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Dal Y, Karagün Ş, Akkuş F, Çolak H, Aytan H, Coşkun A. In premature rupture of membranes, maternal serum delta neutrophil index may be a predictive factor for histological chorioamnionitis and affect fetal inflammatory markers: A retrospective cross-sectional study. Am J Reprod Immunol 2024; 91:e13823. [PMID: 38406995 DOI: 10.1111/aji.13823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/28/2024] [Accepted: 02/01/2024] [Indexed: 02/27/2024] Open
Abstract
PROBLEM We aimed to investigate the predictive value of delta neutrophil index (DNI) for histological choriomanionitis (HCAM) and the effect of maternal inflammatory markers on neonatal outcomes and fetal inflammatory parameters. METHOD OF STUDY In this retrospective cross-sectional study, 68 pregnant women without HCAM (group 1) and 46 pregnant women diagnosed with HCAM (group 2) were divided into two groups. Demographic stories of the groups; maternal hematological parameters; maternal DNI and systemic inflammatory index (SII) values; outcomes of newborns; fetal inflammatory markers were recorded and compared between groups. RESULTS Maternal DNI, and SII levels were significantly higher in group 2 (p value < .05 for all). Admission to the neonatal unit (NICU) was higher in group 2 than in group 1 (p = .0001). We found that fetal inflammatory markers were significantly higher in group 2 (p values .001 for CRP, .0001 for DNI, and .002 for leukocyte). Maternal DNI was determined to be significantly diagnostic at a value of ≥1.3 in HCAM (p = .001). We observed that SII had a significant predictive value of 953036.6 (p = .019) for NICU admission. There is also a positive correlation between fetal inflammatory markers and maternal inflammatory markers. CONCLUSIONS We found that maternal inflammatory markers are high in HCAM, maternal DNI can predict patients who will develop HCAM, maternal SII value can predict NICU admission, fetal inflammatory markers are high in HCAM, and these markers are affected by maternal inflammatory markers.
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Affiliation(s)
- Yusuf Dal
- Department of Obstetrics and Gynecology, Division of Perinatology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Şebnem Karagün
- Department of Obstetrics and Gynecology, Division of Perinatology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Fatih Akkuş
- Department of Obstetrics and Gynecology, Division of Perinatology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Hatun Çolak
- Department of Obstetrics and Gynecology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Hakan Aytan
- Department of Obstetrics and Gynecology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Ayhan Coşkun
- Department of Obstetrics and Gynecology, Division of Perinatology, Mersin University Faculty of Medicine, Mersin, Turkey
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Liu W, Chen L, Wang W, Yue Z, Li J, Tan M, Gu Y, Zhu R, Zhang Y. A comprehensive review of novel biomarkers in the diagnosis of intrahepatic cholestasis of pregnancy. Biomark Med 2023; 17:509-521. [PMID: 37650679 DOI: 10.2217/bmm-2023-0190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
Abstract
Intrahepatic cholestasis of pregnancy (ICP) is a disease specific to pregnancy, featuring maternal itching and elevated serum bile acid levels. It leads to a series of adverse pregnancy outcomes as well as increased fetal mortality. Routine biochemical markers fail to fulfill the tremendous clinical requirements, thereby novel effective biomarkers are urgently desired. In our review, the potential novel biomarkers for ICP diagnosis are classified into four categories and elaborated in detail. The concrete diagnostic performances (sensitivity, specificity and area under the curve) of these biomarkers are demonstrated in tables. Moreover, the relationships between some biomarkers and ICP pathogenesis are briefly expounded. Nevertheless, only a few novel biomarkers are ideal, and their clinical applicability requires more evidence from larger multicenter trials.
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Affiliation(s)
- Weici Liu
- Wuxi Maternal & Child Health Hospital, Wuxi Medical Center of Nanjing Medical University, Wuxi, 214023, Jiangsu, China
- The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, 214023, Jiangsu, China
| | - Lingyan Chen
- Wuxi Maternal & Child Health Hospital, Wuxi Medical Center of Nanjing Medical University, Wuxi, 214023, Jiangsu, China
| | - Wenxiang Wang
- School of Basic Medical Sciences, Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Zhiran Yue
- Second Clinical Medical College of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Jingyang Li
- Wuxi Maternal & Child Health Hospital, Wuxi Medical Center of Nanjing Medical University, Wuxi, 214023, Jiangsu, China
| | - Mengjing Tan
- Department of Gynecology & Obstetrics, Anqing Hospital Affiliated to Anhui Medical University, Anqing, 246003, Anhui, China
| | - Ying Gu
- Wuxi Maternal & Child Health Hospital, Wuxi Medical Center of Nanjing Medical University, Wuxi, 214023, Jiangsu, China
| | - Ru Zhu
- Department of Gynecology & Obstetrics, Anqing Hospital Affiliated to Anhui Medical University, Anqing, 246003, Anhui, China
| | - Yan Zhang
- Wuxi Maternal & Child Health Hospital, Wuxi Medical Center of Nanjing Medical University, Wuxi, 214023, Jiangsu, China
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Dal Y, Akkuş F, Karagün Ş, Çolak H, Coşkun A. Are serum delta neutrophil index and other inflammatory marker levels different in hyperemesis gravidarum? J Obstet Gynaecol Res 2023; 49:828-834. [PMID: 36627732 DOI: 10.1111/jog.15542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 12/26/2022] [Indexed: 01/12/2023]
Abstract
AIM Hyperemesis gravidarum (HEG) is a condition characterized by nausea and vomiting, fluid electrolyte and acid-base imbalance, dehydration, weight loss, and ketonuria in early pregnancy. The relationship of HEG with inflammation has been studied in many studies. This study aimed to investigate the role of serum delta neutrophil index (DNI), a new inflammatory marker, and other inflammatory markers in demonstrating the disease's presence and severity in HEG patients. MATERIAL AND METHOD This retrospective study was conducted by accessing the electronic data of 79 pregnant women diagnosed with HEG in a tertiary center between 2017 and 2022 and 100 healthy pregnant women. The demographic characteristics of the study and control groups, as well as the hematological parameters in the complete blood count and the levels of inflammatory markers, were recorded. RESULTS There was no significant difference between the groups regarding hematological parameters, DNI, platelet-lymphocyte ratio, monocyte-lymphocyte ratio, and systemic inflammation index (p > 0.05). Neutrophil count and neutrophil-lymphocyte ratio (NLR) were higher in the HEG group compared to the control group (p < 0.05). CONCLUSION This is the first study to determine the relationship between HEG and serum DNI, a new inflammatory marker. We found that serum DNI values in HEG patients were not different from normal pregnancies and did not reflect the presence and severity of the disease. We also found that inflammatory markers other than the NLR were not different from normal pregnancies in HEG patients.
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Affiliation(s)
- Yusuf Dal
- Department of Obstetrics and Gynecology, Perinatology Department, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Fatih Akkuş
- Department of Obstetrics and Gynecology, Perinatology Department, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Şebnem Karagün
- Department of Obstetrics and Gynecology, Perinatology Department, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Hatun Çolak
- Department of Obstetrics and Gynecology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Ayhan Coşkun
- Department of Obstetrics and Gynecology, Perinatology Department, Mersin University Faculty of Medicine, Mersin, Turkey
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Keles A, Dagdeviren G, Yucel Celik O, Karatas Sahin E, Obut M, Cayonu Kahraman N, Celen S. Systemic immune-inflammation index to predict placenta accreta spectrum and its histological subtypes. J Obstet Gynaecol Res 2022; 48:1675-1682. [PMID: 35365935 DOI: 10.1111/jog.15254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/13/2022] [Accepted: 03/21/2022] [Indexed: 11/29/2022]
Abstract
AIM In this study, we aimed to investigate the role of systemic immune-inflammation index (SII) and other inflammatory parameters in the diagnosis of placenta accreta spectrum (PAS) and its histological subtypes. METHODS This retrospective case-control study included patients who underwent surgery for placenta previa (PP). Case group (patients with PAS) included pregnant women diagnosed with histologically confirmed PAS, whereas control group (patients with PP) included pregnant women who underwent cesarean section with a PP diagnosis, required no additional intervention during the operation. Both groups were compared with respect to their demographic data, clinical characteristics, SII, and other laboratory parameters. Cut-off values that can predict PAS were calculated. The PAS group was separated into subgroups based on histology findings, and inflammatory parameters were compared between subgroups. RESULTS In this study, data of 273 patients were analyzed. Of these, 68 (24.9%) were included in the PAS group and 205 (75.1%) patients were included in the PP group. Significant differences were observed in SII, platelet distribution width, mean platelet volume, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio (p = 0.000, p = 0.006, p = 0.002, p = 0.000, and p = 0.000, respectively). The best SII cut-off value was 985.02109/L (57.4% sensitivity and 72.2% specificity). There was no significant association between the histologic subtypes of PAS and inflammatory parameters. CONCLUSION SII can be used to predict PAS in pregnant women with PP. The relationship between the histologic subtypes of PAS and inflammatory parameters should be investigated in more comprehensive studies.
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Affiliation(s)
- Ayse Keles
- Department of Perinatology, University of Health Sciences/Etlik Zübeyde Hanım Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | - Gulsah Dagdeviren
- Department of Perinatology, University of Health Sciences/Etlik Zübeyde Hanım Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | - Ozge Yucel Celik
- Department of Perinatology, University of Health Sciences/Etlik Zübeyde Hanım Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | - Ediz Karatas Sahin
- Department of Obstetrics and Gynecology, University of Health Sciences/Etlik Zübeyde Hanım Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | - Mehmet Obut
- Department of Perinatology, University of Health Sciences/Etlik Zübeyde Hanım Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | - Neval Cayonu Kahraman
- Department of Perinatology, University of Health Sciences/Etlik Zübeyde Hanım Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | - Sevki Celen
- Department of Perinatology, University of Health Sciences/Etlik Zübeyde Hanım Women's Health Care, Training and Research Hospital, Ankara, Turkey
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