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Bao T, Yu B, Chen Y, Zhang Y, Cheng H, Tian Z. Correlation between Maternal Systemic Inflammatory Indicators before Delivery and Congenital Pneumonia in Newborns: A Case-Control Study. CHILDREN (BASEL, SWITZERLAND) 2024; 11:985. [PMID: 39201920 PMCID: PMC11352685 DOI: 10.3390/children11080985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Revised: 08/11/2024] [Accepted: 08/12/2024] [Indexed: 09/03/2024]
Abstract
BACKGROUND Congenital pneumonia is a common respiratory disease in newborns, often influenced by obstetric factors. Clinical diagnosis can be delayed, prompting interest in using systemic inflammatory indicators to predict various diseases. OBJECTIVE Our aim was to evaluate the predictive value of maternal systemic inflammatory indicators before delivery for congenital pneumonia in newborns. METHODS This retrospective study included full-term, singleton infants born at the Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University between January 2017 and December 2022. Infants admitted to the neonatal department within 48 h of birth were divided into two groups: 46 with clinical congenital pneumonia (the observation group) and 65 without congenital pneumonia (the control group). Maternal peripheral blood, complete blood cell count, and general condition within 72 h before delivery, as well as neonatal admission data were recorded. Systemic inflammatory indicators were assessed. Receiver operating characteristic curves were used to evaluate the predictive value of the maternal systemic inflammatory indicators before delivery for congenital pneumonia. A prediction model for neonatal pneumonia was constructed by combining systemic inflammatory indicators before delivery with logistic regression. The association between this prediction model and the prognosis of neonatal congenital pneumonia was examined. RESULTS Maternal systemic inflammatory indicators before delivery as predictive markers for congenital pneumonia and the regression model jointly constructed by NLR, MLR, SII, SIRI, and PIV before delivery predicted the occurrence of congenital pneumonia better. Maternal systemic inflammatory indicators correlated with the severity of congenital pneumonia in neonates. CONCLUSIONS Maternal systemic inflammatory indicators before delivery have predictive value for congenital pneumonia in neonates, aiding early identification and treatment.
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Affiliation(s)
| | | | | | | | | | - Zhaofang Tian
- Department of Neonatology, The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Huai’an 223300, China; (T.B.); (B.Y.); (Y.C.); (Y.Z.); (H.C.)
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Agaoglu Z, Tanacan A, Ipek G, Peker A, Ozturk Agaoglu M, Bastemur AG, Kara O, Sahin D. Utility of the cerebro-placental-uterine ratio in predicting composite adverse perinatal outcomes in pregestational diabetes: A prospective cohort study. JOURNAL OF CLINICAL ULTRASOUND : JCU 2024; 52:745-752. [PMID: 38655708 DOI: 10.1002/jcu.23700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/08/2024] [Accepted: 04/14/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE To examine the cerebro-placental-uterine ratio (CPUR) in pregnant women with pregestational diabetes and determine its role in predicting adverse prenatal outcomes. METHODS This prospective, cohort study conducted at a tertiary hospital included 65 patients with pregestational diabetes (25 with type1 diabetes, 40 with type2 diabetes) and 130 low-risk patients in the control group. The cerebroplacental (CPR) ratio and the CPUR were calculated. Composite adverse perinatal outcome (CAPO) is defined as the presence of any of the following: (1) Neonatal intensive care unit (NICU) admission, (2) Apgar at 5 min <7, and (3) umbilical cord arterial pH <7.10. The relationship of CPR and CPUR with CAPO was investigated. RESULTS CPR and CPUR were significantly lower in the pregestational diabetes group than in the control group. The NICU admission was higher in the case group. In receiver operating characteristic analyses, the optimal cut-off value of CPUR was 1.46 (AUC = 0.72, p = 0.003, 80% sensitivity, and 69% specificity) to predict CAPO and the optimal cut-off value of CPUR was 1.50 for NICU admission (AUC = 0.70, p = 0.013, 77% sensitivity, and 66% specificity). CONCLUSION Low CPUR values were found to be associated with adverse perinatal outcomes in women with pregestational diabetes. With the increasing number of studies, CPUR is expected to be utilized more widely in routine obstetric practice.
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Affiliation(s)
- Zahid Agaoglu
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Atakan Tanacan
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Goksun Ipek
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ayca Peker
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Merve Ozturk Agaoglu
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ayse Gulcin Bastemur
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ozgur Kara
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Dilek Sahin
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
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İpek G, Tanaçan A, Peker A, Ağaoğlu Z, Kara Ö, Şahin D. Systemic Inflammation Response Index as a diagnostic and prognostic predictor of intrahepatic cholestasis of pregnancy: A case-control study from a tertiary center. Int J Gynaecol Obstet 2024; 165:717-722. [PMID: 37922220 DOI: 10.1002/ijgo.15216] [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: 05/04/2023] [Revised: 09/15/2023] [Accepted: 10/12/2023] [Indexed: 11/05/2023]
Abstract
OBJECTIVE To investigate the diagnostic and prognostic value of the Systemic Inflammation Response Index (SIRI) in intrahepatic cholestasis of pregnancy (ICP). METHODS The present case-control study comprised 386 participants, including 192 women with ICP and 194 gestational age-matched pregnant women. Increased fasting biliary acid (FBA) levels (≥10 μmol/L) were accepted as ICP criteria. SIRI values were calculated for the first trimester (SIRI 1), time of diagnosis (SIRI 2), and time of delivery (SIRI 3). The ICP and control groups were compared based on SIRI values, and on obstetrical and neonatal outcomes. The ICP subgroups based on FBA levels (severe ICP [FBA ≥40 μmol/L] and mild ICP [FBA <40 μmol/L]) were also compared for SIRI and pregnancy outcomes. RESULTS Adverse outcomes were significantly higher in the ICP group (P < 0.001). SIRI 2 and SIRI 3 showed negative significant differences between the ICP and control groups, with P values of 0.001 and 0.009, respectively. A significant difference in ICP severity subgroups (P = 0.046) was observed for SIRI 3. In receiver operating characteristics curve analyses, optimal cut-off values for the prediction of ICP were found to be 2.01 and 2.08 for SIRI 2 and SIRI 3, respectively. A cut-off value 1.74 was determined to predict the disease severity for SIRI 3. CONCLUSION SIRI has clinical significance in accordance with the inflammatory etiology of ICP. SIRI might be used with other clinical and laboratory findings for ICP diagnosis and prediction.
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Affiliation(s)
- Göksun İpek
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Atakan Tanaçan
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Ayça Peker
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Zahid Ağaoğlu
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Özgür Kara
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Dilek Şahin
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
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Yi J, Chen L, Meng X, Chen Y. The impact of gestational weeks of Coronavirus disease 2019 (COVID-19) infection on perinatal outcomes. Reprod Health 2024; 21:31. [PMID: 38433197 PMCID: PMC10910700 DOI: 10.1186/s12978-024-01762-9] [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: 07/10/2023] [Accepted: 02/24/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND To evaluate the relationship between coronavirus disease 2019 (COVID-19) infection at different time points during pregnancy and perinatal outcomes. METHODS This retrospective study included 611 women who hospitalized for delivery between December 7 and April 30, 2023. Based on the different pregnancy weeks infected with COVID-19, the participants were divided into four groups: Group 1 (14-27+6 weeks gestation), Group 2 (28-36+6 weeks gestation), Group 3 (37-39+6 weeks gestation), and Group 4 (≥ 40 weeks gestation). Data including maternal demographic characteristics, clinical profiles, and perinatal outcomes were analyzed. RESULTS There were no significant differences in maternal demographic characteristics among the four groups (P > 0.05). Compared to Groups 3 and 4, a higher rate of fever was noted in Groups 1 and 2 (P < 0.05). The frequency of preeclampsia and gestational diabetes mellitus showed a decreasing trend as pregnancy progressing (P < 0.05). Preterm delivery and neonatal intensive care unit admission were more frequently observed in Groups 1 and 2 than in Groups 3 and 4 (P < 0.05). Multivariate logistic regression analysis demonstrated that the timing of gestation in which COVID-19 was infected was not associated with preterm delivery and neonatal intensive care unit admission (P > 0.05), whereas gestational age at COVID-19 infection was negatively associated with the occurrence of preeclampsia and gestational diabetes mellitus (P < 0.05). CONCLUSIONS Gestational age at COVID-19 infection is a simple parameter that predicts adverse perinatal outcomes to aid clinicians in determining to provide early enhanced prenatal care and increased monitoring to reduce maternal complications.
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Affiliation(s)
- Jiao Yi
- Department of Obstetrics and Gynecology, Maternal and Child Health Care Hospital Affiliated With Anhui Medical University, Anhui Maternal and Child Health Care Hospital, No 15 Yimin Street, Hefei, 230000, China.
| | - Lei Chen
- Department of Obstetrics and Gynecology, Maternal and Child Health Care Hospital Affiliated With Anhui Medical University, Anhui Maternal and Child Health Care Hospital, No 15 Yimin Street, Hefei, 230000, China
| | - Xianglian Meng
- Department of Obstetrics and Gynecology, Maternal and Child Health Care Hospital Affiliated With Anhui Medical University, Anhui Maternal and Child Health Care Hospital, No 15 Yimin Street, Hefei, 230000, China
| | - Yi Chen
- Department of Obstetrics and Gynecology, Maternal and Child Health Care Hospital Affiliated With Anhui Medical University, Anhui Maternal and Child Health Care Hospital, No 15 Yimin Street, Hefei, 230000, China
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Sahin R, Tanacan A, Serbetci H, Agaoglu Z, Karagoz B, Haksever M, Kara O, Şahin D. The role of first-trimester NLR (neutrophil to lymphocyte ratio), systemic immune-inflammation index (SII), and, systemic immune-response index (SIRI) in the prediction of composite adverse outcomes in pregnant women with systemic lupus erythematosus. J Reprod Immunol 2023; 158:103978. [PMID: 37329867 DOI: 10.1016/j.jri.2023.103978] [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: 04/24/2023] [Revised: 06/01/2023] [Accepted: 06/09/2023] [Indexed: 06/19/2023]
Abstract
To evaluate the utility of neutrophil to lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and systemic immune-response index (SIRI) in the prediction of adverse pregnancy outcomes in pregnant women with systemic lupus erythematosus (SLE). This retrospective case-control study was conducted in Ankara City Hospital perinatology clinic between 2019 and 2023. First-trimester NLR, SII (NLR X platelet count), and SIRI (NLR X monocyte count) values were compared between pregnant women with SLE (n = 29) and low-risk controls (n = 110). Afterward, pregnant women with SLE were divided into two groups: 1) SLE with perinatal complications (n = 15) and 2) SLE without perinatal complications (n = 14). NLR, SII, and SIRI values were compared between the two subgroups. Finally, a ROC analysis was performed to determine optimal cut-off values for NLR, SII, and SIRI in the prediction of composite adverse pregnancy outcomes. The study group had significantly higher first-trimester NLR, SII, and SIRI values compared to the controls. The SLE with perinatal complications group had significantly higher NLR, SII, and SIRI values than the SLE group without perinatal complications (p < 0.05). Optimal cut-off values were 6.5 (66.7% sensitivity,71.4% specificity), 1612.6 (73.3% sensitivity, 71.4% specificity), and, 4.7 (73.3% sensitivity, 77.6% specificity) for NLR, SII, and SIRI, respectively. SII, SIRI, and NLR may be used to predict adverse pregnancy outcomes in pregnant women with SLE.
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Affiliation(s)
- Refaettin Sahin
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, University of Health Sciences, Ankara, Turkey; Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
| | - Atakan Tanacan
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Hakki Serbetci
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Zahid Agaoglu
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Busra Karagoz
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Murat Haksever
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Ozgur Kara
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Dilek Şahin
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
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Pryshliak OY, Marynchak OV, Kondryn OY, Hryzhak IH, Henyk NI, Makarchuk OM, Golovchak IS, Boichuk OP, Protsyk AL, Prokofiev MV. Clinical and laboratory characteristics of COVID-19 in pregnant women. J Med Life 2023; 16:766-772. [PMID: 37520486 PMCID: PMC10375343 DOI: 10.25122/jml-2023-0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 04/13/2023] [Indexed: 08/01/2023] Open
Abstract
This article discusses the distinct characteristics of COVID-19 in pregnant women and investigates potential early predictors of disease severity in this specific patient population. The study included 116 pregnant women with a confirmed diagnosis of COVID-19 in different trimesters of pregnancy. In addition to clinical features, we evaluated general clinical research methods, biochemical parameters (procalcitonin, C-reactive protein, D-dimer), and the leukocyte index of endogenous intoxication and lymphocytic index to identify potential early predictors of disease severity. All pregnant women were divided into two study groups: Group I - pregnant women with mild course, and Group II - pregnant women with moderate and severe course of COVID-19. Most pregnant women (72.4%) experienced a non-severe course characterized by catarrhal symptoms and moderate intoxication. However, pulmonary manifestations and pregnancy-related complications were detected in pregnant women from Group 2. The levels of C-reactive protein and procalcitonin in both study groups were significantly increased compared to the control group. In pregnant women with moderate and severe COVID-19, indicators of endogenous intoxication were significantly pronounced. Establishing associations between leukocyte indices and biomarkers, such as procalcitonin and C-reactive protein, enables the utilization of routine complete blood counts as a primary screening tool for predicting the severity of COVID-19 in pregnant women.
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Affiliation(s)
| | - Oleksandra Vasulivna Marynchak
- Department of Infectious Diseases and Epidemiology, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Oksana Yevgenivna Kondryn
- Department of Infectious Diseases and Epidemiology, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Ihor Hnatovych Hryzhak
- Department of Infectious Diseases and Epidemiology, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Natalia Ivanivna Henyk
- Department of Obstetrics and Gynecology named after I.D. Lanovyi Ivano-Frankivsk, National Medical University, Ivano-Frankivsk, Ukraine
| | - Oksana Mykhailivna Makarchuk
- Department of Obstetrics and Gynecology named after I.D. Lanovyi Ivano-Frankivsk, National Medical University, Ivano-Frankivsk, Ukraine
| | | | - Oleksandr Petrovych Boichuk
- Department of Infectious Diseases and Epidemiology, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Andriy Liubomyrovych Protsyk
- Department of Infectious Diseases and Epidemiology, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Mykola Valeriiovych Prokofiev
- Department of Infectious Diseases and Epidemiology, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
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Attini R, Laudani ME, Versino E, Massaro A, Pagano A, Petey F, Revelli A, Masturzo B. COVID-19 in Pregnancy: Influence of Body Weight and Nutritional Status on Maternal and Pregnancy Outcomes-A Review of Literature and Meta-Analysis. Nutrients 2023; 15:nu15041052. [PMID: 36839410 PMCID: PMC9962478 DOI: 10.3390/nu15041052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/10/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
In the last two and a half years, COVID-19 has been one of the most challenging public health issues worldwide. Based on the available evidence, pregnant women do not appear to be more susceptible to infection than the general population but having COVID-19 during pregnancy may increase the risk of major complications for both the mother and the fetus. The aim of this study is to identify the correlation between BMI and nutritional status and the likelihood of contracting COVID-19 infection in pregnancy, its severity, and maternal pregnancy outcomes. We carry out a systematic literature search and a meta-analysis using three databases following the guidelines of the Cochrane Collaboration. We include 45 studies about COVID-19-positive pregnant women. Compared with normal-weight pregnant women with COVID-19, obesity is associated with a more severe infection (OR = 2.32 [1.65-3.25]), increased maternal death (OR = 2.84 [2.01-4.02]), and a higher rate of hospital admission (OR = 2.11 [1.37-3.26]). Obesity may be associated with adverse maternal and pregnancy outcomes by increasing symptom severity and, consequently, hospital and Intensive Care Unit (ICU) admission, and, finally, death rates. For micronutrients, the results are less definite, even if there seems to be a lower level of micronutrients, in particular Vitamin D, in COVID-19-positive pregnant women.
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Affiliation(s)
- Rossella Attini
- Department of Obstetrics and Gynecology SC2U, Città della Salute e della Scienza, Sant’Anna Hospital, 10126 Turin, Italy
- Correspondence:
| | - Maria Elena Laudani
- Department of Obstetrics and Gynecology SC2U, Città della Salute e della Scienza, Sant’Anna Hospital, 10126 Turin, Italy
| | - Elisabetta Versino
- Department of Clinical and Biological Sciences, University of Turin, 10100 Turin, Italy
- Centre for Biostatistics, Epidemiology and Public Health (C-BEPH), 10100 Turin, Italy
| | - Alessio Massaro
- Department of Obstetrics and Gynecology SC1U, Città della Salute e della Scienza, Sant’Anna Hospital, 10126 Turin, Italy
| | - Arianna Pagano
- Department of Obstetrics and Gynecology SC2U, Città della Salute e della Scienza, Sant’Anna Hospital, 10126 Turin, Italy
| | - Francesca Petey
- Department of Obstetrics and Gynecology SC2U, Città della Salute e della Scienza, Sant’Anna Hospital, 10126 Turin, Italy
| | - Alberto Revelli
- Department of Obstetrics and Gynecology SC2U, Città della Salute e della Scienza, Sant’Anna Hospital, 10126 Turin, Italy
| | - Bianca Masturzo
- Department of Maternal, Neonatal and Infant Medicine, University Hospital “Degli Infermi”, 13875 Ponderano, Italy
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