New aspects of being an adolescent mother: Comparison of psychosocial features between adult and adolescent mothers

Objective: Becoming a mother during the adolescence can cause additional burdens and adversities which might put these individuals at higher risk for psychosocial disturbances. Several studies have reported higher depression rates and worse parenting skills for adolescent mothers but results are contradicting and limited. In accordance with these issues, we aimed to compare perceived social support, selfconfidence in child-bearing, mother-infant bonding profiles and depressive symptoms of adolescent mothers with their counter-parts who got pregnant and gave birth in their medically accepted reproductive stage (between ages of 25 - 30). Methods: Our case group consisted of 47 adolescent mothers who were to our hospital due to pregnancy under the age of 18 and were in the time period of 12 to 18 months after giving birth; whereas control group of the study included total of 53 mothers who got pregnant between ages of 25 - 30 and were in the time period of 12 to 18 months after giving birth. Both groups were evaluated using Beck Depression Inventory (BDI), Multidimensional Scale of Perceived Social Support (MSPSS), Pharis Self-Confidence Scale (PSCS) and Mother to-Infant Bonding Scale (MTIBS) and scores were compared between groups. Results: Adolescent mothers were generally living with family elders (p=0.001), under-educated (p<0.001), unemployed (p<0.001) and mostly didn't receive any physical support for child-bearing (p=0.011). They also had lower MSPSS-Intimate (p<0.001) and MSPSS-Total (p<0.001) scores; whereas adult mothers scored lower on PSCS (p=0.001) and higher on BDI (p<0.001) and MTIBS (p<0.001). There was also a positive correlation between BDI and MTIBS (p<0.001). Furthermore, linear regression models showed that, education level difference was accountable for significant portions of differences in MSPSS-Intimate (p=0.013), MSPSS-Total (p=0.016), MTIBS (p=0.002) and BDI (p=0.003) scores; whereas occupational status was only accountable for significant portion of differences in PSCS scores (p=0.019). Conclusion: Majority of the adolescent mothers was less educated and unemployed; but had better mother-to-infant bonding profiles compared to their counterparts. Regression analyses showed that lower depression scores were accountable for this better mother-to-infant bonding profile among adolescent mothers. In addition, higher educated and employed adult mothers had lower maternal self-confidence in child bearing, worse mother-to-infant bonding profiles and higher depression scores. This might reflect possible protective role of more communal family structure and cultural features as well as negative effect of additional distress which working adult mothers may experience in their daily lives. Further studies with larger sample size and diverse cultural backgrounds are needed to better understand the interaction between various psychosocial features

The effect of body mass index on bone mineral density in postmenopausal women

Background: The aim of this study was to evaluate the association between BMI and BMD among postmenopausal women.Methods: A total of 121 healthy female patients, aged 65.67±8.59 years, previously menopaused, were enrolled. Subjects were divided into five subgroups according to their BMI. History of fracture and BMD were recorded and compared between groups.Results: Among the 121 subjects, 77 (63.6%) individuals had a normal BMD, 32 (26.4%) had osteopenia, and 12 (9.9%) were diagnosed with osteoporosis. Mean of waist circumference was 96.1±8.52cm. The prevalence of fractures was 29.8% in this study. A simple correlation analysis revealed that waist circumference was negatively related to lumbar spine BMD (r= -0.374, p=0.03) and lumbar spine BMD T score (r= -0,352 p=0.002) whereas body weight was positively related to BMD of lumbar spine BMD (r=0.41, p=0.0001) and lumbar spine BMD T score (r=0,31 p=0.001). Age and years since menopause (YSM) were negatively correlated with BMD and T score (p=0.001, p=0.0001, respectively).Conclusions: Even though higher BMI seems to have positive impact on bone density thanks to hormonal and mechanical reasons, increased waist circumference is a sign of a metabolic syndrome and systemic inflammation which are known as having negative effect on bone density. Therefore, postmenopausal women specifically with abdominal obesity should be evaluated for osteoporosis.

Levels of anxiety sensitivity, somatosensory amplification and alexithymia in patients with unexplained infertility

Objective In this study, we aimed to focus on the psychological aspect of unexplained infertility by comparing their psychological features to those of infertile patients with a known causes and fertile patients. Patients and methods Sixty unexplained infertility patients, 50 infertile patients with a known cause and 56 fertile patients were included in the study. Patients were evaluated using socio-demographic data form, Toronto Alexithymia Scale (TAS-20), Somatosensory Amplification Scale (SAS) and Anxiety Sensitivity Index (ASI-3). Results No significant differences in the levels of alexithymia, somatosensory amplification and anxiety sensitivity were detected between the groups (P > .05). When the correlation of clinical scale scores with each other was analysed in the whole group of infertile patients regardless of the cause, a weak positive correlation was found between anxiety sensitivity and difficulty in identifying feelings. Conclusion In our study, it has been found out that; regardless of the knowledge of the aetiology of infertility, the levels of alexithymia, somatosensory amplification and anxiety sensitivity of infertile cases did not differ from those of fertile women. However, it has been shown that as the difficulty in identifying emotions increases in infertile cases, anxiety sensitivity, which may cause psychological infertility, also increases

The effects of Coronavirus disease-2019 (COVID-19) pandemic on routine antenatal care visits and complications of pregnancy

OBJECTIVE: Routine follow-up of pregnancy is a comprehensive care process starting from planning of pregnancy that involves rational and careful use of medical, psychological, and social support. In this study, our objective was to compare the adherence rate to routine antenatal follow-up program during the COVID-19 pandemic with that of previous years among pregnant women, in an effort to shed light on health policies to be developed similar events in the future. METHODS: This retrospective cross-sectional study was carried out between March 11, 2019, when isolation measures were initiated in the context of precautionary steps taken in Turkey against the COVID-19 pandemic, and June 1, 2020, when the "normalization" was initiated. RESULTS: During the study period in 2020, the proportion of cesarean sections were higher, 61.1%, as compared to previous years (p=0.27). The stillbirths were numerically lower (1.2%, p=0.77), but the rate of spontaneous abortions was significantly higher (19.6%, p=0.009). The number of follow-up visits per pregnancy was lower than in previous years (3.8, p=0.02), although the proportion of patients visiting the outpatient units for regular controls to the overall patient group increased as compared to previous years (52.0%). CONCLUSION: During the flare-up of the COVID-19 pandemic (i.e. between March and June 2020), the rate of obstetric/neonatal morbidity and mortality except spontaneous abortion was not significantly higher as compared to the corresponding period in previous years. However, considering the potential increase in the risk of obstetric complications during a pandemic, specialized management programs targeting basic pregnancy follow-up services should be developed

COVID-19 infection in pregnancy: A single-center experience in Rize in the Eastern Black Sea Region

Aim: In this study, it was aimed to share the clinical experiences of mothers and their babies (perinatal, natal) who encountered severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy. Material and Methods: The study was carried out retrospectively, 62 pregnant individuals were diagnosed with the 2019 coronavirus disease (COVID-19). Demographic characteristics, clinical course, laboratory and radiological findings and clinical results of the baby were evaluated by examining electronic and file records. Results: The average age of the 62 pregnant women included in the study was 29.8 +/- 4.7 (19-42) years, and the average gestational week at the time of admission was 28.5 +/- 10.4 (5-40) weeks. More than half of the patients (80,6%) on admission were in their third trimester. The most common initial symptoms were cough (45.2%), myalgia (43.5%),) fever (21%). In total, 15 of the pregnant women had evidence of COVID-19 pneumonia in lung involvement. The PCR test results of all pregnant women were positive. There were three cases admitted to the intensive care unit, one of whom was due to gestational diabetes. No maternal mortality was recorded. One gestation ended in a miscarriage and two women gave birth prematurely. One stillbirth occurred at the 33h week of gestation. Among 22 neonates, two were admitted to the neonatal intensive care unit. Neonatal mortality, congenital malformation, and mother- to- child transmission were not observed in newborns. Discussion: The results of our study suggest that the clinical course of COVID-19 infection in pregnant women was mostly asymptomatic/mild

Are neutrophil count and neutrophil/lymphocyte ratio useful as markers of polycystic ovary syndrome in early reproductive age?

Necrotizing fasciitis (NF) is often fatal, characterized by extensive necrosis of the subcutaneous tissues and fascia. The present study was aimed to validate the Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC) score as a tool to predict/diagnose NF and to differentiate it from other soft tissue infections depending on the score. A Prospective Observational study was conducted in ESICMC PGI MSR, Medical College Hospital, Rajajinagar, Bengaluru, from Jan 2019 to June 2020. Patients ≥18 years of age with severe soft tissue infections were included in the study. Based on the LRINEC score, the patients were categorised as low (≤5), moderate (6-7) and high risk (≥8) for the prediction of onset or diagnosis of NF. Data analysis was performed using SPSS version 21.0. A total of 55 patients were included in the study. A significant association was observed with age (p=0.042), LRINEC score (p=0.0001), C Reactive Protein (CRP; p=0.0001), haemoglobin (p=0.008), serum sodium levels (p=0.004), serum creatinine (0.001), and amputation (p=0.004). Amputation was done in 5 cases. Only 1 mortality was observed in LRINEC high risk group with NSSTI. To conclude, LRINEC scoring system showed a better positive predictive value in identifying the onset of NF and risk strategizing of the patients with severe soft tissue infections. This study has aimed to contribute to the literature by investigating the value of inflammatory biomarkers of polycystic ovary syndrome (PCOS) that can be tested via a complete blood count. This retrospectively designed case-control study included 197 women in early reproductive age; who were in the age range of 18-24 years and who were admitted to the gynecology outpatient clinic. A total of 111 PCOS patients; in whom the diagnosis of PCOS was made based on Rotterdam criteria, were included in the study. A control group was formed by including 86 healthy women. All measurements of inflammatory biomarkers were obtained from the complete blood count test results. Of the inflammatory markers; the neutrophil count and the neutrophil/lymphocyte ratio were statistically significantly higher in the PCOS group compared to the control group (p=0.016 and p=0.002, respectively); however, the measured values of other parameters were similar between two groups. To evaluate whether or not the neutrophil count and neutrophil/lymphocyte ratio could be used as a screening tool to exclude PCOS, we constructed a receiver-operating characteristic curve (ROC). The ROC curve for the neutrophil count was 0.60 (p=0.016) and NLR was 0.627 (p=0.002). The neutrophil count and NLR were higher in the PCOS cases compared to the age-matched individuals in the control group. This finding confirms the presence of inflammation in PCOS cases of early reproductive age. However, it has been demonstrated that the diagnostic values of these markers are not strong in distinguishing PCOS patients from healthy individuals

Antenatal Toxoplasma Gondii, Rubella and Cytomegalovirus Infection Screening Among Pregnant Women Attending Tertiary University Hospital

OBJECTIVE: The present study was designed to determine the seroprevalence of Toxoplasma gondii, Rubella, and Cytomegalovirus, to investigate the frequency of low and high avidity results among preg- nant women and to contribute to the data of our country with the results obtained. STUDY DESIGN: In the present study, the hospital records of the women who applied to the antenatal outpatient of the Rize Recep Tayyip Erdogan University Medical Faculty during the first trimester be- tween January 2016 and October 2018 were retrospectively reviewed. Toxoplasma gondii, RRubella and Cytomegalovirus IgM, IgG and IgG avidity results were evaluated. RESULT: IgM positivity was found to be 0.83% (29/3490) for Toxoplasma gondii, 0.92% (32/3459) for Rubella and 1.90% (65/3404) for Cytomegalovirus; IgG positivity was found to be 33.64% (1174/3490) for Toxoplasma gondii, 90.70% for Rubella (3140/3459), and 99.17% (3376/3404) for Cytomegalovirus. Avidity of Toxoplasma gondii was found to be low (3.70%) in 1 patient, borderline (11.11%) in 3 patients, and high avidity in 23 patients (85.18%). Avidity of Cytomegalovirus was found to be low (1.75%) in 1 patient, borderline (3.50%) in 2 patients and high avidity (94.73%) in 54 patients. Avidity of Rubella was found to be low (4%) in 1 patient, and high avidity (96%) was found in 24 patients. CONCLUSIONS: In our study, although the prevalence of acute infection with Rubella, Cytomegalovirus and Toxoplasma gondii was shown to be low in pregnancy in Rize province, serological screening tests for monitoring and informing high-risk groups that are particularly seronegative appear to be important

The Prevalence of Gestational Diabetes Mellitus Who were Admitted to a Single Center Private Hospital in Rize

Amaç: Çalışmamızda, ülkemizin doğusunda bulunan Rize’de, tek merkezin verileri kullanılarak ‘The International Association of Diabetes and Pregnancy Study Groups’ kriterlerine göre gestasyonel diyabetes mellitus prevalansını araştırmayı ve kriterlerin prevalansı nasıl etkilediğini ülkemizde yapılan diğer çalışmaları da derleyerek göstermeyi amaçladık. Gereç ve Yöntemler: Temmuz 2012 ve Nisan 2018 tarihleri arasında, Özel Şar Hastanesi ‘Kadın Hastalıkları ve Doğum bölümüne’ rutin gebelik takipleri için başvuran 24-28 gebelik haftasındaki 19-51 yaş arasındaki tüm gebeler hastanenin bilgisayar kayıt sistemleri aracılığıyla retrospektif olarak incelendi. Açlık plazma glukozu 126 mg/dl üzerinde olan, daha önce diyabet tanısı alan ve kan glukoz düzeyini etkileyebileceği bilinen bir endokrin hastalığı (Cushing hastalığı, Addison hastalığı, hipofiz yetmezliği, akromegali vs.) olan gebeler çalışmaya dahil edilmedi. ‘The International Association of Diabetes and Pregnancy Study Groups’ tarafından önerilen tek basamaklı 75 gr oral glukoz tolerans testi ile taraması yapılan hastalar çalışmaya dahil edildi. Gestasyonel diyabetes mellitus prevalansı hesaplandı ve yaş gruplarına göre dağılımı incelendi. Bulgular: 3204 hastanın incelendiği bu çalışmada gestasyonel diyabetes mellitus prevalansı %27,9 bulundu. Gestasyonel diyabetes mellitusu olan hastaların yaş ortalamaları 33,78±5,50, sağlıklı hastaların yaş ortalamaları 31,84±4,96 olarak hesaplandı. Her iki grubun yaş ortalamaları arasındaki fark istatistiksel olarak anlamlıydı (p=0,0001). Sonuç: Rize ilindeki gestasyonel diyabetes mellitus prevalansının ülkemizin diğer illerine oranla daha yüksek olduğu gösterilmiştir. Gestasyonel diyabetes mellitus, tüm dünyada ve ülkemizde gittikçe insidansı artan, hem maternal hem de perinatal komplikasyonları açısından önemli bir sağlık sorunudur. Prevalansının düşürülerek maternal ve perinatal mortalitenin azaltılabilmesi için sağlıklı beslenme ve gebelikte egzersiz gibi yaşam kalitesini artıran acil ve etkili müdahalelerin hayata geçirilmesi gerekmektedir.Aim: The aim of the study was to analyze the prevalance of gestational diabetes mellitus according to the International Association of Diabetes and Pregnancy Study Groups’ criterias using the data collected from a single department in Rize. Material and Methods: Computer records of the women who applied for the routine follow up between July 2012 and April 2018 to Şar Hospital, between the age of 19-51 and 24 to 28 weeks of pregnancy were analyzed retrospectively. Participants who has a higher fasting plasma glucose than 126 mg/dl, patients diagnosed with diabetes or an endocrine disease (Cushing’s disease, Addison’s disease, pituitary failure, acromegaly etc.) known to affect blood glucose levels were not included in the study. Patients who were screened with 75 gr oral glucose tolerance test were included in the study. The prevalance of the gestational diabetes mellitus and distribution according to age groups is calculated. Results: 3204 patients records were examined and prevelance of GDM was found 27,9%. The mean age of the GDM patients was 33,78 ±5,50. The mean age of the patients without GDM was 31,84±4,96. The difference between the mean age of the two groups was statistically significant in terms of GDM prevalence (p = 0.0001) Conclusion: It has been shown that the prevalence of GDM in Rize province is higher than the other provinces of our country. In order to reduce maternal and perinatal mortality by decreasing the prevalence of GDM, urgent and effective interventions should be implemented to improve quality of life such as healthy nutrition and exercise during pregnanc

Non-invasive evaluation of meibomian gland morphology and tear film and anterior segment parameters in women with polycystic ovarian syndrome

Purpose: To compare the meibomian glands (MG), non-invasive tear film break-up time (NITBUT), and corneal and anterior segment measurements in patients with polycystic ovary syndrome and healthy women. Methods: The study included 66 polycystic ovarian syndrome (PCOS) patients and 42 healthy volunteers aged 18-35 years. The first and average NITBUT, MG loss, mean keratometry (Km), central (CCT) and thinnest (TCT) corneal thicknesses, anterior chamber depth (ACD), anterior chamber volume (ACV), irido-corneal angle (ICA), corneal volume (CV) and Ocular Surface Disease Index (OSDI) results were analyzed. Results: The mean MG loss values were 29.9 +/- 11.9 and 20.8 +/- 11.0 in the PCOS and control groups, respectively (p = 1) was determined in 64 (96.9%) eyes in the PCOS group and in 36 (85.7%) eyes in the control group. There was no significant difference between the groups in respect of NITBUT, OSDI, Km, CCT, TCT, ACD, ACV, ICA and CV values (p > 0.05, for all). Conclusion: MG loss is a physiological process which is distinct in PCOS patients, but does not cause tear film alterations. Further studies are needed to show the contributing factors of MGD in PCOS patients

Hyperandrogenism in polycystic ovary syndrome affects psychological well-being of adolescents

Besenek, Mert/0000-0003-1637-2485WOS: 000561710100001PubMed: 32830412Aim Polycystic ovary syndrome (PCOS) is a common endocrinological disorder in reproductive age and criterion have recently been revised for adolescent age group. Research regarding effects of PCOS on psychological well-being is limited; and majority of the studies are conducted in adult patients. We aimed to examine psychological effects of PCOS in adolescents who are diagnosed using latest criterion. Methods Cases were divided into PCOS and control groups according to their clinical, ultrasonographical and biochemical features. Beck depression inventory (BDI), State & Trait Anxiety Inventory (STAI-I/II), Self-Confidence Scale (SCS), Multidimensional Peer-Victimization Scale (MPVS) and Social Anxiety Scale for Adolescents (SAS-A) were used in psychiatric evaluation. Results There were no statistically significant differences between groups regarding psychiatric scale scores. However, several biochemical parameters (dehydroepiandrosterone sulfate, 17-hydroxyprogesterone) and clinical (Ferriman-Gallwey score [FGS]) of hyperandrogenism affected certain indicators of psychological well-being such as social anxiety, low self-esteem and peer victimization. in some psychiatric scales, biochemical indicators were found correlated while clinical indicators were not. Conclusion Similar psychiatric scale scores between groups may indicate preliminary stages for adolescent PCOS in which endocrinological, physical and social factors have not yet reached their full potential for their effect on emergence of psychological problems; thus making this age group critical for interventions of prevention measures. in addition, while examining the effects of PCOS on psychological well-being, biochemical parameters of hyperandrogenism might be as effective as physical manifestations (FGS); and high levels of biochemical parameters of hyperandrogenism might also affect psychological state