Hiperemezis gravidarum etiyopatogenezinde vitamin D eksikliğinin rolü var mı ?

Amaç: Bu retrospektif olgu-kontrol çalışmamızda D vitamini eksikliğinin, spesifik olarak, gebeliğin bulantı-kusması ve hiperemezis gravidarum (HG) tablosu üzerindeki etkilerini araştırdık.Gereç ve Yöntemler: Bu retrospektif olgu-kontrol çalışmasına; Medikal Park Göztepe Hastane’si Kadın Hastalıkları ve Doğum Kliniği’ne Ocak 2017–Aralık 2017 yılı içerisinde, ilk trimesterde başvurmuş HG’lu 50 gebe (olgu grubu) ile yaş ve gebelik haftası ile eşleştirilmiş 50 sağlıklı gebe (kontrol grubu ) dahil edildi. Bu çalışmada, HG tablosunun özelliklerini taşıyan ilk trimester gebelerinin, ilk trimesterde rutin olarak baktırdıkları D vitamini düzeyleri incelenmiş ve olgu-kontrol grupları arasında D vitamini düzeyleri arasında istatistiksel olarak anlamlı bir ilişki olup olmadığı ortaya konmaya çalışılmıştır.Bulgular: Olgu ve kontrol grupları arasında D vitamini seviyeleri istatistiksel olarak anlamlı düzeyde farklı bulundu (p<0,037). Olgu grubunda ortalama D vitamini düzeyi 15,85 ng/ml, kontrol grubunda ortalama vitamin D düzeyi 19,64 ng/ml olarak saptandı. İstatistiksel olarak olgu- kontrol gruplarında yaş ortalamaları açısından anlamlı farklılık bulunmadı (p>0,398). Olgu- kontrol grupları arasında gebelik haftası açısından istatistiksel olarak anlamlı bir farklılık bulunmadı (p>0,481).Sonuç: Çalışmamızda 25 hidroksi vitamin D seviyeleri olgu grubunda kontrol grubuna göre istatistiksel olarak düşük saptandı. Düşük 25 hidroksi vitamin D düzeylerinin HG patogenezinde etkin bir rol oynadığını düşünmekteyiz. İlk trimesterde hatta gebelik öncesi dönemde D vitamini eksikliği saptanan gebelerde, D vitamini desteği ile HG sıklığının azaltılabileceği kanaatindeyiz.

Anahtar Kelimeler:

: Hiperemezis gravidarum, Gebeliğin bulantı kusması, D vitamini

What is the role of vitamin D deficiency in the pathogenesis of hyperemesis gravidarum?

Objectives: Therefore in this study, we investigated the relationship between hyperemesis gravidarum and vitamin D deficiency.Materials and methods: This is a retrospective case control study which was held in the Medical Park Goztepe Hospital, Obstetrics and Gyneacology Clinic between 1st of January and 31th of December 2017. The study group consists of 50 women experience with newly- onset nausea and vomitting in the first trimester of pregnancy and the control group consists of 50 healthy pregnant women at the same age group. Therefore, in the current study, we tested the hypothesis that suggests women with hyperemesis gravidarum have lower 25-hydroxyvitamin D levels compared to controls.Results: The mean 25-hydroxy vitamin D levels was significantly different between two groups (15,85ng/ml vs 19,64ng/ml; p<0.037).Conclusion: We found that there was a correlation between vitamin D deficiency and hyperemesis gravidarum. Therefore , it might be speculated that,vitamin D level may play a critical role in controlling inflammatory status associated with hyperemesis gravidarum. We believe that vitamin D supplementation and HG frequency can be reduced in pregnancies in which D vitamin deficiency is detected in the first trimester or even in the pre-pregnancy period.

Keywords:

Hyperemesis gravidarum, vitamin D deficiency, pregnancy,

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