Özgül BULUT, Meryem HOCAOĞLU, Nurgül BULUT, Selin DEMİRER, Abdulkadir TURGUT, Fahri OVALI

Erken ve Geç Başlangıçlı Preeklampside Risk Faktörleri ve Neonatal Sonuçların Karşılaştırılması

Amaç: Erken başlangıçlı ve geç başlangıçlı preeklampside maternal risk faktörleri ve erken dönem neonatal sonuçların karşılaştırılması. Gereç ve Yöntem: Hastanemizde preeklampsi tanısı almış hastalar retrospektif olarak değerlendirildi. Hastalar erken başlangıçlı preeklampsi (≤34 hafta) ve geç başlangıçlı preeklampsi (>34 hafta) olmak üzere 2 gruba ayrıldı. İki grup arasında demografik data, maternal risk faktörleri ve neonatal sonuçları karşılaştırmak için istatistiksel analiz yapıldı. Bulgular: Preeklampsi tanısı alan 92 hastanın, 45 (%49)’i erken başlangıçlı preeklampsi ve 47 (%51)’si geç başlangıçlı preeklampsi idi. Erken başlangıçlı preeklampsi grubunda, sezaryen doğum ve intrauterin büyüme kısıtlılığı (İUBK) oranları anlamlı şekilde daha yüksek bulundu (p=0.01, p=0.025). Lojistik regresyon analizinde, gebelikte yüksek vücut kitle indeksinin geç başlangıçlı preeklampsi için bağımsız bir risk faktörü olduğu saptandı (p=0.012). Erken başlangıçlı preeklampsi grubunda, neonatal morbidite ve yenidoğan yoğun bakım ünitesine (YDYBÜ) yatış oranları anlamlı şekilde daha yüksek bulundu (p<0.05, p=0.005, sırasıyla). Bunun yanında, lojistik regresyon analizinde erken başlangıçlı preeklampsinin, İUBK (OR 2.96; 95% CL: 1.12–7.81), SGA (OR 2.5; 95% CL: 1.05–5.95), respiratuar distres sendromu (OR 15.34; 95% CL: 3.06–76.99), patent duktus arteriosus (OR 11.43; 95% CL: 1.36–96.16) ve YDYBÜ’ne yatış (OR 2.48; 95% CL: 1.06–5.77) riskini anlamlı şekilde artırdığı saptandı. Sonuç: Çalışmamızda, erken başlangıçlı preeklampsi, olumsuz neonatal sonuçlar için önemli bir risk faktörü olarak bulunurken, gebelikte yüksek vücut kitle indeksi geç başlangıçlı preeklampsi ile ilişkili bulundu.

Anahtar Kelimeler:

Erken başlangıç, geç başlangıç, preeklampsi, risk faktörleri, neonatal sonuçlar

Comparison of Risk Factors and Neonatal Outcomes in Early-Onset and Late-Onset Preeclampsia

Objective: To compare the maternal risk factors and early neonatal outcomes in early-onset and late-onset preeclampsia. Material and Methods: In our hospital, patients diagnosed with preeclampsia were evaluated retrospectively. The patients were divided into two groups as early onset preeclampsia (≤34 weeks) and late onset preeclampsia (>34 weeks). Statistical analyses were used to compare demographic data, maternal risk factors and neonatal outcomes between the two groups. Results: Out of 92 patients, 45 (49%) were in the early onset preeclampsia and 47 (51%) were in the late onset preeclampsia groups. Cesarean delivery and intrauterine growth retardation (IUGR) rates were significantly higher in the early onset preeclampsia group (p=0.01, p=0.025). High body mass index was an independent risk factor for late onset preeclampsia in the logistic regression analysis (p=0.012). Neonatal morbidities and hospitalization rates in the neonatal intensive care unit (NICU) were significantly higher in the early onset preeclampsia group (p<0.05, p=0.005, respectively). In addition, in the logistic regression analysis, it was found that early onset preeclampsia significantly increased the risks of IUGR (OR 2.96; 95% CL: 1.12–7.81), being small for gestational age (OR 2.5; 95% CL: 1.05–5.95), respiratory distress syndrome (OR 15.35; 95% CL: 3.06–76.99), patent ductus arteriosus (OR 11.43; 95% CL: 1.36–96.16) and hospitalization in the NICU (OR 2.48; 95% CL: 1.06–5.77). Conclusion: Early-onset preeclampsia was found to be an important risk factor for adverse neonatal outcomes while high body mass index during pregnancy was associated with late-onset preeclampsia.

Keywords:

Early-onset, late-onset, preeclampsia, risk factors, outcomes,

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