Abortus İmminens'te Beslenme Parametreleri ve Gebelik Sonuçları Arasındaki İlişki

Abstract

Amaç: Abortus imminens (AI), gebeliğin 20. haftasından önce vajinal kanama ve/veya pelvik ağrı olarak tanımlanır. Gebeliklerin yaklaşık %20'sini etkiler. Hemoglobin, albümin, lenfosit ve trombosit seviyelerini birleştiren HALP skoru, inflamasyon ve beslenme durumunu gösteren bir belirteçtir. Bu çalışmada, HALP skoru ile AI arasındaki ilişki ve gebelik sonuçlarını tahmin etmedeki potansiyel rolü araştırılmaktadır. Yöntemler: Bu retrospektif çalışma Eylül 2022 ile Mart 2024 tarihleri arasında Ankara Etlik Şehir Hastanesi'nde gerçekleştirildi. Toplam 254 AI hastası ve 260 kontrol dahil edildi. Maternal demografik verileri ve hemoglobin, albümin, lenfosit ve trombosit seviyeleri gibi laboratuvar parametrelerine ilişkin veriler toplandı. İstatistiksel analizler SPSS 22.0 kullanılarak yapıldı ve anlamlılık p<0,05 olarak belirlendi. Bulgular: HALP skoru AI grubunda kontrollerden anlamlı olarak daha yüksekti (p=0,002). Ancak AI tanısı alıp abort eden hastalar ile gebeliklerine devam eden hastalar arasında HALP skorlarında anlamlı bir fark gözlenmedi (p=0,350). AI vakalarında erken doğum, yenidoğan yoğun bakıma yatış ve solunum sıkıntısı daha sıktı. Sonuç: HALP skoru AI tanısı için pratik ve maliyet etkin bir araçtır. Klinik faydasını araştırmak için daha fazla çalışmaya ihtiyaç vardır.

Keywords

• Abortus imminens
• HALP skoru
• beslenme
• gebelik sonuçları

The relationship between nutritional parameters and pregnancy outcomes in abortus imminens

Abstract

Aims: Abortus imminens (AI) is defined as vaginal bleeding and/or pelvic pain before the 20th week of pregnancy. It affects approximately 20% of pregnancies. The HALP score, which integrates hemoglobin, albumin, lymphocyte, and platelet levels, is a marker of inflammation and nutritional status. This study investigates the association between the HALP score and AI and its potential role in predicting pregnancy outcomes. Methods: This retrospective study was conducted at Ankara Etlik City Hospital between September 2022 and March 2024. A total of 254 patients with AI and 260 controls were included. Data on maternal demographics and laboratory parameters, including hemoglobin, albumin, lymphocyte, and platelet levels, were collected. Statistical analyses were performed using SPSS 22.0, with significance set at p<0.05. Results: The HALP score was significantly higher in the AI group than in controls (p=0.002). However, no significant difference in HALP scores was observed between patients who experienced pregnancy loss and those who continued their pregnancies (p=0.350). Preterm birth, newborn intensive care unit admission, and respiratory distress were more frequent in AI cases. Conclusion: The HALP score is a practical and cost-effective tool for diagnosing AI. Further studies are needed to explore its clinical utility.

Keywords

• Abortus imminens
• HALP score
• nutrition
• pregnancy outcomes

References

1. Usta CS, Atik TK, Ozcaglayan R, Bulbul CB, Camili FE, Adali E. Does the fibrinogen/albumin ratio predict the prognosis of pregnancies with abortus imminens? Saudi Med J. 2021;42(3):255-263. doi:10.15537/smj. 2021.42.3.20200695
2. Balikoğlu M, Bayraktar B, Arici Yurtkul A, Özeren M. The effect of vaginal bleeding in early pregnancy on first trimester screening test, uterine artery doppler indices and perinatal outcomes. Med Rec. 2023; 5(2):393-399. doi:10.37990/medr.1196046
3. Katar-Yildirim C, Tokmak A, Yildirim C, Erel O, Caglar AT. Investigation of serum thiol/disulphide homeostasis in patients with abortus imminens. J Matern-Fetal Neonatal Med Off J Eur Assoc Perinat Med Fed Asia Ocean Perinat Soc Int Soc Perinat Obstet. 2018;31(18):2457-2462. doi:10.1080/14767058.2017.1344962
4. Weiss JL, Malone FD, Vidaver J, et al. Threatened abortion: a risk factor for poor pregnancy outcome, a population-based screening study. Am J Obstet Gynecol. 2004;190(3):745-750. doi:10.1016/j.ajog.2003.09.023
5. Zhao Y, D’Souza R, Gao Y, et al. Progestogens in women with threatened miscarriage or recurrent miscarriage: a meta-analysis. Acta Obstet Gynecol Scand. 2024;103(9):1689-1701. doi:10.1111/aogs.14829
6. Hanna LM, Habashi LN, Topouzada ST, El Shebini SM, Galal OM. Nutritional status and unfavourable pregnancy outcome in Egyptian women. Nutr Rep Int. 1989;39(6):1217-1226.
7. Tommaselli GA, Di Spiezio Sardo A, Di Carlo C, et al. Do serum leptin levels have a role in the prediction of pregnancy outcome in case of threatened miscarriage? Clin Endocrinol (Oxf). 2006;65(6):772-775. doi: 10.1111/j.1365-2265.2006.02665.x
8. Çendek BD, Bayraktar B, Körpe B, Üstün YE, Keski NL, Erel Ö. Ischemia-modified albumin levels in threatened abortion and missed abortion compared to healthy pregnancies. J Exp Clin Med. 2024;41(1):102-107.

9. Hakeem LA, Bello YO, Obajimi GO, et al. Inflammatory cytokines in maternal serum between women with threatened miscarriage and normal pregnancy. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet. 2024;164(1):255-261. doi:10.1002/ijgo.15009
10. Isenlik BS, Sarica MC, Kaygun BC, Inal HA. An evaluation of serum blood parameters and amyloid a levels in pregnant women with threatened miscarriage. Am J Reprod Immunol N Y N 1989. 2024;91(3): e13829. doi:10.1111/aji.13829
11. Calleja-Agius J, Schembri-Wismayer P, Calleja N, Brincat M, Spiteri D. Obstetric outcome and cytokine levels in threatened miscarriage. Gynecol Endocrinol Off J Int Soc Gynecol Endocrinol. 2011;27(2):121-127. doi:10.3109/09513590.2010.487614
12. Chen XL, Xue L, Wang W, et al. Prognostic significance of the combination of preoperative hemoglobin, albumin, lymphocyte and platelet in patients with gastric carcinoma: a retrospective cohort study. Oncotarget. 2015;6(38):41370. doi:10.18632/oncotarget.5629
13. Farag CM, Antar R, Akosman S, Ng M, Whalen MJ. What is hemoglobin, albumin, lymphocyte, platelet (HALP) score? A comprehensive literature review of HALP’s prognostic ability in different cancer types. Oncotarget. 2023;14:153-172. doi:10.18632/oncotarget.28367
14. Alshuweishi Y, Basudan AM, Alfaifi M, Daghistani H, Alfhili MA. Association of the HALP score with dyslipidemia: a large, nationwide retrospective study. Med Kaunas Lith. 2023;59(11):2002. doi:10.3390/medicina59112002
15. Xu H, Zheng X, Ai J, Yang L. Hemoglobin, albumin, lymphocyte, and platelet (HALP) score and cancer prognosis: a systematic review and meta-analysis of 13,110 patients. Int Immunopharmacol. 2023;114: 109496. doi:10.1016/j.intimp.2022.109496
16. Ekinci F, Balcik OY, Oktay E, Erdogan AP. HALP score as a new prognostic index in metastatic renal cell cancer. J Coll Physicians Surg--Pak JCPSP. 2022;32(3):313-318. doi:10.29271/jcpsp.2022.03.313
17. Acar O, Ayhan M, Demir B, Ekinci F, Aytac A, Erdogan AP. HALP score as a new prognostic factor for patients with metastatic bladder cancer. J Coll Physicians Surg--Pak JCPSP. 2023;33(12):1405-1409. doi:10.29271/jcpsp.2023.12.1405
18. Sargin ZG, Dusunceli I. The effect of HALP score on the prognosis of gastric adenocarcinoma. J Coll Physicians Surg--Pak JCPSP. 2022;32(9): 1154-1159. doi:10.29271/jcpsp.2022.09.1154
19. Rodgers SK, Chang C, DeBardeleben JT, Horrow MM. Normal and abnormal US findings in early first-trimester pregnancy: review of the society of radiologists in ultrasound 2012 consensus panel recommendations. Radiogr Rev Publ Radiol Soc N Am Inc. 2015;35(7): 2135-2148. doi:10.1148/rg.2015150092
20. Soysal C, Sarı H, Işıkalan MM, et al. Role of the systemic immune-inflammation index in threatened abortion patients and predicting of abortion. J Obstet Gynaecol Res. 2023;49(7):1723-1728. doi:10.1111/jog. 15655
21. Biyik I, Albayrak M, Keskin F. Platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in missed abortion. Rev Bras Ginecol E Obstet Rev Fed Bras Soc Ginecol E Obstet. 2020;42(5):235-239. doi:10.1055/s-0040-1709693
22. Vecchié A, Bonaventura A, Carbone F, et al. Antiapolipoprotein A-1 autoantibody positivity is associated with threatened abortion. BioMed Res Int. 2020;2020:9309121. doi:10.1155/2020/9309121
23. Mate A, Reyes-Goya C, Santana-Garrido Á, Vázquez CM. Lifestyle, maternal nutrition and healthy pregnancy. Curr Vasc Pharmacol. 2021; 19(2):132-140. doi:10.2174/1570161118666200401112955
24. Oñate-Ocaña LF, Aiello-Crocifoglio V, Gallardo-Rincón D, et al. Serum albumin as a significant prognostic factor for patients with gastric carcinoma. Ann Surg Oncol. 2007;14(2):381-389. doi:10.1245/s10434-006-9093-x
25. Caro JJ, Salas M, Ward A, Goss G. Anemia as an independent prognostic factor for survival in patients with cancer: a systemic, quantitative review. Cancer. 2001;91(12):2214-2221. doi.org/10.1002/1097-0142(20010615)91: 12<2214::AID-CNCR1251>3.0.CO;2-P
26. Soykan Sert Z, Bertizlioğlu M. Predictive value of the HALP score for pre-eclampsia with severe features. Postgrad Med. 2024;136(4):468-473. doi:10.1080/00325481.2024.2359892
27. Hasan R, Baird DD, Herring AH, Olshan AF, Jonsson Funk ML, Hartmann KE. Association between first-trimester vaginal bleeding and miscarriage. Obstet Gynecol. 2009;114(4):860-867. doi:10.1097/AOG.0b013e3181b79796
28. Basama FMS, Crosfill F. The outcome of pregnancies in 182 women with threatened miscarriage. Arch Gynecol Obstet. 2004;270(2):86-90. doi:10. 1007/s00404-003-0475-z
29. Saraswat L, Bhattacharya S, Maheshwari A, Bhattacharya S. Maternal and perinatal outcome in women with threatened miscarriage in the first trimester: a systematic review. BJOG Int J Obstet Gynaecol. 2010; 117(3):245-257. doi:10.1111/j.1471-0528.2009.02427.x
30. Ozdemirci S, Karahanoglu E, Esinler D, Gelisen O, Kayıkcıoglu F. Influence of threatened miscarriage on pregnancy and early postpartum period: a case-control report. J Matern-Fetal Neonatal Med Off J Eur Assoc Perinat Med Fed Asia Ocean Perinat Soc Int Soc Perinat Obstet. 2015;28(10):1186-1189. doi:10.3109/14767058.2014.947577