Abstract
Amaç
Preeklampsi hem maternal hem de neonatal komplikasyonlara yol açabilen bir hastalıktır. Hastalığın fetal ve neonatal komplikasyonlarına uteroplasental yetersizliğin yol açtığı düşünülmektedir. Güncel bilgiler doğrultusunda hastalığın etyolojisi ve patogenezinde inflamasyonun da maternal bulgulardan sorumlu olduğu görülmüş ve neonatal bulguların da inflamasyonla ilişkili olabileceği düşünülmüştür. Bu amaçla, preeklampsi olan gebelerde yüksek olduğu görülen MPV’nin (mean platelet volume) preeklamptik anne bebeklerinde de değerlendirilmesi planlanmıştır.
Materyal ve metod
Bu çalışma, Hacettepe Üniversitesi Ihsan Doğramacı Çocuk Hastanesi Yenidoğan Yoğunbakım Ünitesi’ne yatışı yapılmış olan 148 preeklamptik anne bebeği ve kontrol grubu için tabakalı örnekleme sistemi ile seçilmiş 147 bebeğin değerlendirmeleri ile yapılmıştır. Gruplar arasında hematolojik parametreler (MPV, hemoglobin değerleri, beyaz küre trombosit sayısı) ve sık görülen neonatal morbiditeler (SGA (gebelik haftasına göre düşük ağırlık), respiratuar distres sendromu, nekrotizan enterokolit, intraventriküler kanama, PDA (patent ductus arteriosus)) karşılaştırılmıştır.
Bulgular
Preeklamptik annelerin bebeklerinde MPV ve hemoglobin değerleri anlamlı olarak (p<0.0001, p:0.032) yüksek, beyaz küre ve trombosit sayıları anlamlı olarak düşük (p:0.002, p:0.011) bulunmuştur. Preeklamptik anne bebeklerinde SGA oranı anlamlı olarak (p<0.0001) yüksek bulunmuş olup diğer morbiditeler açısından belirgin fark bulunmamıştır. Hematolojik parametler incelenirken MPV ve trombosit sayısının ters orantılı olduğu, SGA bebeklerde MPV yüksek olduğu ve PDA olan bebeklerde MPV düşük olduğu görülmüştür.
Sonuç
Preeklampsi olan gebelerde olduğu gibi inflamasyonla seyreden birçok hastalıkta MPV yüksekliği dikkat çekmektedir. Preeklamptik anne bebeklerinde MPV artışı bulgularımıza dayanarak, preeklampsinin neonatal komplikasyonlarının da inflamatuar bir süreçle ilişkili olabileceği düşünülmüştür.
Keywords
References
- 1. Magee LA, Pels A, Helewa M, Rey E, von Dadelszen P, Canadian Hypertensive Disorders of Pregnancy Working Group. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy: executıve summary. J Obstet Gynaecol Can 2014;36:416-438
- 2. Järemo P, Lindahl TL, Lennmarken C, Forsgren H. The use of platelet density and volume measurements to estimate the severity of pre-eclampsia. Eur J Clin Invest 2000;30:1113-1118.
- 3. Sola-Visner M, Sallmon H, Brown R. New insights into the mechanisms of nonimmune thrombocytopenia in neonates. Semin Perinatol 2009;33:43-51.
- 4. Murray NA, Roberts IA. Circulating megakaryocytes and their progenitors in early thrombocytopenia in preterm neonates. Pediatr Res 1996;40:112-119.
- 5. Casella I, Feccia T, Chelucci C, Samoggia P, Castelli G, Guerriero R, et al Autocrine-paracrine VEGF loops potentiate the maturation of megakaryocytic precursors through Flt1 receptor. Blood 2003;101:1316-1323.
- 6. Tsao PN, Wei SC, Su YN, Chou HC, Chen CY, Hsieh WS. Excess soluble fms-like tyrosine kinase 1 and low platelet counts in premature neonates of preeclamptic mothers. Pediatrics 2005;116:468-472.
- 7. Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des 2011;17:47-58.
- 8. Powe CE, Levine RJ, Karumanchi SA. Preeclampsia, a disease of the maternal endothelium: the role of antiangiogenic factors and implications for later cardiovascular disease. Circulation 2011;123:2856-2869.
- 9. Akcan AB, Oygucu SE, Ozel D, Oygür N. Mean platelet volumes in babies of preeclamptic mothers. Blood Coagul Fibrinolysis 2011;22:285-287.
- 10. Cekmez F, Tanju IA, Canpolat FE, et al, Mean platelet volume in very preterm infants: a predictor of morbidities? Eur Rev Med Pharmacol 2013;17:134-137
- 11. Canpolat FE, Yurdakok M, Armangil D, Yigit S, Mean platelet volume in neonatal respiratory distress syndrome. Pediatr Int. 2009;51:314-316
Abstract
Aim
Preeclampsia may cause both maternal and neonatal complications. Uteroplacental dysfunction is one of the reasons of fetal and neonatal complications in preeclampsia. Recent findings about the etiology and pathogenesis of the disease shows that inflammation is one of the factors responsible for maternal complications, thus neonatal complications should be associated with the same inflammatory process. We considered evaluating mean platelet volume (MPV) of infants born to mothers with preeclampsia, based on the findings of elevated MPV values in pregnant women with preeclampsia.
Materials and methods
This study was carried out at the Neonatal Intensive Care Unit of Hacettepe University Ihsan Dogramacı Children’s Hospital and consisted of 148 infants born to mothers with preeclampsia and 147 infants as a control group which were selected by stratified sampling system. Hematological parameters (mean platelet volume, hemoglobin values, white blood cell and platelet counts) and common neonatal morbidities (small for gestational age, respiratory distress syndrome, necrotizing enterocolitis, intraventricular hemorrhage and patent ductus arteriosus) were evaluated between groups.
Results
The infants of mothers with preeclampsia had significantly elevated MPV and hemoglobin values (p<0.0001, p:0.032) and significantly lower platelet and white blood cell counts than the control group (p:0.002, p:0.011). Small for gestational age (SGA) ratio was higher in infants of preeclamptic mothers (p<0.0001) and there was no difference between groups for other morbidities. When examining the hematological parameters, MPV and platelet counts were inversely proportional. MPV was higher in SGA infants and lower in infants with patent ductus arteriosus.
Conclusion
Elevated MPV values are noticed in various diseased associated with inflammation like preeclampsia. Interpreting our findings of elevated MPV values of infants born to mothers with preeclampsia, neonatal complications of preeclampsia should be related with an inflammatory process.
References
- 1. Magee LA, Pels A, Helewa M, Rey E, von Dadelszen P, Canadian Hypertensive Disorders of Pregnancy Working Group. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy: executıve summary. J Obstet Gynaecol Can 2014;36:416-438
- 2. Järemo P, Lindahl TL, Lennmarken C, Forsgren H. The use of platelet density and volume measurements to estimate the severity of pre-eclampsia. Eur J Clin Invest 2000;30:1113-1118.
- 3. Sola-Visner M, Sallmon H, Brown R. New insights into the mechanisms of nonimmune thrombocytopenia in neonates. Semin Perinatol 2009;33:43-51.
- 4. Murray NA, Roberts IA. Circulating megakaryocytes and their progenitors in early thrombocytopenia in preterm neonates. Pediatr Res 1996;40:112-119.
- 5. Casella I, Feccia T, Chelucci C, Samoggia P, Castelli G, Guerriero R, et al Autocrine-paracrine VEGF loops potentiate the maturation of megakaryocytic precursors through Flt1 receptor. Blood 2003;101:1316-1323.
- 6. Tsao PN, Wei SC, Su YN, Chou HC, Chen CY, Hsieh WS. Excess soluble fms-like tyrosine kinase 1 and low platelet counts in premature neonates of preeclamptic mothers. Pediatrics 2005;116:468-472.
- 7. Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des 2011;17:47-58.
- 8. Powe CE, Levine RJ, Karumanchi SA. Preeclampsia, a disease of the maternal endothelium: the role of antiangiogenic factors and implications for later cardiovascular disease. Circulation 2011;123:2856-2869.
- 9. Akcan AB, Oygucu SE, Ozel D, Oygür N. Mean platelet volumes in babies of preeclamptic mothers. Blood Coagul Fibrinolysis 2011;22:285-287.
- 10. Cekmez F, Tanju IA, Canpolat FE, et al, Mean platelet volume in very preterm infants: a predictor of morbidities? Eur Rev Med Pharmacol 2013;17:134-137
- 11. Canpolat FE, Yurdakok M, Armangil D, Yigit S, Mean platelet volume in neonatal respiratory distress syndrome. Pediatr Int. 2009;51:314-316
Details
| Primary Language | English |
|---|---|
| Subjects | Paediatrics |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | April 1, 2021 |
| Submission Date | November 4, 2020 |
| Acceptance Date | November 27, 2020 |
| Published in Issue | Year 2021 Volume: 18 Issue: 1 |
