, Selcuk University Medical School, Konya, Turkey
| | - Efser Oztas
- Department of Perinatology, Eskisehir City Hospital, Eskisehir, Turkey
| | | | - Ozcan Erel
- Department of Clinical Biochemistry, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
| | - Ali Turhan Caglar
- Department of Clinical Biochemistry, Aralik State Hospital, Gaziantep, Turkey
| | - Merve Ergin
- Department of Pathology, Etlik Zübeyde Haním Women's Health Education and Research Hospital, Ankara, Turkey
| | - Dilek Uygur
- Department of Clinical Biochemistry, Aralik State Hospital, Gaziantep, Turkey
| | - Nuri Danisman
- Department of Perinatology, Acıbadem Acıbadem University Medical School, Istanbul, Turkey
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Can Ibanoglu M, Yasar Sanhal C, Ozgu-Erdinc S, Kara O, Yucel A, Uygur D. Maternal plasma fetuin-A levels in fetal growth restriction: A case-control study. Int J Reprod Biomed 2019; 17:487-492. [PMID: 31508574 PMCID: PMC6718885 DOI: 10.18502/ijrm.v17i7.4860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 12/24/2018] [Accepted: 04/30/2019] [Indexed: 01/10/2023] Open
Abstract
Background Higher Fetuin-A (FA) concentrations were found to be associated with obesity and there is an interest to the relation between maternal FA and pregnancy outcomes. Objective In this study, our aim was to evaluate the association of maternal plasma levels of FA with fetal growth restriction (FGR). Materials and Methods 41 pregnant women with FGR and 40 controls were recruited in this case-control study between July and November 2015. At the diagnosis of FGR, venous blood samples (10 cc) were obtained for FA analysis. Results Maternal plasma FA levels were significantly higher in fetal growth-restricted pregnant women compared with controls (19.3 ± 3.0 ng/ml vs 25.9 ± 6.8 ng/ml, p = 0.001). Area under receiver operating characteristic curve analysis of FA in FGR was 0.815 (95% confidence interval (CI): 0.718-0.912, p < 0.001). The maternal FA levels with values more than 22.5 ng/ml had a sensitivity of about 73.17% (95% CI: 56.79-85.25) and a specificity of about 82.5% (95% CI: 66.64-92.11) with positive and negative predictive values of about 81.08% (95% CI: 64.29-91.45) and 75% (95% CI: 59.35-86.30), respectively. Therefore, the diagnostic accuracy was obtained about 77.78%. Conclusion The results of this study show higher maternal plasma levels of FA in FGR. Further studies are needed in order to demonstrate the long-term effects of FA in pregnancies complicated with FGR and early prediction of FGR.
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Affiliation(s)
- Mujde Can Ibanoglu
- University of Health Sciences, Dr. Zekai Tahir Burak Women's Health Care, Education and Research Hospital, Ankara, Turkey
| | - Cem Yasar Sanhal
- University of Health Sciences, Dr. Zekai Tahir Burak Women's Health Care, Education and Research Hospital, Ankara, Turkey
| | - Seval Ozgu-Erdinc
- University of Health Sciences, Dr. Zekai Tahir Burak Women's Health Care, Education and Research Hospital, Ankara, Turkey
| | - Ozgur Kara
- University of Health Sciences, Dr. Zekai Tahir Burak Women's Health Care, Education and Research Hospital, Ankara, Turkey
| | - Aykan Yucel
- University of Health Sciences, Dr. Zekai Tahir Burak Women's Health Care, Education and Research Hospital, Ankara, Turkey
| | - Dilek Uygur
- University of Health Sciences, Dr. Zekai Tahir Burak Women's Health Care, Education and Research Hospital, Ankara, Turkey
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Engin Üstün Y, Sanisoğlu S, Çınar M, Keskin HL, Uygur D, Özcan A, Karaahmetoğlu S, Kabasakal A, Çolak G, Keskinkılıç B, Şencan İ. A view of maternal mortalities in women conceiving through assisted reproductive techniques: A nation-based study of Turkey. J Chin Med Assoc 2018; 81:985-989. [PMID: 30104132 DOI: 10.1016/j.jcma.2018.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 05/29/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Our aim was to evaluate maternal mortality causes among Turkish women giving birth after assisted reproductive techniques (ARTs). METHODS All maternal deaths following conception with ART pregnancies were identified through the National Maternal Mortality Surveillance System. We analyzed the system data collected between 2007 and 2014. During this period, there were 10,369,064 live births and 1788 maternal deaths resulting from both direct and indirect causes. We identified 28 maternal death cases following ART procedures. The age, gestational age at birth, number of antenatal visits, delivery route, time of death, cause of death, and neonatal outcomes were recorded. Also, any existing delay (phase 1, 2, or 3) and preventability of maternal death were assessed. RESULTS Hypertensive disorders, pulmonary embolism, and cardiovascular disease were the leading causes of maternal death. Twelve (40%) women were over 35 years of age. Of the deaths, 15 (54%) were attributed to indirect causes. The number of unpreventable maternal deaths was 19 (67.9%), and 9 (36%) were classified as preventable after being assessed by the review commission of maternal mortality. CONCLUSION Pregnancies conceived with ARTs should undergo a careful assessment of risk factors for hypertensive disorders, pulmonary embolism and cardiovascular diseases. Those women require closer antenatal surveillance because 1/3 of these deaths were preventable.
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Affiliation(s)
- Yaprak Engin Üstün
- University of Health Sciences, Dr. Zekai Tahir Burak Health Practice Research Center, Ankara, Turkey
| | - Sema Sanisoğlu
- University of Health Sciences, Dr. Zekai Tahir Burak Health Practice Research Center, Ankara, Turkey
| | - Mehmet Çınar
- University of Health Sciences, Dr. Zekai Tahir Burak Health Practice Research Center, Ankara, Turkey.
| | - Hüseyin Levent Keskin
- Turkish Public Health Agency, Preliminary Investigation Committee for Maternal Deaths, Ministry of Health, Ankara, Turkey
| | - Dilek Uygur
- University of Health Sciences, Dr. Zekai Tahir Burak Health Practice Research Center, Ankara, Turkey
| | - Ayşe Özcan
- Turkish Public Health Agency, Preliminary Investigation Committee for Maternal Deaths, Ministry of Health, Ankara, Turkey
| | - Selma Karaahmetoğlu
- Turkish Public Health Agency, Preliminary Investigation Committee for Maternal Deaths, Ministry of Health, Ankara, Turkey
| | - Aysun Kabasakal
- Turkish Public Health Agency, Preliminary Investigation Committee for Maternal Deaths, Ministry of Health, Ankara, Turkey
| | - Gülşen Çolak
- Turkish Public Health Agency, Preliminary Investigation Committee for Maternal Deaths, Ministry of Health, Ankara, Turkey
| | - Bekir Keskinkılıç
- Turkish Public Health Agency, Preliminary Investigation Committee for Maternal Deaths, Ministry of Health, Ankara, Turkey
| | - İrfan Şencan
- Turkish Public Health Agency, Preliminary Investigation Committee for Maternal Deaths, Ministry of Health, Ankara, Turkey
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17
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Ibanoglu MC, Ozgu-Erdinc AS, Kara O, Topcu HO, Uygur D. Association of Higher Maternal Serum Levels of Plac1 Protein with Intrauterine Growth Restriction. Z Geburtshilfe Neonatol 2018; 223:285-288. [PMID: 30267394 DOI: 10.1055/a-0743-7403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The aim of this study was to determine the maternal PLAC1 protein levels in infants with IUGR. A total of 40 pregnant women with IUGR and 40 controls were recruited in this case control study between June 2014 and November 2014. Maternal serum PLAC1 levels were established as significantly higher in IUGR cases compared to the control groups (8.42±3.59 ng/ml vs. 6.27±4.04 ng/ml, p<0.001). Area under ROC curve (AUC) analysis of PLAC1 in IUGR was 0.708, (95% confidence interval (CI): 0.593-0.823, p=0.001) (Figure 1). Maternal PLAC1 levels above 7.41 ng/ml had a sensitivity of 62.5% (95% C1: 45.81-76.83), a specificity of 77.5% (95% CI: 61.15-88.6); positive and negative predictive values (PPV and NPV) were 73.53% (95% CI: 55.35-86.49) and 67.39% (95% CI: 51.86-80.03), respectively, with a diagnostic accuracy of 70%. In conclusion, we were able to demonstrate a significantly important link between IUGR and higher maternal serum levels of the PLAC1 protein.
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Affiliation(s)
- Mujde Can Ibanoglu
- Dr. Zekai Tahir Burak Health Practice Research Center, University of Health Sciences, Ankara, Turkey
| | - A Seval Ozgu-Erdinc
- Dr. Zekai Tahir Burak Health Practice Research Center, University of Health Sciences, Ankara, Turkey
| | - Ozgur Kara
- Dr. Zekai Tahir Burak Health Practice Research Center, University of Health Sciences, Ankara, Turkey
| | - H Onur Topcu
- Dr. Zekai Tahir Burak Health Practice Research Center, University of Health Sciences, Ankara, Turkey
| | - Dilek Uygur
- Dr. Zekai Tahir Burak Health Practice Research Center, University of Health Sciences, Ankara, Turkey
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Vural Yilmaz Z, Gencosmanoglu Turkmen G, Daglar K, Yılmaz E, Kara O, Uygur D. Elevated red blood cell distribution width is associated with intrahepatic cholestasis of pregnancy. Ginekol Pol 2018; 88:75-80. [PMID: 28326516 DOI: 10.5603/gp.a2017.0015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 11/08/2016] [Accepted: 01/08/2017] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Intrahepatic cholestasis of pregnancy is the most common pregnancy specific liver disease and related with adverse maternal and perinatal outcome. Red blood cell distribution width, an anisocytosis marker in a complete blood count, has been used as an inflammation marker in various diseases. However the association of red blood cell distribution width with intrahepatic cholestasis of pregnancy is unknown. We aimed to evaluate the relationship between red blood cell distribution width and intrahepatic cholestasis of pregnancy. MATERIAL AND METHODS Ninety pregnant women with intrahepatic cholestasis of pregnancy and ninety healthy pregnant women were included in the study. Their clinical and laboratory characteristics including red blood cell distribution width, liver function tests, fasting and postprandial bile acid concentrations were analyzed. RESULTS Serum red blood cell distribution width cell levels were significantly higher in pregnants with intrahepatic cholestasis of pregnancy than healthy pregnants. We also demonstrated that red blood cell distribution Width levels were higher in severe disease than mild disease and was significantly correlated with fasting and postprandial bile acid concentration in intrahepatic cholestasis of pregnancy group. CONCLUSIONS Our study showed that red blood cell distribution width, an easy and inexpensive marker; were associated with intrahepatic cholestasis of pregnancy and can be used as a diagnostic and prognostic marker in intrahepatic cholestasis of pregnancy.
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Affiliation(s)
- Zehra Vural Yilmaz
- Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Ankara, Turkey.
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Ibanoglu MC, Ozgu-Erdinc AS, Uygur D. Maternal placi protein levels in early- and late-onset preeclampsia. Ginekol Pol 2018; 89:147-152. [PMID: 29664550 DOI: 10.5603/gp.a2018.0025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 02/02/2018] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The objective of this study was to determine the maternal PLAC1 protein levels in early and late onset preec-lampsia. MATERIAL AND METHODS A total of 135 pregnant women were included in the study, of which 55 were at < 34 weeks of gesta-tion and 80 were at ≥ 34 weeks of gestation, between June and November 2014 were recruited in this case control study. RESULTS Analysis of maternal serum PLAC1 levels did not reveal any significant differences between early onset PE and controls (p = 0.422). However, late onset PE patients exhibited significantly elevated levels of PLAC1, in comparison with healthy controls (p = 0.026). The difference in PLAC1 levels between early onset PE and late onset PE was also significant (p = 0.001). Area under ROC curve of PLAC1 for early and late onset PE was 0.563 and 0.646 with p values of 0.422 and 0.026 respectively. Area under ROC curve of PLAC1 in PE was 0.613 with p value = 0.024. The cutoff value for PLAC1 was 6.19 ng/mL with sensitivity: 56% (95% CI 44.1-67.3) and specificity: 63 %; (95% CI 49.9-75.1) and diagnostic odds ratio: 2.2 (95% CI 1.1-4.4) (p value = 0.037). The cutoff value for PLAC1 was 7.2 ng/mL with sensitivity: 43% (95% CI 31.5-54.6) and specificity: 78% (95% CI 65.5-87.5) and diagnostic odds ratio: 2.69 (95% CI 1.25-5.79) (p value = 0.016) CONCLUSION: In conclusion, the results of the current study showed that PLAC1 protein levels were significantly elevated in pregnant women with late onset PE in comparison with healthy control group.
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Affiliation(s)
| | - A Seval Ozgu-Erdinc
- Dr Zekai Tahir Burak Women's Health Care, Education And Research Hospital, Ankara, Turkey.
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Gençosmanoğlu Türkmen G, Vural Yilmaz Z, Dağlar K, Kara Ö, Sanhal CY, Yücel A, Uygur D. Low serum vitamin D level is associated with intrahepatic cholestasis of pregnancy. J Obstet Gynaecol Res 2018; 44:1712-1718. [DOI: 10.1111/jog.13693] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 05/13/2018] [Indexed: 12/27/2022]
Affiliation(s)
| | - Zehra Vural Yilmaz
- Zekai Tahir Burak Women's Health Care; Training and Research Hospital; Ankara Turkey
| | - Korkut Dağlar
- Zekai Tahir Burak Women's Health Care; Training and Research Hospital; Ankara Turkey
| | - Özgür Kara
- Zekai Tahir Burak Women's Health Care; Training and Research Hospital; Ankara Turkey
| | - Cem Yaşar Sanhal
- Zekai Tahir Burak Women's Health Care; Training and Research Hospital; Ankara Turkey
| | - Aykan Yücel
- Zekai Tahir Burak Women's Health Care; Training and Research Hospital; Ankara Turkey
| | - Dilek Uygur
- Zekai Tahir Burak Women's Health Care; Training and Research Hospital; Ankara Turkey
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Timur H, Aksoy RT, Tokmak A, Timur B, Coskun B, Uygur D, Danisman N. Maternal and perinatal outcomes of dichorionic diamniotic twin pregnancies diagnosed with vanishing twin syndrome: a retrospective analysis from a single clinical center. Ginekol Pol 2018; 89:30-34. [DOI: 10.5603/gp.a2018.0006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 01/07/2018] [Accepted: 01/08/2018] [Indexed: 11/25/2022] Open
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Ersoy AO, Unlu S, Oztas E, Ozler S, Uygur D, Yucel A. Influenza infections in the 2014–2015 season and pregnancy outcomes. J Infect Dev Ctries 2017; 11:766-771. [DOI: 10.3855/jidc.8461] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 01/09/2017] [Indexed: 10/31/2022] Open
Abstract
Introduction: The most recent influenza season saw a prominent infectious burden over a period of six months in the Turkish capital, reminding observers of the pandemic in 2009 year. The aim of the present study was to investigate the consequences of seasonal outbreaks in pregnant women during the 2014–2015 influenza season.
Methodology: Forty-seven pregnant female patients with symptoms of influenza-like illness who were admitted to tertiary perinatal care center in Ankara, Tukrey, between October 2014 and May 2015 were included in this case-control study. The subtype determination of influenza was performed with real-time reverse transcriptase-polymerase chain reaction (RT-PCR) testing. Clinical observations and pregnancy outcomes were compared with respect to subtypes.
Results: Classifications were available for 35 patients, of whom 12 were determined to have influenza A infection, while 10 had influenza B infection. The remaining 13 patients were influenza-negative. Eight of the 22 (36.4%) influenza-positive patients delivered their babies in the preterm period (< 37 weeks). The corresponding rate was 8.3% (1/12) in the influenza-negative group. This difference was not statistically significant (p = 0.077).
Conclusions: Preterm deliveries in pregnant women did not differ significantly among influenza-postive and influenza-negative pregnant women in non-vaccinated study population. Further studies with larger sample sizes may provide more supporting results.
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Yılmaz S, Akdağ Cırık D, Demirtaş C, Timur H, Şahin A, Danışman N, Uygur D. Do vitamin D and high-sensitivity-C reactive protein levels differ in patients with hyperemesis gravidarum? A preliminary study. Turk J Obstet Gynecol 2017; 13:123-126. [PMID: 28913106 PMCID: PMC5558301 DOI: 10.4274/tjod.76753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 08/17/2016] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES The high sensitivity-C reactive protein (hs-CRP) is an inflammatory marker and vitamin D is an immune modulator that might play a critical role in the pathogenesis of hyperemesis gravidarum. Therefore, in the current study, we tested the hypothesis that suggests women with hyperemesis gravidarum have lower 25-hydroxyvitamin D levels and higher hs-CRP levels, compared to controls. MATERIALS AND METHODS This prospective case-control study included 30 women with hyperemesis gravidarum (study group) and 30 age- and body mass index-matched healthy women (control group). The levels of 25-hydroxyvitamin D and hs-CRP were compared between two groups. RESULTS Both the serum 25-hydroxyvitamin D (5.30 μg/L vs. 6.44 μg/L; p=0.09) and hs-CRP levels (0.29 mg/dL vs. 0.47 mg/dL; p=0.93) were not significantly different between the study and control groups. Vitamin D deficiency was present in 27 (90.0%) women in the study group and 22 (73.3%) women in the control group (p=0.181). There was also no correlation between 25-hydroxyvitamin D and hs-CRP levels in both groups. CONCLUSION Although it did not reach statistical significance, vitamin D levels were lower in the study group compared with controls. Therefore, vitamin D might be speculated to play a crucial role in controlling the inflammatory status associated with hyperemesis gravidarum. Larger studies are required to clarify whether there is a relation between vitamin D deficiency and hyperemesis gravidarum.
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Affiliation(s)
- Saynur Yılmaz
- Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey
| | - Derya Akdağ Cırık
- Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey
| | - Canan Demirtaş
- Gazi University Faculty of Medicine, Department of Biochemistry, Ankara, Turkey
| | - Hakan Timur
- Zekai Tahir Burak Women's Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey
| | - Ayşe Şahin
- Zekai Tahir Burak Women's Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey
| | - Nuri Danışman
- Zekai Tahir Burak Women's Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey
| | - Dilek Uygur
- Zekai Tahir Burak Women's Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey
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Daglar K, Tokmak A, Kirbas A, Kara O, Biberoglu E, Uygur D, Danisman N. Anterior placenta previa is associated with increased umbilical cord blood hematocrit concenrations. J Neonatal Perinatal Med 2017; 9:279-84. [PMID: 27589555 DOI: 10.3233/npm-16915145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE We aimed to evaluate the umbilical cord blood (CB) hematocrit (Hct) levels in women with anterior located placenta previa (PP). METHODS This is a prospective case-control study performed in a tertiary level maternity hospital. Thirty seven pregnant women diagnosed with anterior PP (study group) and 37 women without PP (control group) included into the study. Groups were matched with regard to age, gestational age, and fetal gender. All women underwent Cesarean section. Umbilical CB Hct levels of the newborns were measured. Demographics, operative features, and neonatal outcomes were recorded. RESULTS Umbilical CB Hct levels were statistically significantly higher in the PP patients compared with controls (p: 52.6±5.0 vs. 47.5±5.0, p < 0.001). Preoperative maternal hemoglobin (Hgb) and Hct levels were similar in the two groups. However, postoperative Hb and Hct levels were significantly lower in the study group (p: 0.003, p < 0.001, respectively). Intraoperative complication rates were higher in this group. Neonatal Apgar scores were lower and neonatal intensive care unit admission was more common in the PP group when compared with controls. CONCLUSION We think that anterior PP is associated with increased umbilical CB Hct levels. Neonatologists should consider this condition in the infants born to mothers with anterior PP.
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Türkmen GG, Timur H, Yilmaz Z, Kirbas A, Daglar K, Tokmak A, Uygur D, Danişman N. Effect of intrahepatic cholestasis of pregnancy on maternal serum screening tests. J Neonatal Perinatal Med 2017; 9:411-415. [PMID: 28009332 DOI: 10.3233/npm-161618] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE In this study, we aimed to evaluate whether the changes in the first and second trimester maternal serum biochemical markers used for prenatal screening are associated with euploid pregnancies complicated by intrahepatic cholestasis of pregnancy (ICP). METHODS A total of 94 pregnant women were included in this retrospective comparative study. Thirty-seven women whose pregnancy was complicated with ICP constituted the study group whereas 57 of them constituted the control group. All hospital records were examined in terms of combined first trimester screening test and second trimester triple test parameters. Perinatal outcomes were also recorded. RESULTS No significant difference was observed between the two groups in term of age, BMI, and obstetric history (all p > 0.05). Mean serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) and serum bile acid concentrations in the study group were significantly higher than in the controls (p < 0.001). There were no significant differences between the two groups in terms of first and second trimester serum biochemical markers. Newborn gender, route of birth, and NICU admission rates were also similar in the two groups. Mean birth weight of the control group was statistically significantly higher than the ICP group (p = 0.012). CONCLUSION We report no significant differences between pregnancies complicated by ICP and healthy pregnancies in terms of first and second trimester maternal serum screening test results.
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Sanhal CY, Daglar K, Kara O, Yılmaz ZV, Turkmen GG, Erel O, Uygur D, Yucel A. An alternative method for measuring oxidative stress in intrahepatic cholestasis of pregnancy: thiol/disulphide homeostasis. J Matern Fetal Neonatal Med 2017; 31:1477-1482. [DOI: 10.1080/14767058.2017.1319922] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Cem Yasar Sanhal
- Department of Perinatology, Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | - Korkut Daglar
- Department of Perinatology, Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | - Ozgur Kara
- Department of Perinatology, Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | - Zehra Vural Yılmaz
- Department of Perinatology, Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | | | - Ozcan Erel
- Department of Clinical Biochemistry, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
| | - Dilek Uygur
- Department of Perinatology, Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | - Aykan Yucel
- Department of Perinatology, Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Ankara, Turkey
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Ozler S, Oztas E, Guler BG, Ersoy AO, Ergin M, Uygur D, Danisman N. 3Ds: decorin, discordance, and diamniotic dichorionic twins. CLIN EXP OBSTET GYN 2017. [DOI: 10.12891/ceog3378.2017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Ozler S, Oztas E, Erel O, Guler BG, Ergin M, Uygur D, Danisman N. Impact of Gestational Diabetes Mellitus and Maternal Obesity on Cord Blood Dynamic Thiol/Disulfide Homeostasis. Fetal Pediatr Pathol 2017; 36:8-15. [PMID: 27629439 DOI: 10.1080/15513815.2016.1223237] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIM Our aim in this study was to investigate the effect of maternal obesity and gestational diabetes mellitus (GDM) on cord blood dynamic thiol/disulfide homeostasis. METHODS A prospective case-control study was carried out in 125 pregnant women (27 GDM, 30 obese, 68 controls). Cord blood samples were collected from all participants and native thiol-disulfide exchanges were examined with automated method enabling the measurement of both sides of thiol-disulfide balance. RESULTS Disulfide amounts, disulfide/native thiol and disulfide/total thiol ratios were increased (p < 0.001), while native thiol/total thiol was decreased in the cord blood of babies born to an obese or diabetic mother (p < 0.001). Moreover, increased disulfide amounts, disulfide/native thiol, disulfide/totalthiol ratios and decreased native/total thiol were found to be significantly associated with adverse outcomes in GDM. CONCLUSION The current study suggests that the offsprings born to obese or diabetic mothers are exposed to increased oxidative stress.
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Affiliation(s)
- Sibel Ozler
- a Zekai Tahir Burak Women's Health Education and Research Hospital , Department of Perinatology , Ankara , Turkey
| | - Efser Oztas
- a Zekai Tahir Burak Women's Health Education and Research Hospital , Department of Perinatology , Ankara , Turkey
| | - Ozcan Erel
- b Department of Clinical Biochemistry, Faculty of Medicine , Yildirim Beyazit University , Ankara , Turkey
| | - Basak Gumus Guler
- c Department of Obstetrics and Gynecology , Liv Hospital , Ankara , Turkey
| | - Merve Ergin
- d Aralık State Hospital , Gaziantep , Turkey
| | - Dilek Uygur
- a Zekai Tahir Burak Women's Health Education and Research Hospital , Department of Perinatology , Ankara , Turkey
| | - Nuri Danisman
- a Zekai Tahir Burak Women's Health Education and Research Hospital , Department of Perinatology , Ankara , Turkey
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Ozler S, Oztas E, Guler BG, Ersoy AO, Ergin M, Uygur D, Danisman N. 3Ds: decorin, discordance, and diamniotic dichorionic twins. CLIN EXP OBSTET GYN 2017; 44:239-243. [PMID: 29746030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
UNLABELLED aullimary Investigation: The cause of discordance in dichorionic diamniotic (DD) twins is still unknown. The authors aimed to compare decorin (DCN) and oxidative/antioxidative state levels between the placentas of discordant and concordant twins. MATERIALS AND METHODS Prospective study of 43 spontaneous DD twin pregnancies included and placentas samples taken from each twin and prepared for homogenization. Total oxidant/antioxidant status levels in placental tissue were determined by automated colorimetric method. Decorin levels were detected by using ELISA method; 23 of these were discordant and 20 of them were concordant. RESULTS DCN levels in the placentas of the low birth-weight twins were significantly lower than the levels of the placentas of appropriate gestational age twins (p = 0.006). There were no statistically significant differences in total antioxidant status (TAS), total oxidant status (TOS), or arylesterase (ARES) levels in discordant (p = 0.631, p = 0.370, and p = 0.079, respectively) and in the placental DCN, TAS, TOS, or ARES levels of the concordant twins (p = 0.407, p = 0.035, p = 0.194, and p = 0.979, respectively). When the authors compared the twins of similar birth weight, the DCN, TAS, and TOS levels were significantly lower in the discordant twins (p < 0.001, p < 0.001, and p = 0.002, respectively). CONCLUSIONS Decreased levels of DCN in discordant twin fetuses compared to the same birth weight-concordant twins shows that it contributes to disease pathogenesis.
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Yılmaz ZV, Türkmen GG, Yılmaz E, Dağlar K, Kırbaş A, Sanhal C, Yücel A, Uygur D. Influence of Behçet's disease on first and second trimester serum screening markers. J Obstet Gynaecol Res 2016; 43:511-515. [DOI: 10.1111/jog.13237] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 09/20/2016] [Accepted: 10/20/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Zehra Vural Yılmaz
- Department of Perinatology; Zekai Tahir Burak Women's Health Education and Training Hospital; Ankara Turkey
| | | | - Elif Yılmaz
- Department of Obstetrics and Gynaecology; Dr. Sami Ulus Women's and Children's Health Training and Research Hospital; Ankara Turkey
| | - Korkut Dağlar
- Department of Perinatology; Zekai Tahir Burak Women's Health Education and Training Hospital; Ankara Turkey
| | - Ayşe Kırbaş
- Department of Perinatology; Zekai Tahir Burak Women's Health Education and Training Hospital; Ankara Turkey
| | - Cem Sanhal
- Department of Perinatology; Zekai Tahir Burak Women's Health Education and Training Hospital; Ankara Turkey
| | - Aykan Yücel
- Department of Perinatology; Zekai Tahir Burak Women's Health Education and Training Hospital; Ankara Turkey
| | - Dilek Uygur
- Department of Perinatology; Zekai Tahir Burak Women's Health Education and Training Hospital; Ankara Turkey
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Sanisoğlu S, Uygur D, Keskinkılıç B, Engin-Üstün Y, Keskin HL, Karaahmetoğlu S, Özcan A, Esen M, Ongun V, Özkan S. Maternal mortality cases from pulmonary embolism: A nation-wide study in Turkey. J OBSTET GYNAECOL 2016; 37:151-156. [PMID: 27976969 DOI: 10.1080/01443615.2016.1217509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The aim of the study was to evaluate the maternal mortality cases attributed to pulmonary embolism (PE). PE constituted 7.58% of maternal deaths in 2013. Risk factors for PE were present in 15 (88.2%) of the women. Five women (29.4%) were overweight, and 5 (29.4%) were obese. Four women (23.5%) had cardiac diseases. PE occurred in the postpartum period after caesarean delivery in 9 (52.9%) patients. Eleven (64.7%) of the maternal deaths were recognised as preventable. More deaths attributed to PE occurred in the postpartum period (n = 11) than the antepartum period (n = 5). One other maternal mortality case was after therapeutic abortion. Caesarean section, obesity and cardiac diseases were important risk factors. It can be suggested that monitoring all risk factors and timely recognition of related symptoms and signs with initiation of appropriate management have paramount importance for reducing maternal mortality rate related to pulmonary embolism. Increasing awareness of healthcare professionals as well as the public, and continuously reviewing the cases are also important tools for achieving this goal.
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Affiliation(s)
- Sema Sanisoğlu
- a Turkish Public Health Agency, Preliminary Investigation Committee for Maternal Deaths, Government of Health , Ankara , Turkey
| | - Dilek Uygur
- a Turkish Public Health Agency, Preliminary Investigation Committee for Maternal Deaths, Government of Health , Ankara , Turkey
| | - Bekir Keskinkılıç
- a Turkish Public Health Agency, Preliminary Investigation Committee for Maternal Deaths, Government of Health , Ankara , Turkey
| | - Yaprak Engin-Üstün
- a Turkish Public Health Agency, Preliminary Investigation Committee for Maternal Deaths, Government of Health , Ankara , Turkey
| | - Hüseyin Levent Keskin
- a Turkish Public Health Agency, Preliminary Investigation Committee for Maternal Deaths, Government of Health , Ankara , Turkey
| | - Selma Karaahmetoğlu
- a Turkish Public Health Agency, Preliminary Investigation Committee for Maternal Deaths, Government of Health , Ankara , Turkey
| | - Ayşe Özcan
- a Turkish Public Health Agency, Preliminary Investigation Committee for Maternal Deaths, Government of Health , Ankara , Turkey
| | - Meral Esen
- a Turkish Public Health Agency, Preliminary Investigation Committee for Maternal Deaths, Government of Health , Ankara , Turkey
| | - Veli Ongun
- a Turkish Public Health Agency, Preliminary Investigation Committee for Maternal Deaths, Government of Health , Ankara , Turkey
| | - Seçil Özkan
- a Turkish Public Health Agency, Preliminary Investigation Committee for Maternal Deaths, Government of Health , Ankara , Turkey
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Sanhal CY, Daglar HK, Kara O, Uygur D, Yucel A. Assessment of fetal myocardial performance index in women with pregestational and gestational diabetes mellitus. J Obstet Gynaecol Res 2016; 43:65-72. [DOI: 10.1111/jog.13174] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Accepted: 08/19/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Cem Yasar Sanhal
- Department of Perinatology; Zekai Tahir Burak Women's Health Care, Training and Research Hospital; Ankara Turkey
| | - Halil Korkut Daglar
- Department of Perinatology; Zekai Tahir Burak Women's Health Care, Training and Research Hospital; Ankara Turkey
| | - Ozgur Kara
- Department of Perinatology; Zekai Tahir Burak Women's Health Care, Training and Research Hospital; Ankara Turkey
| | - Dilek Uygur
- Department of Perinatology; Zekai Tahir Burak Women's Health Care, Training and Research Hospital; Ankara Turkey
| | - Aykan Yucel
- Department of Perinatology; Zekai Tahir Burak Women's Health Care, Training and Research Hospital; Ankara Turkey
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Yılmaz ZV, Akkaş E, Türkmen GG, Kara Ö, Yücel A, Uygur D. Dietary sodium and potassium intake were associated with hypertension, kidney damage and adverse perinatal outcome in pregnant women with preeclampsia. Hypertens Pregnancy 2016; 36:77-83. [DOI: 10.1080/10641955.2016.1239734] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Zehra Vural Yılmaz
- Zekai Tahir Burak Women’s Health Education and Training Hospital, Department of Perinatology, Ankara, Turkey
| | - Elif Akkaş
- Dr. Sami Ulus Women’s and Children’s Health Training and Research Hospital, Department of Obstetrics and Gynaecology, Ankara, Turkey
| | | | - Özgür Kara
- Zekai Tahir Burak Women’s Health Education and Training Hospital, Department of Perinatology, Ankara, Turkey
| | - Aykan Yücel
- Zekai Tahir Burak Women’s Health Education and Training Hospital, Department of Perinatology, Ankara, Turkey
| | - Dilek Uygur
- Zekai Tahir Burak Women’s Health Education and Training Hospital, Department of Perinatology, Ankara, Turkey
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Uygur D, Aytan H, Zergeroglu S, Batioglu S. Leflunomide—an Immunomodulator—Induces Regression of Endometrial Explants in a Rat Model of Endometriosis. ACTA ACUST UNITED AC 2016; 13:378-83. [PMID: 16713311 DOI: 10.1016/j.jsgi.2006.03.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2005] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To test if leflunomide, an immunomodulator, could impede the growth of an ectopic uterine tissue. METHODS Endometriosis was surgically induced in 26 rats by transplanting an autologous fragment of endometrial tissue onto the inner surface of the abdominal wall. Four weeks later two rats were killed. The volume and weight of the implants were measured. The remaining rats were randomly grouped, and in group 1 no medication was given. To the rats in group 2, 35 mg/kg/d of leflunomide was administered orally. Four weeks later, rats were killed and ectopic uterine tissues were reevaluated morphologically and histologically. A scoring system was used to evaluate preservation of epithelia. RESULTS Two rats in the control group died 5 weeks after surgery. There was a significant difference in post-treatment spherical volumes (139.1 +/- 92.8 versus 33.5 +/- 12.5 mm3) and explant weights (156.3 +/- 105.6 versus 38.6 +/- 12.6 mg) between the control and leflunomide-treated groups. The epithelia were found to be preserved significantly better in the control group when compared with the leflunomide-treated group (median 2.5 [interquartile range, 1.25] versus median 1.00 [interquartile range, 1.5]). CONCLUSION Leflunomide appeared to cause regression of experimental endometriosis in rats.
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Affiliation(s)
- Dilek Uygur
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women Health Care, Research and Education Hospital, Ankara, Turkey
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Abstract
OBJECTIVE The aim of the present study was to evaluate the obstetric and perinatal outcomes in treated women who were diagnosed with non-gynecologic cancer and to compare these findings with pregnant women with no history of cancer. MATERIALS AND METHODS This retrospective study was conducted on 21 pregnant women with non-gynecologic cancer who were in remission (study group) and 63 pregnant women with no history of cancer (control group). The women were admitted to the high-risk pregnancy clinic of Zekai Tahir Burak Women's Health Training and Research Hospital with a diagnosis of pregnancy and cancer between January 2010 and January 2015. Obstetric outcomes and demographic characteristics of the patients were recorded. Age, gravida, parity, abortus, body mass index (BMI), gestational week, smoking, mode of delivery, gestational weight, and perinatal outcomes were examined for each woman. RESULTS The most common cancer types were thyroid (28.5%) and breast cancers (23.8%), which constituted just over half of the non-gynecologic cancer cases during pregnancy. The time elapsed after the diagnosis was 3.8±2.2 (1-9) years. No statistically significant differences were found between the two groups with regard to age, obstetric history, BMI, gestational week, smoking, and obstetric and perinatal outcomes (p>0.05). CONCLUSION Negative perinatal outcomes in non-gynecologic cancer patients in remission were found to be within acceptable levels.
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Affiliation(s)
- Hakan Timur
- Clinic of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Training and Research Hospital, Ankara, Turkey
| | - Aytekin Tokmak
- Clinic of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Training and Research Hospital, Ankara, Turkey
| | - Cantekin Iskender
- Clinic of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Training and Research Hospital, Ankara, Turkey
| | - Elif Sumer Yildiz
- Clinic of Obstetrics and Gynecology, Gaziosmanpaşa Taksim Training and Research Hospital, İstanbul, Turkey
| | - Hasan Ali Inal
- Clinic of Obstetrics and Gynecology, Konya Training and Research Hospital, Konya, Turkey
| | - Dilek Uygur
- Clinic of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Training and Research Hospital, Ankara, Turkey
| | - Nuri Danisman
- Clinic of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Training and Research Hospital, Ankara, Turkey
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Yucel A, Sanhal CY, Ersoy AO, Yuksel S, Erkaya S, Uygur D. Prediction of the length of repeat post C-section hospital stay and comparison of perinatal outcomes in patients with ≥3 versus <3 previous C-section. J Matern Fetal Neonatal Med 2016; 30:1207-1212. [PMID: 27379939 DOI: 10.1080/14767058.2016.1209647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To create a model for prediction of repeat post cesarean section (CS) length of hospital stay (LOHS) in patients undergoing repeat CS. Our other aim was to compare the perinatal outcomes in patients with ≥3 versus <3 previous CS procedures. METHODS Individual characteristics, pre-, intra- and post-operative data of 186 pregnant women who had ≥3 previous CS were compared with 195 pregnant women with <3 previous CS. RESULTS Regression analyses revealed that models can be used to predict the dependents "postpartum LOHS" and "needed units of erythrocyte suspension", both pre-operatively and intra-operatively. Patients with ≥3 previous CS procedures were older, delivered earlier and had lower Apgar 1 and Apgar 5 values than patients with <3 previous CS. The rate of elective CS operations was lower in patients with ≥3 previous CS. Pregnant women ≥3 previous CS had significantly more severe intraperitoneal adhesion (IPA) and higher rate of bladder injury. CONCLUSIONS Prediction models can be conducted for LOHS and other perinatal and operative parameters in patients with previous CS. Pregnancy and repeat CS, even in patients with ≥3 previous CS procedures, are both safe conditions with optimal follow-up and management.
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Affiliation(s)
- Aykan Yucel
- a Department of Perinatology , Zekai Tahir Burak Women's Health Care, Training and Research Hospital , Ankara , Turkey and
| | - Cem Yasar Sanhal
- a Department of Perinatology , Zekai Tahir Burak Women's Health Care, Training and Research Hospital , Ankara , Turkey and
| | - Ali Ozgur Ersoy
- a Department of Perinatology , Zekai Tahir Burak Women's Health Care, Training and Research Hospital , Ankara , Turkey and
| | - Selcen Yuksel
- b Department of Biostatistics , Yıldırım Beyazıt University , Ankara , Turkey
| | - Salim Erkaya
- a Department of Perinatology , Zekai Tahir Burak Women's Health Care, Training and Research Hospital , Ankara , Turkey and
| | - Dilek Uygur
- a Department of Perinatology , Zekai Tahir Burak Women's Health Care, Training and Research Hospital , Ankara , Turkey and
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Oztas E, Ozler S, Tokmak A, Erel O, Ergin M, Uygur D, Danisman N. Oxidative stress markers in severe preeclampsia and preeclampsia-related perinatal morbidity — preliminary report. Ginekol Pol 2016; 87:436-41. [DOI: 10.5603/gp.2016.0022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 06/30/2016] [Indexed: 11/25/2022] Open
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Turkmen GG, Timur H, Tokmak A, Yilmaz Z, Kirbas A, Daglar K, Sanhal CY, Uygur D. Levels of serum vitamin D and calcium in pregnancies complicated with fetal congenital diaphragmatic hernia and normal pregnancies. J Matern Fetal Neonatal Med 2016; 30:990-994. [DOI: 10.1080/14767058.2016.1196662] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ozgu-Erdinc AS, Iskender C, Uygur D, Oksuzoglu A, Seckin KD, Yeral MI, Kalaylioglu ZI, Yucel A, Danisman AN. One-hour versus two-hour postprandial blood glucose measurement in women with gestational diabetes mellitus: which is more predictive? Endocrine 2016; 52:561-70. [PMID: 26645814 DOI: 10.1007/s12020-015-0813-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 11/20/2015] [Indexed: 11/30/2022]
Abstract
The purpose of this study is to investigate postprandial 1-h (PP1) and 2-h (PP2) blood glucose measurements' correlation with adverse perinatal outcomes. This prospective cohort study consisted of 259 women with gestational diabetes mellitus. During each antenatal visit, HbA1c and fasting plasma glucose (FPG) as well as plasma glucose at PP1 and PP2 were analyzed. There were 144 patients on insulin therapy and 115 patients on diet therapy. A total of 531 blood glucose measurements were obtained at different gestational ages between 24 and 41 gestational weeks. PP2 plasma glucose measurements (but not PP1) were positively correlated with fetal macrosomia. But on adjusted analysis, neither PP1 nor PP2 measurements predicted perinatal complications. In addition to PP1 and PP2, neither FPG nor HbA1c were able to predict perinatal complications or fetal macrosomia when controlled for confounding factors except for a positive correlation between fetal macrosomia and HbA1c in patients on diet therapy. Postprandial 1-h and postprandial 2-h plasma glucose measurements were not superior to each other in predicting fetal macrosomia or perinatal complications. Based on our findings, it can be concluded that both methods may be suitable for follow-up as there are no clear advantages of one measurement over the other.
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Affiliation(s)
- A Seval Ozgu-Erdinc
- Department of Perinatology, Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Talatpasa Bulvari, 06230, Ankara, Turkey.
| | - Cantekin Iskender
- Department of Perinatology, Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Talatpasa Bulvari, 06230, Ankara, Turkey
| | - Dilek Uygur
- Department of Perinatology, Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Talatpasa Bulvari, 06230, Ankara, Turkey
| | - Aysegul Oksuzoglu
- Department of Perinatology, Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Talatpasa Bulvari, 06230, Ankara, Turkey
| | - K Doga Seckin
- Department of Perinatology, Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Talatpasa Bulvari, 06230, Ankara, Turkey
| | - M Ilkin Yeral
- Department of Perinatology, Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Talatpasa Bulvari, 06230, Ankara, Turkey
| | | | - Aykan Yucel
- Department of Perinatology, Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Talatpasa Bulvari, 06230, Ankara, Turkey
| | - A Nuri Danisman
- Department of Perinatology, Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Talatpasa Bulvari, 06230, Ankara, Turkey
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Çınar M, Timur H, Aksoy RT, Güzel Aİ, Tokmak A, Bedir Fındık R, Uygur D. Evaluation of maternal and perinatal outcomes among overweight women who experienced stillbirth. J Matern Fetal Neonatal Med 2016; 30:38-42. [PMID: 26857830 DOI: 10.3109/14767058.2016.1152255] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To investigate associations between overweight and adverse clinical outcomes among women who experienced stillbirth. METHODS 234 pregnant women (stillbirth group, n = 115; live birth group, n = 119) were included in this retrospective case-control study. Recorded risk factors were age, gravidity, parity, gestational weeks, fetal birth weight, gestational diabetes mellitus (GDM), preeclampsia (PE), intrauterine growth restriction (IUGR), levels of prenatal test markers (alpha-fetoprotein (AFP), pregnancy-associated plasma protein, human chorionic gonadotropin (β-hCG) and E3) and body mass index (BMI). RESULTS Statistically significant differences were observed between the groups in terms of birth weight, IUGR, GDM, PE, AFP level, β-hCG level, maternal E3 level and BMI (p < 0.05). Subgroup analyses revealed that 34 and 81 patients in the stillbirth group were of normal weight and overweight, respectively, fetal birth weight, IUGR, GDM, PE, AFP level, β-hCG level and E3 level differed significantly between these subgroups and the live birth group (p < 0.05). CONCLUSIONS Women who experience stillbirth tend to be more overweight than those who experience live birth. Additionally, IUGR, GDM and PE are more common among overweight women. Therefore, overweight women should be encouraged to lose weight before pregnancy. If they become pregnant without losing weight, they should be followed up closely to avoid adverse perinatal outcomes.
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Affiliation(s)
- Mehmet Çınar
- a Department of Obstetrics and Gynecology , Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey
| | - Hakan Timur
- a Department of Obstetrics and Gynecology , Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey
| | - Rıfat Taner Aksoy
- a Department of Obstetrics and Gynecology , Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey
| | - Ali İrfan Güzel
- a Department of Obstetrics and Gynecology , Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey
| | - Aytekin Tokmak
- a Department of Obstetrics and Gynecology , Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey
| | - Rahime Bedir Fındık
- a Department of Obstetrics and Gynecology , Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey
| | - Dilek Uygur
- a Department of Obstetrics and Gynecology , Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey
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Timur H, Çinar M, Hançerlioğullari N, Alkan M, İnal HA, Uygur D, Yilmaz N. Associations between first-trimester uterine artery Doppler velocimetry indices and adverse perinatal outcomes in women conceiving via in vitro fertilization. J Matern Fetal Neonatal Med 2016; 30:684-688. [DOI: 10.1080/14767058.2016.1182979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Hakan Timur
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey
| | - Mehmet Çinar
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey
| | - Necati Hançerlioğullari
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey
| | - Mihriban Alkan
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey
| | - Hasan Ali İnal
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey
| | - Dilek Uygur
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey
| | - Nafiye Yilmaz
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey
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Sanhal C, Can Kavcar M, Yucel A, Erkeneklı K, Erkaya S, Uygur D. Comparison of plasma fetuin A levels in patients with early-onset pre-eclampsia vs late-onset pre-eclampsia. Eur J Obstet Gynecol Reprod Biol 2016; 200:108-12. [DOI: 10.1016/j.ejogrb.2016.03.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Revised: 01/14/2016] [Accepted: 03/09/2016] [Indexed: 12/31/2022]
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Topçu HO, İskender CT, Çelen Ş, Oskovi A, Uygur D, Erkaya S. Maternal hypoglycemia on 50 g glucose challenge test: outcomes are influenced by fetal gender. J Perinat Med 2016; 44:369-76. [PMID: 25918915 DOI: 10.1515/jpm-2015-0060] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 03/20/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To assess the perinatal outcomes in pregnant women with maternal hypoglycemia following a second trimester oral glucose challenge test (GCT). MATERIALS AND METHODS This retrospective case control study consisted of 2091 pregnant women with hypoglycemia (glucose levels >88 mg/dL 1 h following a 50 g GCT in the second trimester of pregnancy) and a control group of 2091 pregnant women with a GCT result between 88 and 130 mg/dL. Perinatal and neonatal characteristics obtained from electronic medical records were compared between groups. RESULTS The rates of pregnancy complications were similar in both groups, with the exception of a lower incidence of polyhydramnios and a higher rate of deliveries before the 34th week of gestation in patients with hypoglycemia (0.5% vs. 1.1%, P=0.016 vs. 2.6% vs. 1.7%, P=0.033); respectively. Neonates born to mothers with hypoglycemia had significantly less birth trauma (0.3% vs. 0.9%, P=0.027) and neonatal hypoglycemia. When the data for male and female infants were analyzed separately, male infants had a 1.5-fold (95% CI: 1.05-2.18) increased chance of being small for gestational age (SGA), whereas the risk for female infants did not increase (OR: 0.79, 95% CI: 0.56-1.11). CONCLUSION A low maternal plasma glucose level on the GCT is associated with favorable outcomes, such as decreased rates of birth trauma and neonatal hypoglycemia. In addition, male infants have a higher risk of being SGA than female infants when maternal GCT results were <88 mg/dL.
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Ersoy AO, Ozler S, Oztas E, Ersoy E, Ergin M, Erkaya S, Uygur D. The Association between N-terminal Pro-Brain Natriuretic Peptide Levels in the Umbilical Vein and Amniotic Fluid Volume Abnormalities. Rev Bras Ginecol Obstet 2016; 38:177-82. [PMID: 27096950 PMCID: PMC10309466 DOI: 10.1055/s-0036-1583172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Purpose The amniotic fluid volume (AFV) is known as a predictor for the wellness of a fetus. We aimed to investigate whether N-terminal pro-brain natriuretic peptide (NTproBNP) levels reflect AFV abnormalities in otherwise normal fetuses. Methods We recruited 24 women with isolated oligohydramnios, 23 women with isolated polyhydramnios, and 36 women with normal AFV at a tertiary referral center. NT-proBNP levels in umbilical venous samples and the individual characteristics of the three groups were compared. One-way ANOVA and Kruskal-Wallis analysis of variance were used for multi-group comparisons of continuous variables. When a significant difference was detected, the Scheffe test was performed as a post-hoc analysis. Proportions were compared using the Chi-square (χ2) test. Results Maternal age, body mass indices, weight gained in pregnancy and NT-proBNP levels were similar among the three groups. Apgar scores at 1 and 5 minutes significantly correlated with NT-proBNP levels in all newborns (Spearman's r = 0.23; p = 0.03 and Spearman's r = 0.24; p = 0.02, respectively). The umbilical venous NT-proBNP levels did not differ between newborns who needed mechanical ventilation and those who didn't (p = 0.595). Conclusions NT-proBNP is a biomolecule that may provide insights into the pathogenesis of fetal circulatory problems and subsequent renal failure. Further investigations are warranted.
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Affiliation(s)
- Ali Ozgur Ersoy
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | - Sibel Ozler
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | - Efser Oztas
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | - Ebru Ersoy
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | - Merve Ergin
- Department of Biochemistry, Ataturk Education and Research Hospital, Ankara, Turkey
| | - Salim Erkaya
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | - Dilek Uygur
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Ankara, Turkey
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Timur H, Daglar HK, Kara O, Kirbas A, Inal HA, Turkmen GG, Yilmaz Z, Elmas B, Uygur D. A study of serum Apo A-1 and Apo B-100 levels in women with preeclampsia. Pregnancy Hypertens 2016; 6:121-5. [PMID: 27155339 DOI: 10.1016/j.preghy.2016.04.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 02/26/2016] [Accepted: 04/18/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To investigate Apo A-1 and Apo B-100 levels and Apo B-100/Apo A-1 ratios in preeclamptic (PE) patients. MATERIALS AND METHODS Forty-eight PE and 48 without PE patients (healthy pregnancies) matched for gestational age were included. Maternal age, parity, gestational age at delivery, obstetrical complications including intrauterine growth restriction (IUGR) and gestational diabetes mellitus (GDM), serum Apo A-1 and Apo B-100 levels, and the Apo B-100/Apo A-1 ratio were compared. RESULTS Preeclamptic patients had significantly lower Apo A-1 levels (167.07mg/dl±14.61mg/dl vs. 244.37mg/dl±20.84mg/dl, p<0.001), higher Apo B-100/Apo A-1 ratio (0.63±0.07 vs. 0.42±0.05, p<0.001), but similar Apo B-100 levels (104.84mg/dl±7.05mg/dl vs. 102.39mg/dl±8.08mg/dl, p=0.118). Mean Apo A-1 and Apo B-100 levels and the Apo B-100/Apo A-1 ratio were similar in patients with severe PE, HELLP syndrome, IUGR, and patients requiring antihypertensive therapy compared to PE patients who did not have these complications (p>0.05). Apo A-1 levels had the best accuracy followed by the Apo B-100/Apo A-1 ratio in patients with PE. CONCLUSION Apo A-1 and the Apo B-100/Apo A-1 ratio may be useful markers in patients with PE. Further studies are required to elucidate this issue.
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Affiliation(s)
- Hakan Timur
- Dr. Zekai Tahir Burak Women's Health Education and Research Hospital, Departmant of Perinatology Unit, Ankara, Turkey.
| | - Halil Korkut Daglar
- Dr. Zekai Tahir Burak Women's Health Education and Research Hospital, Departmant of Perinatology Unit, Ankara, Turkey
| | - Ozgur Kara
- Dr. Zekai Tahir Burak Women's Health Education and Research Hospital, Departmant of Perinatology Unit, Ankara, Turkey
| | - Ayse Kirbas
- Dr. Zekai Tahir Burak Women's Health Education and Research Hospital, Departmant of Perinatology Unit, Ankara, Turkey
| | - Hasan Ali Inal
- Konya Education and Research Hospital, Department of Obstetrics and Gynecology, Konya, Turkey
| | - Gulenay Gencosmanoglu Turkmen
- Dr. Zekai Tahir Burak Women's Health Education and Research Hospital, Departmant of Perinatology Unit, Ankara, Turkey
| | - Zehra Yilmaz
- Dr. Zekai Tahir Burak Women's Health Education and Research Hospital, Departmant of Perinatology Unit, Ankara, Turkey
| | - Burak Elmas
- Dr. Zekai Tahir Burak Women's Health Education and Research Hospital, Departmant of Perinatology Unit, Ankara, Turkey
| | - Dilek Uygur
- Dr. Zekai Tahir Burak Women's Health Education and Research Hospital, Departmant of Perinatology Unit, Ankara, Turkey
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Oztas E, Ozler S, Ersoy AO, Iskender CT, Sucak A, Ergin M, Uygur D, Danisman N. Increased levels of serum clusterin is associated with intrauterine growth restriction and adverse pregnancy outcomes in preeclampsia. J Perinat Med 2016; 44:269-75. [PMID: 26352072 DOI: 10.1515/jpm-2015-0120] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 07/09/2015] [Indexed: 01/12/2023]
Abstract
AIM Our aim was to investigate serum clusterin levels in preeclampsia and to determine whether any changes in clusterin levels are useful in distinguishing the presence of concomitant intrauterine growth restriction (IUGR) and in predicting adverse pregnancy outcomes. METHODS A prospective case-control study was carried out which included 86 pregnant women (47 patients with preeclampsia and 39 healthy controls). Maternal serum samples obtained from all participants and clusterin levels were determined by enzyme-linked immunosorbent assay (ELISA). RESULTS Compared with controls, women with preeclampsia had significantly higher clusterin levels (mean 83.8±23.6 vs. 119.2±40.5, P<0.01). Further analysis revealed the highest clusterin levels were in patients with preeclampsia and IUGR (P<0.001). According to the receiver operating characteristic (ROC) analysis performed for the predictive value of clusterin levels for adverse maternal outcomes, the area under the curve (AUC) was 0.738 (95% CI: 0.616-0.859). The best clusterin cut-off value in predicting adverse maternal outcomes was 102.6 pg/mL with 75% sensitivity and 66% specifity. Multivariable logistic regression analysis revealed serum clusterin levels of >102.6 pg/mL was independently associated with preeclampsia (OR: 6.18, 95% CI: 2.41-15.9) and maternal adverse outcomes (OR: 5.13, 95% CI: 2.01-13.1) and also clusterin levels higher than 117.4 pg/mL were associated with adverse neonatal outcomes (OR: 5.02, 95% CI: 1.04-24.3). CONCLUSIONS The current study suggests that increased levels of clusterin is associated with IUGR and probably predictive for adverse pregnancy outcomes in preeclampsia.
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Abstract
OBJECTIVE To investigate the presence of oxidative stress (OS) in pregnant women with Familial Mediterranean fever (FMF) in the first trimester by evaluating thiol/disulphide homeostasis. STUDY DESIGN A total of 31 pregnant women with a diagnosis of FMF, between 11(0) and 13(6) weeks of gestation, were compared with 51 healthy pregnant controls at the same gestational weeks. A recently defined method was used to measure plasma native thiol, total thiol and disulphide levels. RESULTS There were no differences between groups in terms of maternal age, body mass index and numbers of gravida and parity. Antenatal complications (45.2% vs. 9.8%, P = 0.001) and primary caesarean section (22.6% vs. 5.9%, P = 0.037) were higher in the FMF group. Pregnant women with FMF had significantly lower first trimester serum levels of native thiol (297.5 μmol/l (153.2-441.8) vs. 366.1 μmol/l (288.7-432.4), P = 0.000), total thiol (327.2 μmol/l (171.0-471.0) vs. 389.9 μmol/l (317.1-449.8), P = 0.000) and higher levels of disulphide (14.2 ± 4.5 μmol/l vs. 12.4 ± 3.4 μmol/l, P = 0.045). No differences were found in these parameters among FMF patients with and without antenatal complications. CONCLUSIONS The main outcome demonstrates a relation between OS and pregnant women with FMF in the first trimester of gestation. OS in the first trimester may be a major aetiological factor of unfavourable pregancy outcomes in this group of patients.
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Affiliation(s)
- Aykan Yucel
- a Department of Perinatology , Zekai Tahir Burak Women's Health Care, Training and Research Hospital , Ankara , Turkey
| | - Cem Yasar Sanhal
- a Department of Perinatology , Zekai Tahir Burak Women's Health Care, Training and Research Hospital , Ankara , Turkey
| | - Korkut Daglar
- a Department of Perinatology , Zekai Tahir Burak Women's Health Care, Training and Research Hospital , Ankara , Turkey
| | - Ozgur Kara
- a Department of Perinatology , Zekai Tahir Burak Women's Health Care, Training and Research Hospital , Ankara , Turkey
| | - Dilek Uygur
- a Department of Perinatology , Zekai Tahir Burak Women's Health Care, Training and Research Hospital , Ankara , Turkey
| | - Ozcan Erel
- b Department of Clinical Biochemistry, Faculty of Medicine , Yildirim Beyazit University , Ankara , Turkey
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Abstract
AIM Placenta previa (PP) is a potential life-threatening pregnancy complication. Pro-brain natriuretic peptide (ProBNP), creatine kinase (CK), cardiac form of CK (CK-MB) and Troponin I are circulatory biomarkers related to cardiac functions. We aimed to determine whether these biomarkers are related to PP and placenta accreta. METHODS In this case-control study, fifty-four pregnant women who attended our tertiary care center for perinatology with the diagnosis of PP totalis, and of them, 14 patients with placenta accreta were recruited as the study groups. Forty-six uncomplicated control patients who were matched for age, BMI were also included. Maternal venous ProBNP, CK, CK-MB and Troponin I levels were compared between the three groups. RESULTS Obstetric history characteristics were comparable among groups, generally. CK and CK-MB levels were similar among three groups. Troponin I levels in the previa and accreta groups were significantly higher than the controls. ProBNP levels in the accreta group were significantly higher than other two groups. The multivariate regression model revealed that ProBNP could predict placental adhesion anomalies. CONCLUSIONS Troponin I and ProBNP levels in PP cases were higher than controls and ProBNP could predict placenta accreta.
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Affiliation(s)
- Ali Ozgur Ersoy
- a Department of Obstetrics and Gynecology , Zekai Tahir Burak Women's Health Care Training and Research Hospital , Ankara , Turkey
| | - Efser Oztas
- a Department of Obstetrics and Gynecology , Zekai Tahir Burak Women's Health Care Training and Research Hospital , Ankara , Turkey
| | - Sibel Ozler
- a Department of Obstetrics and Gynecology , Zekai Tahir Burak Women's Health Care Training and Research Hospital , Ankara , Turkey
| | - Ebru Ersoy
- a Department of Obstetrics and Gynecology , Zekai Tahir Burak Women's Health Care Training and Research Hospital , Ankara , Turkey
| | - Kudret Erkenekli
- a Department of Obstetrics and Gynecology , Zekai Tahir Burak Women's Health Care Training and Research Hospital , Ankara , Turkey
| | - Dilek Uygur
- a Department of Obstetrics and Gynecology , Zekai Tahir Burak Women's Health Care Training and Research Hospital , Ankara , Turkey
| | - Ali Turhan Caglar
- a Department of Obstetrics and Gynecology , Zekai Tahir Burak Women's Health Care Training and Research Hospital , Ankara , Turkey
| | - Nuri Danisman
- a Department of Obstetrics and Gynecology , Zekai Tahir Burak Women's Health Care Training and Research Hospital , Ankara , Turkey
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Ozler S, Oztas E, Caglar AT, Uygur D, Ergin M, Erel O, Danisman N. Thiol/disulfide homeostasis in predicting adverse perinatal outcomes at 24-28 weeks of pregnancy in gestational diabetes. J Matern Fetal Neonatal Med 2016; 29:3699-704. [PMID: 26769102 DOI: 10.3109/14767058.2016.1141885] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The main aim of this study was to investigate thiol/disulfide homeostasis at 24-28 weeks of pregnancy and to evaluate whether it is predictive for adverse perinatal outcomes or not in gestational diabetes mellitus (GDM). METHODS A total of 110 pregnant women at 24-28 weeks of pregnancy (74 GDM patients and 36 age- and BMI-matched healthy pregnant women) were enrolled in this prospective case-control study. Thiol/disulfide homeostasis was evaluated with a novel spectrophotometric method to determine if there is an association with adverse perinatal outcomes in GDM, by using logistic regression analysis. RESULTS GDM patients, with decreased native thiol levels at 24-28 weeks (OR: 4.890, 95% CI: 1.355-5.764, p = 0.015) and with higher pre-pregnancy BMI (OR: 1.280, 95% CI: 1.072-1.528, p = 0.006), were found to be at increased risk of adverse perinatal outcomes in GDM. There were no statistically significant differences in thiol/disulfide homeostasis between diet- and insulin-treated GDM subgroups. Additionally, 1-h and 2-h glucose levels on 100 g OGTT were found to be predictive for the insulin need in achieving good glycemic control in GDM (OR: 1.022, 95% CI: 1.005-1.038, p = 0.010 and OR: 1.019, 95% CI: 1.004-1.035, p = 0.015). CONCLUSIONS GDM patients, with decreased native thiol levels at 24-28 weeks of pregnancy and with higher pre-pregnancy BMI, have an increased risk of possible adverse perinatal outcomes. Also, increased 1-h and 2-h glucose levels on 100 g OGTT can predict the need for insulin treatment for GDM.
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Affiliation(s)
- Sibel Ozler
- a Department of Perinatology , Zekai Tahir Burak Women's Health Training and Research Hospital , Ankara , Turkey and
| | - Efser Oztas
- a Department of Perinatology , Zekai Tahir Burak Women's Health Training and Research Hospital , Ankara , Turkey and
| | - Ali Turhan Caglar
- a Department of Perinatology , Zekai Tahir Burak Women's Health Training and Research Hospital , Ankara , Turkey and
| | - Dilek Uygur
- a Department of Perinatology , Zekai Tahir Burak Women's Health Training and Research Hospital , Ankara , Turkey and
| | - Merve Ergin
- b Department of Clinical Biochemistry , Faculty of Medicine, Yildirim Beyazit University , Ankara , Turkey
| | - Ozcan Erel
- b Department of Clinical Biochemistry , Faculty of Medicine, Yildirim Beyazit University , Ankara , Turkey
| | - Nuri Danisman
- a Department of Perinatology , Zekai Tahir Burak Women's Health Training and Research Hospital , Ankara , Turkey and
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Timur H, Kokanalı MK, Topçu HO, Topçu S, Erkılınç S, Uygur D, Yakut Hİ. Factors That Affect Perinatal Outcomes of the Second Pregnancy of Adolescents. J Pediatr Adolesc Gynecol 2016; 29:18-21. [PMID: 26428190 DOI: 10.1016/j.jpag.2015.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 04/30/2015] [Accepted: 05/05/2015] [Indexed: 10/23/2022]
Abstract
STUDY OBJECTIVE We assessed factors that might affect perinatal outcomes in second pregnancies in adolescents. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, MAIN OUTCOME MEASURES: This longitudinal retrospective study was carried out on 66 adolescents who experienced 2 deliveries during their adolescence. Data were collected for the first and second pregnancies. Odds ratios (ORs) and 95% confidence intervals (CIs) for adverse perinatal outcomes in the second pregnancy were calculated using a logistic regression model and SPSS software (version 17.0 for Windows; SPSS Inc, Chicago, IL). A P value < .05 was considered to indicate statistical significance. RESULTS Body mass index, number of antenatal care visits, weight gain during pregnancy, incidence of anemia, smoking status, gestational week at delivery, cesarean section rate, and birth weight were similar between the first and second pregnancies of these adolescents. Neonatal intensive care unit admission rate, preeclampsia rate, low neonatal birth weight rate, and 5-minute Apgar scores <7 were significantly higher in the first than in the second pregnancy (P < .001). Age of 16 years or younger at the time of first pregnancy (OR = 1.5; 95% CI, 0.9-2.1; P < .01), less than an 18-month interval between births (OR = 1.4; 95% CI, 0.2-1.7; P < .04), presence of gestational complications in the first pregnancy (OR = 1.9; 95% CI, 1.0-3.4; P < .01), and the presence of perinatal complications in the first pregnancy (OR = 1.3; 95% CI, 1.0-1.9; P < .01) were found to be significant indicators for adverse neonatal outcomes in second pregnancies of adolescents. CONCLUSION We found that the second pregnancies of adolescents were associated with fewer adverse perinatal outcomes than were their first pregnancies. However, some factors regarding the presence of perinatal complications in the first pregnancy, such as maternal age of 16 years or younger at the time of the first pregnancy and interval between first and second pregnancy of less than 18 months, were found to increase the risk of adverse perinatal outcomes for the second births.
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Affiliation(s)
- Hakan Timur
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
| | - Mahmut Kuntay Kokanalı
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
| | - Hasan Onur Topçu
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
| | - Seda Topçu
- Division of Social Pediatrics, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Selçuk Erkılınç
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
| | - Dilek Uygur
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
| | - Halil İbrahim Yakut
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
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