Aims We evaluated the clinical value of selected serum biomarkers BMP-4, BMP-2, GDF-15, MMP-9, and GP39 in pregnant women with obesity and the comorbidities diabetes mellitus (DM) and gestational hypertension (GHT). Methods This observational study had groups of controls, including healthy pregnant women; women with only obesity, including pregnant women with BMI≥30 kg/m²; women with gestational DM (GDM) with obesity, including pregnant women with GDM and obesity; women with pregestational DM (PGDM) with obesity, including pregnant women with PGDM and obesity; and women with GHT with obesity, including pregnant women with GHT and obesity. We measured serum levels of selected biomarkers by ELISA. ResultsObesity increased serum levels of all the biomarkers; GDM developed in obese women caused a more pronounced increase in the serum levels of BMP-4 and BMP-2, and GHT developed in obese women caused a more pronounced increase in the serum levels of GDF-15. In the women with GDM-, PGDM-, and GHT-complicated obesity, serum levels of MMP-9 and GP39 did not change meaningfully. Conclusions Obesity and its comorbidities DM and GHT lead to meaningful changes in the studied serum biomarkers. Since obesity has a causal effect on developing numerous conditions, reliable clinical biomarkers are needed to improve the early prediction and diagnosis of high-risk conditions during pregnancy. Received: 29 March 2022 Accepted after revision: 16 August 2022 Article published online: 28 September 2022 © 2022. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

This study sought to translate the Antenatal Risk Questionnaire-Revised (ANRQ-R) into Turkish and evaluate its psychometric properties for assessing psychosocial vulnerabilities among Turkish-speaking pregnant women. The ANRQ-R was translated into Turkish following standard linguistic adaptation procedures. Psychometric properties were then examined using a cross-sectional study design, involving 156 pregnant women recruited from antenatal clinics in Turkey. Participants completed the Turkish ANRQ-R and the Edinburgh Postnatal Depression Scale (EPDS). Statistical analyses, including intraclass correlation coefficients (ICC) for test-retest reliability, Pearson correlation analysis for item-total test correlations, and Receiver Operating Characteristic (ROC) analysis for diagnostic accuracy, were conducted. The ANRQ-R Turkish version showed high test-retest reliability with an ICC of 0.888 for the total score. Moderate to good ICCs were obtained for individual Likert-type items (0.572–0.849). Criterion-related validity was established via moderate correlations with the EPDS and its anxiety subscale EPDS-3 A (r = 0.537 and r = 0.431, respectively). ROC analysis demonstrated good discriminatory power (Area Under the Curve = 0.75) with an optimal cut-off score of 17, yielding 78% sensitivity and 65% specificity for identifying potential depression cases. This study provides preliminary evidence of the overall reliability of the Turkish version of the ANRQ-R as a measure of psychosocial risk among Turkish-speaking women during pregnancy. Despite some limitations in item-level internal consistency indicators, integration of the ANRQ-R into routine antenatal care could enhance early identification and intervention strategies, potentially improving maternal health outcomes. Future research should aim to further validate the scale across diverse populations and settings, using a diagnostic tool as the reference standard.

Background: Missed abortion (MA) is a form of spontaneous abortion in which the embryo has died, but the body fails to recognize the pregnancy loss and continues hormone production, accounting for approximately 15% of clinically diagnosed pregnancies. The aim of this study was to compare inflammatory markers measured between 6 and 18 weeks of gestation in the same women during 2 different pregnancies: one that resulted in MA and another that resulted in a healthy birth. Methods: In this retrospective cohort study, medical records from 2016 to 2024 were reviewed. From 350 women with documented MA history, 300 were excluded (280 due to unavailable data from healthy pregnancies, 5 with thyroid disease, 3 with multiple gestations, 5 with coagulation disorders, 5 with chronic conditions, and 2 with fetal chromosomal abnormalities), resulting in 50 eligible participants. The study compared several inflammatory markers (neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, eosinophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, and systemic immune-inflammation index) between women with miscarriage and those with healthy pregnancies during the first and early second trimesters (6–18 weeks of gestation). Results: In the 50 women included in the study, hemoglobin levels were significantly higher in healthy pregnancies (12.6 g/dL in healthy pregnancy vs 12.05 g/dL in MA; P = .003). Platelet distribution width was also significantly higher in healthy pregnancy (15.60% vs 12%; P = .001). Similarly, eosinophil percentage was significantly higher in healthy pregnancy compared to MA (1.7% vs 1.15%; P = .047). However, inflammatory indices such as neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, eosinophil-to-lymphocyte ratio, and systemic immune-inflammation index did not show statistically significant differences between both pregnancy states ( P > .05). The ROC curve analysis showed that hemoglobin had the highest diagnostic performance (area under the curve = 0.72) with a sensitivity of 68%, specificity of 62%, positive predictive value of 64%, and negative predictive value of 66% at the optimal cutoff value of 12.3 g/dL. Conclusion: This study reveals that many inflammatory markers do not differ significantly between MA and healthy pregnancy in the same women. These findings suggest that inflammatory markers may be of limited value in predicting MA when individual variability is taken into account.