Hematolojik enflamasyon belirteçleri erken gebelik kaybının göstergesi olabilir mi?

Yıl 2020, Cilt: 4 Sayı: 11, 952 - 955, 01.11.2020

Taylan Onat , Demet Aydoğan Kırmızı , Melike Demir Çaltekin , Emre Başer , Ethem Serdar Yalvaç

https://doi.org/10.28982/josam.736881

Cited By: 1

Öz

Amaç: İnsan gebeliklerinin yaklaşık % 50'sinde gebelik kaybı meydana gelmektedir ve erken gebeliğin en sık görülen komplikasyonudur. Bu çalışmanın amacı, erken gebelik kaybı ile inflamasyon arasındaki ilişkiyi hematolojik belirteçler ile değerlendirmektir.
Yöntemler: Çalışma Ocak 2016 / Mart 2019 tarihleri arasında kliniğimizde gerçekleşmiş olan erken gebelik kaybı olgularını değerlendiren, olgu-kontrol çalışmasıdır. Erken gebelik kaybı grubu 94 hasta, kontrol grubu ise 104 miadında doğum yapmış kadından oluşturuldu. Grupların demografik verilerine ve tam kan sayımı sonuçlarına hasta dosyaları ve hastane bilgi yönetim sistemi taranarak ulaşıldı.
Bulgular: İki grup arasında yaş ve vücut kitle indeksi açısından istatistiksel olarak anlamlı bir fark yoktu. Abortus grubunda gebelik kayıpları ortalama 9,03 (3,62) haftada gerçekleşmiştir. Abortus grubunda kontrol grubuna kıyasla platelet sayısı (P=0,003), NLR (P=0,036), PLR (P=0,032) ve plateletkrit (P=0,007) yüksek olarak saptanmıştır. Diğer taraftan, LMR (P=0,034) abortus grubunda düşük olarak saptanmıştır.
Sonuçlar: Hematolojik enflamasyon parametreleri kolay ulaşılabilen ve maliyet olarak ucuz tetkiklerdir. Çalışmamızda bu parametrelerin erken gebelik kaybını öngörme başarısı değerlendirilmiş ve sonuç olarak, gruplar arasında hematolojik inflamasyon belirteçlerinde anlamlı farklılıklar olmasına rağmen, bu belirteçlerin duyarlılık ve özgüllüğünün düşük olduğu bulunmuştur.

Anahtar Kelimeler

Erken gebelik kaybı, Enflamasyon, Hematolojik belirteçler

Can hematologic inflammation markers be the indicator of early pregnancy loss?

Öz

Aim: Pregnancy loss occurs in 50% of human pregnancies and is the most common complication of early pregnancy. The aim of this study is to evaluate the relationship between early pregnancy loss and inflammation with hematological markers.
Methods: This case-control study was carried out between January 2016-March 2019 in our clinic to evaluate the cases of early pregnancy loss. The early pregnancy loss group consisted of 94 patients, while the control group consisted of 104 women giving normal birth. Demographic data and complete blood count results of the groups were obtained from the patient files and hospital information management systems.
Results: There were no statistically significant differences in terms of age and body mass index between the two groups. Pregnancy losses in the abortion group occurred at an average of 9.03 (3.62) weeks. In the abortus group, platelet count (P=0.003), NLR (P=0.036), PLR (P=0.032) and plateletcrit (P=0.007) were higher, while LMR (P=0.034) was lower, compared to the control group.
Conclusions: Hematological inflammation parameters are easy to perform and cost-effective examinations. In our study, the success of these parameters to predict early pregnancy loss was evaluated, and it was found that although there are significant differences in hematological inflammation markers between the groups, the sensitivity and specificity of these markers are low.

Anahtar Kelimeler

Early pregnancy loss, Inflammation, Hematologic markers

Kaynakça

• 1. Regan L, Rai R. Epidemiology and the medical causes of miscarriage. Baillieres Best Pract Res Clin Obstet Gynaecol. 2000;14:839-54.
• 2. Wang X, Chen C, Wang L, Chen D, Guang W, French J. Conception, early pregnancy loss, and time to clinical pregnancy: a population-based prospective study. Fertil Steril. 2003;79:577-84.
• 3. Karlı P. Abortus Sonuçlarının Retrospektif Değerlendirilmesi, İki Yıllık Deneyim. AU Sağlık Bil Derg. 2017;3:565-70.
• 4. Rai R, Regan L. Recurrent miscarriage. Lancet. 2006;368:601-11.
• 5. Nybo Andersen AM, Wohlfahrt J, Christens P, Olsen J, Melbye M. Maternal age and fetal loss: population based register linkage study. BMJ. 2000;320:1708-12.
• 6. Regan L, Braude PR, Trembath PL. Influence of past reproductive performance on risk of spontaneous abortion. BMJ. 1989;299:541-5.
• 7. Ness RB, Grisso JA, Hirschinger N, Markovic N, Shaw LM, Day NL, et al. Cocaine and tobacco use and the risk of spontaneous abortion. N Engl J Med. 1999;340:333-9.
• 8. Landres IV, Milki AA, Lathi RB. Karyotype of miscarriages in relation to maternal weight. Hum Reprod. 2010;25:1123-6.
• 9. Amegah AK, Klevor MK, Wagner CL. Maternal vitamin D insufficiency and risk of adverse pregnancy and birth outcomes: A systematic review and meta-analysis of longitudinal studies. PloS One. 2017;12:e0173605.
• 10. Sacks G, Redman C, Sargent I. Monocytes are primed to produce the Th1 type cytokine IL-12 in normal human pregnancy: an intracellular flow cytometric analysis of peripheral blood mononuclear cells. Clin Exp Immunol. 2003;131:490-7.
• 11. Oylumlu M, Ozler A, Yildiz A, Oylumlu M, Acet H, Polat N, et al. New inflammatory markers in pre-eclampsia: echocardiographic epicardial fat thickness and neutrophil to lymphocyte ratio. Clin Exp Hypertens. 2014;36:503-7.
• 12. Tamhane UU, Aneja S, Montgomery D, Rogers E-K, Eagle KA, Gurm HS. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol. 2008;102:653-7.
• 13. Celikbilek M, Dogan S, Ozbakır O, Zararsız G, Kücük H, Gürsoy S, et al. Neutrophil–lymphocyte ratio as a predictor of disease severity in ulcerative colitis. J Clin Lab Anal. 2013;27:72-6.
• 14. Li T, Xu H, Yang L, Tan P, Wei Q. Predictive value of preoperative lymphocyte-to-monocyte ratio for patients with upper tract urothelial carcinoma. Clin Chim Acta. 2019;492:50-6.
• 15. Choi YH, Lee JW, Lee SH, Choi JH, Kang J, Lee BS, et al. A high monocyte-to-lymphocyte ratio predicts poor prognosis in patients with advanced gallbladder cancer receiving chemotherapy. Cancer Epidemiol Biomarkers Prev. 2019;28:1045-51.
• 16. Yücel B, Ustun B. Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume, red cell distribution width and plateletcrit in preeclampsia. Pregnancy Hypertens. 2017;7:29-32.
• 17. Daglar H, Kirbas A, Kaya B, Kilincoglu F. The value of complete blood count parameters in predicting preterm delivery. Eur Rev Med Pharmacol Sci. 2016;20:801-5.
• 18. Koroglu N, Tayyar A, Tola EN, Cetin BA, Ozkan BO, Bahat PY, et al. Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, mean platelet volume and plateletcrit in isolated intrauterine growth restriction and prediction of being born small for gestational age. Arch Med Sci Civil Dis. 2017;2:139-44.
• 19. Akgun N, Namli Kalem M, Yuce E, Kalem Z, Aktas H. Correlations of maternal neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) with birth weight. J Matern Fetal Neonatal Med. 2017;30:2086-91.
• 20. Zhang J, Gilles JM, Barnhart K, Creinin MD, Westhoff C, Frederick MM. A comparison of medical management with misoprostol and surgical management for early pregnancy failure. N Engl J Med. 2005;353:761-9.
• 21. Kwak JY, Beer AE, Kim SH, Mantouvalos HP. Immunopathology of the implantation site utilizing monoclonal antibodies to natural killer cells in women with recurrent pregnancy losses. Am J Reprod Immunol. 1999;41:91-8.
• 22. Ünsal E, Aksaray S, Köksal D, Şipit T. Potential role of interleukin 6 in reactive thrombocytosis and acute phase response in pulmonary tuberculosis. Postgrad Med J. 2005;81:604-7.
• 23. Sato Y, Fujiwara H, Konishi I. Role of platelets in placentation. Med Mol Morphol. 2010;43:129-33.
• 24. Kara PH, Ünlüer S. Are There any Predictive Values of Mean Platelet Volume (MPV) and MPV/Platelet Count Ratio in Patients with Spontaneous Abortion? Eurasian J Emerg Med. 2017;16:57.
• 25. Kaplanoglu M, Yuce T, Bulbul M. Decreased mean platelet volume is associated with the developing stage of fetoplacental unit in spontaneous abortion. Int J Clin Exp Med. 2015;8:11301.
• 26. Eroglu M, Keskin U, Yildirim A, Saygi IA, Gun I, Topuz S. Can mean platelet volume predict abortion? Med Glas. 2013;10:283-7.
• 27. Cakmak EA EA, Erturk M, Kalkan AK, Satılmısoglu MH, Gul M. Association between New Platelet Indices and Calcific Aortic Stenosis: Plateletcrit and Platelet to Lymphocyte Ratio. Van Tıp Derg. 2016;23:330-7.
• 28. Ata, N., Kulhan, M., Kulhan, N. G., & Turkler, C. Can neutrophil-lymphocyte and platelet-lymphocyte ratios predict threatened abortion and early pregnancy loss?. Ginekologia Polska. 2020;91:210-5.
• 29. Choi YH, Lee JW, Lee SH, Choi JH, Kang J, Lee BS, et al. A high monocyte-to-lymphocyte ratio predicts poor prognosis in patients with advanced gallbladder cancer receiving chemotherapy. Cancer Epidemiol Biomarkers Prev. 2019;28:1045-51.
• 30. Laskin CA, Bombardier C, Hannah ME, Mandel FP, Ritchie K, Farewell V, et al. Prednisone and aspirin in women with autoantibodies and unexplained recurrent fetal loss. N Engl J Med. 1997;337:148-54.