Ayşe KELEŞ, Gulsah DAGDEVİREN, Ozge YUCEL CELİK, Azize Cemre ÖZTÜRK, Mehmet OBUT, Şevki ÇELEN, Ali ÇAĞLAR

İnflamatuvar İndeksler Tekrarlayan İdrar Yolu Enfeksiyonu olan Gebelerde Olumsuz Gebelik Sonuçlarını Tahmin Etmek için Kullanılabilir mi?

Amaç: Bu çalışmanın amacı tekrarlayan idrar yolu enfeksiyonu olan hamile kadınlarda inflamatuar indekslerin olumsuz maternal ve neonatal sonuçları tahmin etmedeki yararını araştırmaktır. Gereç ve Yöntemler: Bu geriye dönük çalışma, 2017 ve 2021 yılları arasında semptomatik idrar yolu enfeksiyonu (İYE) nedeniyle tedavi edilen gebeler üzerinde yapılmıştır. İki veya daha fazla semptomatik İYE atağı olan gebeler çalışma grubuna dahil edilmiştir. Kontrol grubuna tek İYE geçiren gebeler dahil edilmiştir. Çalışma grubu 91 (%46,9) hastadan ve kontrol grubu ise 103 (%53,1) hastadan oluşmuştur. Gruplar klinik özellikler, olumsuz sonuçlar ve inflamatuar indeksler açısından karşılaştırıldı. Bulgular: Kontrol grubu ile karşılaştırıldığında, çalışma grubunda daha fazla olumsuz maternal ve neonatal sonuçların meydana geldiği bulundu (sırasıyla p=0,021 ve p<0,001). Olumsuz maternal sonuçları öngörmek için trombosit-lenfosit oranı (TLR), nötrofil-lenfosit oranı (NLR) ve sistemik immün-inflamasyon indeksi (Sİİ) için kesim değerleri sırasıyla, 185,00 (p=0,015; eğri altında kalan alan (EAA)=0,604; %95 güven aralığı (GA)=0,558-0,782), 4,34 (p=0,051; EAA=0,584; %95 GA=0,514-0,746) ve 1210,48 (p=0,008; EAA=0,614; %95 GA=0,547-0,771) idi. Negatif neonatal sonuçları tahmin etmek için PLR, NLR ve Sİİ için kesim değerleri sırasıyla, 192,98 (p=0,001; EAA=0,692; %95 GA=0,572-0,812), 4,67 (p=0,166; EAA=0,583; %95 GA=0,475-0,740) ve 1339,47 (p=0,006; EAA=0,666; %95 GA=0,526-0,777) idi. Sonuç: Ayırt etme başarısı zayıf olmakla birlikte, TLR ve Sİİ, tekrarlayan İYE'li gebe kadınlarda olumsuz maternal ve neonatal sonuçları tahmin etmek için faydalı olabilir.

Anahtar Kelimeler:

olumsuz gebelik sonuçları, İnflamatuar indeksler, tekrarlayan idrar yolu enfeksiyonları

Can Inflammatory Indices be Used to Predict Adverse Pregnancy Outcomes in Pregnant Women with Recurrent Urinary Tract Infection?

Aim: This study aimed to investigate the utility of inflammatory indices in predicting adverse maternal and neonatal outcomes in pregnant women with recurrent urinary tract infections. Material and Methods: This retrospective study was conducted on pregnant women treated for symptomatic urinary tract infection (UTI) between 2017 and 2021. Pregnant women with two or more episodes of symptomatic UTI were included in the study group. Pregnant women with one UTI were included in the control group. The study group consisted of 91 (46.9%) patients and the control group consisted of 103 (53.1%) patients. The groups were compared in terms of clinical characteristics, adverse outcomes, and inflammatory indices. Results: It was found that more adverse maternal and neonatal outcomes occurred in the study group compared to the control group (p=0.021, and p<0.001, respectively). The cut-off values for platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) to predict adverse maternal outcomes were found 185.00 (p=0.015, area under the curve (AUC)=0.604, 95% confidence interval (CI)=0.558-0.782,), 4.34 (p=0.051, AUC=0.584, 95% CI=0.514-0.746), and 1210.48 (p=0.008, AUC=0.614, 95% CI=0.547-0.771), respectively. The cut-off values for PLR, NLR, and SII for predicting negative neonatal outcomes were found 192.98 (p=0.001, AUC=0.692, 95% CI=0.572-0.812), 4.67 (p=0.166, AUC=0.583, 95% CI=0.475-0.740), and 1339.47 (p=0.006, AUC=0.666, 95% CI=0.526-0.777), respectively. Conclusion: Although the success of discrimination is weak, PLR and SII may be useful to predict adverse maternal and neonatal outcomes in pregnant women with recurrent UTI.

Keywords:

Adverse pregnancy outcomes;, inflammatory indices, recurrent urinary tract infections,

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