IDENTIFICATION OF FACTORS INFLUENCING BIRTH WEIGHT, LENGTH, AND HEAD CIRCUMFERENCE

Newborn size at birth is an important indicator of fetal health, neonatal health, infant survival and childhood morbidity. The aim of our study was to assess and identify factors that significantly influence birth weight, length, and head circumference by performing a post hoc analysis of the data collected during the retrospective-prospective observational cohort study which was conducted at the Clinic for Gynecology and Obstetrics at the University Clinical Centre Kragujevac, Serbia. The influence of potential factors on birth weight, length, and head circumference was evaluated by multiple linear regression analysis. The study included 320 pregnant women and 332 newborns. Four factors had a significant negative effect on birth weight: smoking, twin pregnancy, use of methyldopa and corticosteroids during pregnancy. Smoking, twin pregnancy and corticosteroid use also had a significant negative effect on birth length. Negative effect on fetal head circumference at birth had smoking, use of corticosteroids and antibiotics during pregnancy. Maternal height and gestational age at birth showed a positive influence on fetal anthropometric measurements. Clinicians should pay attention to pregnant women with lower body height, twin pregnancy, who smoke and use corticosteroids, methyldopa and antibiotics

Porođaj nakon carskog reza i perinatalni ishod novorođenčadi

Uvod. Dugo vremena je u akušerstvu važio čuveni diktum Edwarda Craginaiz 1916. godine: ”Jednom carski rez, uvijek carski rez”. Vremenom, rukovodećise postupcima iz prošlosti i porastom broja patoloških trudnoća sa jednestrane, kao i uticajem medija i zahtjevima pacijenata sa druge strane, procenatporođaja završenih ovom operativnom metodom je u stalnom porastu. Ciljrada je da se utvrdi učestalost carskog reza i uspješnost vaginalnog porođajanakon prethodnog porođaja carskim rezom i uporedi perinatalni ishod novorođenčadirođene carskim rezom i vaginalnim porođajem nakon prethodnogporođaja carskim rezom.Metode. Opservaciona studija urađena je na Porođajnom odjeljenju Univerzitetskebolnice Foča u periodu od 1. 7. 2005. do 31. 6. 2011. godine. Ispitivanjeje obuhvatilo 206 ispitanica koje su podijeljenje u dvije grupe. GrupaA - pacijentkinje u probnom vaginalnom porođaju nakon carskog reza (n =65) podijeljene su u dvije podgrupe, A1 – pacijentkinje kod kojih je probnivaginalni porođaj uspješno završen, A2 – pacijentkinje kod kojih je u probnomvaginalnom porođaju usljed nastanka komplikacija urađen carski rez. GrupaB - porodilje kod kojih je urađen elektivni, iterativni carski rez (n = 141).Rezultati. Učestalost carskog reza u ukupnom broju od 2028 porođaja unašoj ustanovi u posmatranom periodu je 17,11%. U odnosu na ukupan brojporođaja nakon porođaja carskim rezom (vaginalni porođaji + iterativnicarski) procenat vaginalnih porođaja nakon porođaja carskim rezom iznosioje 22,33%. Povećanjem broja ovog načina porođaja smanjivao se broj ukupnih carskih rezova. Nije postojala statistička značajnost u fetalnom morbiditetu i mortalitetu (u istraživanju nije bilo mrtvorođene djece) koja bi opravdavalaponovni carski rez u aktuelnom porođaju nakon porođaja carskim rezom.Zaključak. Vaginalni porođaj nakon prethodnog porođaja carskim rezomsigurna je alternativa rutinskom ponovnom carskom rezu sa aspekta smanjenjaprocentualne stope ukupnog broja carskih rezova. Ne postoji statističkaznačajnost u perinatalnom ishodu novorođenčadi koja bi opravdavala ponovni carski rez u aktuelnom porođaju.

Factors Associated with Abnormal Uterine Bleeding in Perimenopausal Women

Background: Abnormal uterine bleeding (AUB) is one of the most common health problems encountered in women of the perimenopausal age group. The aim of this study was to investigate the characteristics of functional AUB in perimenopausal women, and to identify predictors of the occurrence of functional AUB in perimenopausal women. Methods: This was a cross-sectional study that included 45 women with complaints of AUB admitted to the gynecology ward in the University Hospital in Foča, and 45 women without AUB who underwent a gynecological examination in the Primary Health Center in Foča, Bosnia and Herzegovina. We included women with AUB who had a normal ultrasound finding without obvious genital or cervical lesions, and who were not on hormonal therapy. The existence of AUB was determined on the basis of a clinical examination by a gynecologist and existing medical documentation. A logistic regression model was used to assess the possible relationship between the occurrence of the functional AUB and the risk factors for its occurrence. Results: The mean patient age was 48.38 ± 2.40 years. There was no significant difference in age, frequency of physical activity, or previous use of oral contraceptives between the two groups of patients divided by the presence of the functional AUB in perimenopause. The logistic regression model showed that age (p = 0.008), high values of body mass index (BMI) (p = 0.001), consumption of alcohol and cigarettes on a daily basis (p = 0.001), and hypertension (p = 0.046) represented significant risk factors associated with functional AUB in perimenopausal women. Conclusions: During routine exams of women approaching menopause, gynecologists should emphasize the harms of smoking and alcohol use, as well as the significance of non-pharmacological and pharmacological methods for the treatment of obesity and hypertension

The Impact of Cytokines on Health-Related Quality of Life in Adolescents with Allergic Rhinitis

Background: Frequent episodes of nasal symptoms are the usual clinical manifestations (CM) of allergic rhinitis (AR) and have a significant negative impact on health-related quality of life (HRQoL) in adolescents. The purpose of this cross-sectional study was to test the hypothesis that cytokines in nasal mucus may be associated with HRQoL in adolescents with AR. Methods: European Quality of Life 5 Dimensions 3 Level Version (EQ-5D-3L), “The Adolescent Rhinoconjunctivitis Quality of Life Questionnaire” (AdolRQLQ) and the Total 4 Symptom Score (T4SS) scoring system were administered to 113 adolescents with AR, nonallergic rhinitis (NAR) and to healthy control subjects. Nasal secretions were sampled and tested for 13 cytokines using a multiplex flow cytometric bead assay. Results: The AR group had significantly lower EQ-5D-3L (0.661 ± 0.267 vs. 0.943 ± 0.088; p p p = 0.002), IL-6 (p = 0.031), IL-8 (p p = 0.013) and IL-18 (p = 0.014) compared to the control group, and IL-1β, IL-6, IL17-A and IL-18 were significantly (p < 0.050) increased with disease progression. Cytokines IL-1β, IL-6, as well as severe CM, were identified as significant predictors of lower HRQoL in adolescents with AR. Conclusions: This study identified IL-1β, IL-6, as well as severe CM, as predictors of lower HRQoL in adolescents with AR. However, these results should only serve as a starting point for additional confirmation research