To identify the underlying factors that may affect the changing rates of modes of delivery over the decades based on Robson-10 group classification system (TGCS) in a single tertiary health care ce...

Aim: To investigate the relationship of cholelithiasis and urolithiasis with Methylenetetrehydrofolate Reductase (MTHFR) polymorphism(s) in patients with poor obstetric history to search whether they are risk factors for adverse pregnancy outcome. Materials and Method: This study is consisted of 94 patients with poor obstetric history. Patients were evaluated in terms of the presence of cholelithiasis and urolithiasis in association with MTHFR polymorphism(s). Additional laboratory tests including homocysteine measurements were also performed. ROC analysis for assessing the performance of blood homocysteine level in predicting the presence of cholelithiasis and urolithiasis were also performed. Results: Patients were divided into three groups such as cholelithiasis group (n = 9, 9.6%), urolithiasis group (n = 18, 19.1%) and control group (n = 67, 71.3%). Groups did not differ in term of age and Beksac obstetrics index (BOI) which is “[living child+(π/10)]/gravidity.” The rate of the presence of MTHFR polymorphisms were 88.9% (8/9), 88.9% (16/18) and 43.3% (29/67) in cholelithiasis, urolithiasis and control groups respectively. Median homocysteine levels were found to be 13.1, 11.6 and 7.2 micromol/lt for the groups respectively. Statistically significant differences were found for MTHFR polymorphism rates and homocysteine levels (<0.001 for both). According to ROC analysis, 10.9 mcmol/L (88.9% sensitivity, 89.6% specificity) and 9.25 mcmol/L (83.3% sensitivity, 73.1% specificity) were determined to be cutoff values of homocysteine for cholelithiasis and urolithiasis respectively. Conclusion: More frequent MTHFR polymorphisms are observed in women with a clinical history of gall or renal stones. Thus, screening of these patients may be benefical for the approprate management of their subsequent pregnancies.

In this study we aimed to investigate the levels of selected heavy metals and trace elements (Hg, Pb, Cd, As, Mn, Se, and Cu) in three different biomatrices—maternal urine (Mu), neonatal urine (Nu), and cord blood—of preterm newborns born at less than 35 weeks’ gestation who were staying in the NICU and their mothers, and the relationships of these elements with maternal and neonatal characteristics. Cord Pb, As, and Hg were significantly lower than in Mu, whereas Se and Cu were higher (p < 0.001). All elements were excreted more in Mu than in Nu (p < 0.001). Nu levels of Cd, Mn, Se, and Cu were lower, while As and Hg were higher than in cord blood. Nu metal excretion increased significantly over time (p < 0.001). Positive correlations were found between MuCu and NuCu (r_s = 0.35) and between maternal Se and maternal age (r_s = 0.41). NuHg, MuMn, and cord Mn showed negative correlations with penile length, and NuHg was also negatively correlated with anogenital distance. The first and second NuPb levels were positively correlated with birth weight percentile. The findings suggest transplacental transmission and ongoing exposure to heavy metals and trace elements in preterm infants, highlighting the importance of prenatal environmental exposure awareness for healthcare providers.