Öz
Amaç
Gebelikte giderek yaygınlaşan yağlı karaciğer, maternal sağlık riskleriyle ilişkilidir. Bu çalışma, ultrasonografi ile tespit edilen yağlı karaciğerin, maternal lipid düzeyleri ve olumsuz obstetrik sonuçlarla olan bağlantısını araştırmayı amaçlamaktadır.
Yöntem
Bu prospektif kohort çalışması, 1 Şubat 2020-31 Aralık 2020 tarihleri arasında Sağlık Bilimleri Üniversitesi, Prof. Dr. Cemil Taşçıoğlu Şehir Hastanesi, Kadın Hastalıkları ve Doğum Kliniği’ne 24-42 haftalık gebelik döneminde antenatal ziyaret için başvuran hamile kadınları içermektedir.
Bulgular
Ultrasonografi bulgularına dayanarak 232 katılımcı iki gruba ayrılmıştır: Grup 1 (n=121) derece 0-1 yağlı karaciğer, ve Grup 2 (n=111) derece 2-3 yağlı karaciğer olanlar. Ultrasonografi ile yağlı karaciğer tanısı konulan kadınlarda maternal yaş, gebelik öncesi vücut kitle indeksi (VKİ) ve fetal ağırlıkta istatistiksel olarak anlamlı artışlar gözlenmiştir. VKİ için, ≥27,2 kg/m² eşik değeri %58,6 duyarlılık, %66,12 özgüllük, %61,30 pozitif öngörü değeri (PPV), %63,50 negatif öngörü değeri (NPV) ve 1,73 pozitif olasılık oranı LR(+) bulunmuştur. Benzer şekilde, trigliseritler için, ≥240 mg/dL eşik değeri %62,16 duyarlılık, %87,60 özgüllük, %82,10 PPV, %71,60 NPV ve 5,01 LR(+) göstermiştir. Çok değişkenli lojistik regresyon analizi, gestasyonel diyabet riskinde artış [0,98 (0,96-0,99) olasılık oranı (OO) %95 güven aralığı (GA); p=0,045)] ve gestasyonel yaşa göre düşük doğum ağırlığı riskinde azalma [0,98 (0,96-1,00) OO %95 GA; p=0,016)] ortaya koymuştur.
Sonuç
Gebelikte yağlı karaciğer, gestasyonel diyabet riskinde artış ile ilişkilidir, ancak diğer olumsuz obstetrik sonuçlarla ilişkili değildir.
Anahtar Kelimeler: Gebelik, maternal lipid düzeyleri, olumsuz obstetrik sonuçlar, yağlı karaciğer
Kaynakça
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