Relation of inflammatory markers with both presence and severity of hyperemesis gravidarum

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(2) . P R A C E. O R Y G I N A L N E po ł o ż n i c t wo. Relation of inflammatory markers with both presence and severity of hyperemesis gravidarum Związek pomiędzy markerami stanu zapalnego a obecnością i nasileniem wymiotów ciężarnych

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(5) ! " Mustafa Kemal University Medical School, Department of Obstetrics and Gynecology, Hatay, Turkey. Abstract Objectives: The aim of our study is to determine the newly introduced systemic inflammation marker, neutrophil lymphocyte ratio (NLR) in hyperemesis gravidarum (HG) patients and to investigate the association between severity of the disease and NLR. Method: The study population consisted of 55 pregnant patients with HG and 50 pregnant women without complaints matched for gestational age as a control group. The HG patients were grouped as mild (n=16), moderate (n=19) and severe (n=20) according to Modified Pregnancy- Unique Quantification of Emesis and Nausea Scoring Index Questionnaire. Furthermore, hsCRP, neutrophils, lymphocytes, and NLR were evaluated with complete blood count. Results: The HG group had significantly higher NLR values compared to the control group (2.69±1.81 vs 1.97±1.34, p=0.004). HsCRP levels were significantly higher among HG patients compared to the control group (1.95±2.2 vs 0.56±0.30, p<0.001). The subgroup analysis revealed statistically significant increases in NLR and hsCRP values with increased HG severity (p<0.001, p=0.002). The correlation analysis demonstrated a strong correlation between NLR and hsCRP levels (r: 0.703, p<0.001). Conclusion: Our study results showed that NLR and hsCRP levels are increased in HG disease compared to gestational age matched control group subjects. Furthermore, NLR and hsCRP values are correlated with severity of disease. NLR could be used as a marker for both presence and severity of hyperemesis gravidarum.. Key words:

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(10) / / . / Streszczenie Cel pracy: Celem pracy była ocena nowo wprowadzonych markerów stanu zapalnego, wskaźnika neutrofili do limfocytów (NLR) u ciężarnych z wymiotami (HG) oraz zbadanie powiązań między ciężkością choroby a NLR.. Corresponding author: Raziye Keskin Kurt Mustafa Kemal Üniversitesi Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı, 31100, Hatay, TURKEY ph./fax: +90 326 245 51 14, +90 326 245 53 57 e-mail: drraziyekeskinkurt@yahoo.com. Nr 8/2014. © Polskie Towarzystwo Ginekologiczne. Otrzymano: 12.12.2013 Zaakceptowano do druku: 02.03.2014. 589.

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(12) . P R A C E O R Y G I N A L N E poł ożn i ct wo. Raziye Keskin Kurt et al. Relation of inflammatory markers with both presence and severity of hyperemesis gravidarum.. Metoda: Grupę badaną stanowiło 55 ciężarnych z HG i 50 ciężarnych bez dolegliwości, jako grupa kontrolna dopasowana do grupy badanej pod względem wieku ciążowego. Pacjentki z wymiotami zostały podzielone na podgrupy w zależności od nasilenia objawów, tj. łagodne (n=16), średnie (n=19) i ciężkie (n=20), na podstawie zmodyfikowanego kwestionariusza oceny nudności i wymiotów w ciąży. Następnie oznaczono w krwi pełnej hsCRP, neutrofile, limfocyty i NLR. Wyniki: Pacjentki z wymiotami miały znacząco wyższe wartości NLR w porównaniu do grupy kontrolnej (2,69±1,81 vs 1,97±1,34, p=0,004). Poziom hsCRP był istotnie wyższy w grupie HG w porównaniu do grupy kontrolnej (1,95±2,2 vs 0,56±0,30, p<0,001). Analiza w obrębie podgrup HG wykazała istotny wzrost wartości NRL i hsCRP wraz ze wzrostem nasilenia wymiotów (p<0,001, p=0,002). Dalsza analiza wykazała silną korelację pomiędzy poziomem NLR a hsCRP (r:0,703, p<0,001). Wnioski: nasze badanie pokazuje, że poziom NLR i hsCRP jest zwiększony u pacjentek z wymiotami ciążowymi w porównaniu do zdrowych ciężarnych w tych samych tygodniach ciąży. Co więcej, NLR i hsCRP korelują z nasileniem choroby. NLR może być markerem obecności i ciężkości wymiotów ciężarnych.. Słowa kluczowe:

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(601) !1. Conclusion. Source of financing: The present study has no funding.. References 1. Gadsby R, Barnie-Adshead AM, Jagger C. A prospective study of nausea and vomiting during pregnancy. Br J Gen Pract. 1993;43, 245-248. 2. Fairweather DV. Nausea and vomiting in pregnancy. Am J Obstet Gynecol. 1968, 102, 135-175. 3. Celik F, Guzel AI, Kuyumcuoglu U, Celik Y. Dietary antioxidant levels in hyperemesis gravidarum: a case control study. Ginekol Pol. 2011, 82, 840-844. 4. Kallen B. Hyperemesis during pregnancy and delivery outcome: a registry study. Eur J Obstet Gynecol Reprod Biol. 1987, 26, 291-302.. 9

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(676) %1. Authors’ Contribution 1. Raziye Keskin Kurt – concept, analysis and interpretation of data, article draft, corresponding author. 2. Ayşe Güler – concept, analysis and interpretation of data, acquisition of data, assumptions. 3. Dilek Benk Silfeler – study design, acquisition of data, article draft, analysis and interpretation of data. 4. Mustafa Doğan Özçil – concept, analysis and interpretation of data, acquisition of data. 5. Atilla Karateke – revised article critically, acquisition of data, study design, article draft. 6. Ali Ulvi Hakverdi – revised article critically, analysis and interpretation of data, article draft. Authors’ statement This is to certify, that the publication will not violate the copyrights of a third party, as understood according to the Act in the matter of copyright and related rights of 14 February 1994, Official Journal 2006, No. 90, Clause 63, with respect to the text, data, tables and illustrations (graphs, figures, photographs); there is no ‘conflict of interests’ which occurs when the author remains in a financial or personal relationship which unjustly affects his/her actions associated with the publication of the manuscript; any possible relationship(s) of the author(s) with the party/parties interested in the publication of the manuscript are revealed in the text of the article; the manuscript has not been published in or submitted to any other journal.. Nr 8/2014. 5. Sherman PW, Flaxman SM. Nausea and vomiting of pregnancy in an evolutionary perspective. Am J Obstet Gynecol. 2002, 186, 190-197. 6. Goodwin TM, Hershman JM, Cole L. 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