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Copyright of Turkish Journal of Obstetrics & Gynecology is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Experimental data indicate that betatrophin plays a significant role in the regulation of lipid metabolism and glucose homeostasis. In recent years, considerable attention has focused on the relationship between betatrophin and diabetes mellitus in humans. This case-control study included 45 women diagnosed with gestational diabetes mellitus (GDM) and 45 pregnant healthy controls. The groups were matched for maternal and gestational age and body mass index. Serum betatrophin levels were significantly higher in women with GDM (median = 635.8 ng/L; range: 290–1841.6 ng/L) compared to control subjects (median = 320.1 ng/L; range: 94.6–936.8 ng/L;p = 0.001). No significant correlations were observed between serum betatrophin levels and clinical or biochemical parameters in the control group. However, in the GDM group, serum betatrophin levels were positively correlated with weight gain during pregnancy (r = 0.304,p = 0.042), systolic blood pressure (r = 0.394,p = 0.007), fasting insulin level (r = 0.348,p = 0.019), and homeostatic model assessment insulin resistance (HOMA-IR;r = 0.311,p = 0.038). Multivariate stepwise linear regression analysis revealed that fasting insulin levels (β = 0.342,p = 0.022) and HOMA-IR (β = 0.312,p = 0.037) were independently associated with serum betatrophin levels. 实验数据表明，促胰岛生成素在脂质的代谢及糖类的稳态的调节方面起很重要的作用。近年来大量的注意力集中在促胰岛生成素和人类糖尿病的关系上。本病例对照研究包括45例诊断为妊娠期糖尿病的孕妇，以45例健康的孕妇作为对照组。以孕妇、胎龄、体重指数作为匹配项目。妊娠期糖尿病组(中位数=635.8ng/L；范围: 290–1841.6 ng/L)的血清促胰岛生成素水平显著高于对照组(中位数=320.1 ng/L；范围: 94.6–936.8 ng/L; p=0.001)。对照组的血清促胰岛生成素水平和临床、生物化学参数并没有发现有明显相关性。然而，妊娠期糖尿病组血清促胰岛生成素水平和妊娠期间体重增长(r=0.304, p=0.042)、收缩压(r=0.394, p=0.007)、空腹血糖(r=0.348, p=0.019)、与胰岛素抵抗相关的稳态模型(HOMA-IR;r=0.311, p=0.038)均有明显相关性。多元线性回归分析显示空腹血糖(β=0.342, p=0.022)及HOMA-IR (β =0.312, p=0.037)均与血清促胰岛生成素水平有独立相关性。 [ABSTRACT FROM AUTHOR]

Objective: To evaluate whether first, second, and third-trimester maternal serum hepcidin levels are different in pregnancies with and without adverse pregnancy outcomes (APO). Methods: A 165 nullipar pregnant women were included in this prospective cohort study. Serum hepcidin, ferritin, IL-6, C-reactive protein (CRP) and Hb values were measured at 11-14, 24-28, and 30-34 weeks of gestation. The relation between these parameters and APO and neonatal outcomes were investigated. Preterm delivery, intrauterine growth restriction, pre-eclampsia, gestational hypertension and placental abruption were determined as adverse pregnancy outcomes. Results: The risk of APO was three times higher in women with high IL-6 levels in the second trimester. High hepcidin levels in the second trimester were associated with a 1.6 times increased risk of APO. Newborns of women with high IL-6 levels in the third trimester had a 1.6-fold increased risk of neonatal complications. High ferritin levels in the third trimester were associated with minimally increased risk of neonatal complications. Conclusions: Mean serum hepcidin levels were similar in all pregnant women, however, elevated second trimester serum hepcidin and IL-6 levels were associated with a higher risk of APO and high third trimester hepcidin, ferritin and IL-6 levels were associated with higher risk of neonatal complications. [ABSTRACT FROM AUTHOR]

Purpose: To investigate hepcidin levels in each trimester and their association with other haematological variables and inflammation markers during normal pregnancy among low-risk pregnant women in rural Turkey. Method: The series comprised 103 healthy Turkish primigravida women with a normal pregnancy. Blood samples were obtained at 11-14, 24-28 and 30-34 weeks of gestation. Haemoglobin, hematocrit, red cell indices, white blood cell count, platelet count, iron status indicators (plasma iron, transferrin, ferritin levels and iron binding capacity), serum hepcidin, interleukin-6 and C-reactive protein levels were analysed. The proportions were compared using Pearson's χ2 test or Friedman's test. Results: The mean serum hepcidin concentrations at 11-14, 24-28 and 30-34 weeks of gestation were as follows: 7.8 ± 3.4 ng/mL, 8.6 ± 3.1 ng/mL and 7.3 ± 3.0 ng/mL, respectively. The mean serum ferritin concentrations with median values at each trimester were 14.2 (11.5), 9.5 (8.8) and 11.2 (9.3), respectively. The mean serum CRP values at each trimester were 5.1 (4.0), 5.5 (4.6) and 6.0 (5.5), respectively. The serum hepcidin levels were not related to iron status or the haemoglobin, IL-6 or C-reactive protein levels. Conclusions: There was no association between serum hepcidin and serum ferritin, IL-6 or CRP concentrations in each trimester among low-risk pregnant women. [ABSTRACT FROM AUTHOR]

Objective: Folic acid supplementation during the pre-conception period and first trimester of pregnancy reduces the incidence of neural tube defects (NTDs). In this study, our aim is to investigate knowledge and use of folic acid among women attending our clinic. Material and Methods: Between January 2012 and June 2012, 817 participants, consisting of 345 pregnant and 472 non-pregnant women, were enrolled in this survey. A questionnaire including socio-de-mographic information, knowledge and use of folic acid was applied. Results: 48.2% of participants were aware of folic acid for the prevention of congenital anomalies. Knowledge and use of folic acid increase with socio-economic status and educational level. Participants who were already knowledgeable about folic acid cited health care professionals as common sources of information. Although 88.2% of the pregnancies were planned among the currently pregnant women, only 14.2% of them stated that they had used folic acid in the pre-conception period. The use of folic acid during the first trimester among pregnant women was 48.6%. Furthermore, 18.4% of participants had not used folic acid and 29.3% of them had not remembered whether they had or not. Even though 94.4% of health care professionals had heard about folic acid, 28.3% reported that they had used folic acid before pregnancy. Conclusion: It is thought that there is a relatively high incidence of NTD in Turkey, which is due to inadequate information about NTDs and the use of folic acid. Primarily health care professionals such as midwives, nurses and family physicians should aim to inform all re productive age women about folic acid for the prevention of NTDs, who should be encouraged to take the supplement when planning pregnancy. [ABSTRACT FROM AUTHOR]

Objective: To predict the risk of cesarean delivery (CS) for multiparous women who have undergone previous vaginal delivery. Material and Methods: A prospective observational study was performed, among multiparous pregnancies that were between 38 and 41 gestational weeks and had a singleton, vertex presentation fetus. Women's physical activity score, obstetric history, intrapartum and postpartum events were assessed. Multivariable logistic regression was used to explore risk factors associated with CS. Results: Of the 245 total 83.7% had spontaneous labor and 16.3% were induced. Seventy-five percent of the induced women required CS, whereas only 19.5% of those with spontaneous labor required CS (p<0.001). The logistic regression analysis model included maternal weight gain, physical activity score, cervical dilatation, and fetal weight as the predictors of CS. We detected 7 (10%) maternal complications in women who underwent intrapartum CS. Conclusion: Labor induction is significantly associated with increased risk of cesarean delivery among previously vaginally delivered women and maternal weight gain, physical activity score, cervical dilatation, and fetal weight are most accurate parameters in the prediction of the risk of CS delivery. Intrapartum CS has an increased risk of maternal morbidity. [ABSTRACT FROM AUTHOR]

Objective: To investigate the maternal and neonatal characteristics of the clinical subtypes of preterm birth (preterm premature rupture of the membranes, pPROM vs spontaneous preterm delivery with intact membranes, SPD). Materials and methods: A retrospective study, including 53 women with pPROM and 96 women with SPD during the years 2007-2010 was conducted. Data were analyzed using the chi-square test, the Mann-Whitney U test, and the Kaplan-Meier survival analysis. Results: Women with pPROM were consistently older (30 vs 27 years), had higher parity, had a higher previous preterm delivery history, and had a higher detection of infection during pregnancy. Although, their gestational age at admission was higher (35 vs 34 weeks, p<0.001), gestational age of delivery (35.1 vs 36 weeks, p<0.001) was significantly lower than those with SPD. There were more women with vaginal bleeding during the first or second trimester (p=0.031) in the SPD group, but placental abruption was more common in the pPROM group. Admission to the NICU and the length of stay were found to be higher in the newborns from pPROM group (58.5% vs 22.9%, p<0.001). pPROM group also had higher infectious neonatal problems, such as sepsis and pneumonia compared to SPD group (9.5% vs 2.0%, p<0.047). Conclusion: Compared to SPD, pPROM was a more accurate diagnosis, had a shorter latency, and led to more infectious morbidity in newborns. Maternal infectious morbidity was also higher in pPROM group. On the other hand, patients with SPD had vaginal bleeding more frequently during the course of their pregnancy. [ABSTRACT FROM AUTHOR]

Objective. Aimed to investigate (a) the effect of non-stress test (NST) and music on maternal anxiety (b) the effect of maternal anxiety and music on fetal heart rate (FHR) changes. Material and method. The two hundred and one pregnant women coming for routine prenatal care were randomized to receive either music ( n == 96) or no music ( n == 105) during NST. Before and after the test, these women were asked to complete the Spielberg State-Trait Anxiety Inventory on two interviews; primary outcome was considered as a maternal state anxiety score before and after NST. Secondary outcome was the baseline FHR, the number of fetal movement, large accelerations, dubious NST, variable decelerations, and the minimum procedure time. Results. Before NST, the mean state anxiety score of the music and control groups was found as 38.1 ±± 8.8 and 38.08 ±± 8.2, respectively ( p > 0.05). On the other hand, after NST, the mean state anxiety score of the music and control groups was found as 35.5 ±± 8.2 and 40.2 ±± 9.2, respectively ( p < 0.001). While in control group, NST brought about a statistically significant increase in a state anxiety score (38.08 ±± 8.2 versus 40.2 ±± 9.2, p < 0.001), listening to music during NST resulted in decrease in a state anxiety score of the study group but it was not statistically significant (38.1 ±± 8.8 versus 35.5 ±± 8.2, p > 0.05). The baseline FHR of the music group was significantly higher than that of the control group (134.09 ±± 7.2 versus 130.3 ±± 5.7, p < 0.001).The number of fetal movement in the music group was significantly higher than that of the control group (8.9 ±± 4.7 versus 5.9 ±± 3.9, p < 0.001). The number of large accelerations in music group was significantly higher than that of the control group (5.7 ±± 2.1 versus 4.5 ±± 2.04, p < 0.001). The minimum procedure time in music group was significantly lower than that of control group (13.4 ±± 5.2 versus 15.6 ±± 6.1, p < 0.05). The number of dubious NST and variable decelerations was found to be similar for both groups ( p > 0.05). Conclusion. NST has anxiogenic effects on mothers and listening to music during the test has positive impact on both maternal and fetal parameters but it is an open question whether maternal anxiety during pregnancy may affect fetal accelerations to such an extent that it could influence clinical judgments. [ABSTRACT FROM AUTHOR]

Objective. The aim of this study was to evaluate plasma platelet-activating factor acetylhydrolase (PAF-AH) activity in euglycaemic women with history of gestational diabetes (GDM), and to explore whether this activity is associated with metabolic syndrome (MS) in this group of women. Methods. The cross-sectional study included 36 women with history of GDM and 40 women with history of normal glucose tolerance in pregnancy (control group). Results. Compared to the controls, the GDM group had significantly higher mean values for serum glucose, insulin, HOMA-IR, triglyceride, GGT and plasma PAF-AH activity, and a statistically higher prevalence of MS. Within the GDM group, women diagnosed with MS had significantly higher PAF-AH activity than those without MS ( p = 0.002). Conclusion. This is the first study to have shown that plasma PAF-AH activity and GGT levels may be significant for evaluating atherosclerosis risk and metabolic hepatic damage in women with history of GDM. [ABSTRACT FROM AUTHOR]

Objectives: To investigate maternal serum ghrelin levels in pregnancies complicated by preeclampsia and to explore the relationship between ghrelin level and disease severity., Materials and Methods: This case-control study included 40 healthy pregnant women, 42 women with mild preeclampsia, and 40 women with severe preeclampsia. The groups were matched in terms of maternal and gestational age and body mass index. Serum ghrelin levels were measured via enzyme immunoassay., Results: Serum ghrelin levels were significantly higher in women with mild and severe preeclampsia than in healthy controls (p < 0.001). Although serum ghrelin levels were somewhat higher in the severe compared to the mild preeclampsia group, the difference was not statistically significant (p > 0.05). In the control group, no significant correlation was observed between ghrelin level and any other parameter, but in the preeclampsia group, serum ghrelin levels were negatively correlated with uterine artery Doppler index values and both systolic and diastolic blood pressure (all p-values < 0.05). Multivariate stepwise linear regression analysis revealed that systolic blood pressure (β = 0.493, p = 0.023) was independently associated with serum ghrelin level., Conclusion: Elevated blood ghrelin levels were correlated with disease severity in pregnancies complicated by preeclampsia.