Tiroid Hastalığı olan Gebelerin Hemogram Parametrelerinde İnflamatuar Belirteçlerin Obstetrik ve Neonatal Sonuçlara Etkisi

Öz

Amaç: Bu çalışmanın amacı, tiroid hastalığı olan gebelerin hemogram parametrelerinde, özellikle inflamatuar belirteçlerde ve perinatal ve neonatal sonuçlardaki farklılıkları belirlemek ve bu farklılıkların gebelik sonuçları üzerindeki etkisini incelemektir. Gereç ve Yöntemler: 2016 ve 2019 yılları arasında ilk başvurusunda Amerikan Tiroid Derneği (American Thyroid Association, ATA) kriterlerine göre tiroid hastalığı tanısı alan 80 gebe kadın ile tiroid hormon düzeyleri normal referans aralığında olan 100 gebe kadının verileri geriye dönük olarak analiz edildi. Doğum tipi ve zamanı ve gebelikte ek hastalık varlığı gibi obstetrik sonuçlar ile doğumda kilo, cinsiyet ve Apgar skoru gibi neonatal sonuçlar karşılaştırıldı. Yine, nötrofil/lenfosit oranı (neutrophil-to-lymphocyte ratio, NLR), trombosit/lenfosit oranı (platelet-to-lymphocyte ratio, PLR), beyaz kan hücresi (white blood cell, WBC) sayısı ve inflamasyon belirteçleri olarak kabul edilen hemoglobin (Hb) ve ortalama trombosit hacmi (mean platelet volume, MPV) değerleri de gruplar arasında karşılaştırıldı. Bulgular: Hipotiroidili ve hipertiroidili gebeler arasında Hb (p=0,319) ve PLR (p=0,341) değerleri açısından anlamlı bir farklılık yoktu. Hipotiroidili gebelerde kontrol grubuna göre 3. trimester WBC (p=0,015) değerleri daha yüksek ve MPV (p=0,007) değerleri daha düşüktü. En yüksek NLR (p=0,005) değeri hipotiroid grubunda gözlendi. Ek hastalık hipotiroid grubunda %27,4 (n=20), hipertiroid grubunda %14,3 (n=1) ve kontrol grubunda %1,0 (n=1) olarak saptandı (p<0,001). Sonuç: Tiroid hastalığı olan gebelerin hemogram parametrelerinde özellikle inflamatuar belirteçlerde farklılıklar olabilir ve bu farklılıklar gebelik sonuçlarını etkileyebilir.

Anahtar Kelimeler

• Tiroid hastalığı
• NLR
• PLR
• perinatal ve neonatal sonuçlar
• gebelik

The Effect of Inflammatory Markers in the Hemogram Parameters of Pregnant Women with Thyroid Disease on Obstetric and Neonatal Outcomes

Abstract

Aim: This study aimed to determine the differences in hemogram parameters, especially in inflammatory markers and perinatal and neonatal outcomes of pregnant women with thyroid disease, and to examine the effects of these differences on pregnancy outcomes. Material and Methods: The data of 80 pregnant women diagnosed with thyroid disease according to the American Thyroid Association (ATA) criteria at the first admission between 2016 and 2019 and 100 pregnant women whose thyroid hormone levels were within the normal reference range were retrospectively analyzed. Obstetric outcomes such as type and time of delivery, and the presence of additional disease during pregnancy, and neonatal outcomes such as weight, gender, and Apgar score at birth were compared. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), white blood cell (WBC) count, and hemoglobin (Hb) and mean platelet volume (MPV) values, which are accepted as inflammation markers, were also compared between groups. Results: There was no significant difference between hypothyroid and hyperthyroid pregnant women in terms of Hb (p=0.319) and PLR (p=0.341) values. Third-trimester WBC (p=0.015) values were higher and MPV (p=0.007) values were lower in the hypothyroid pregnant women compared to the control group. The highest NLR (p=0.005) value was observed in the hypothyroid group. Comorbidities were found to be 27.4% (n=20) in the hypothyroid group, 14.3% (n=1) in the hyperthyroid group, and 1.0% (n=1) in the control group (p<0.001). Conclusion: Pregnant women with thyroid disease may have differences in hemogram parameters, especially in inflammatory markers, and these differences may affect pregnancy outcomes.

Keywords

• Thyroid disease
• NLR
• PLR
• perinatal and neonatal outcomes
• pregnancy

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