Objectives: Gestational diabetes mellitus (GDM) is a multifactorial metabolic disorder associated with altered glucose metabolism and systemic physiological adaptations during pregnancy. Subtle changes in renal-related biochemical parameters may reflect underlying metabolic alterations accompanying GDM. This study aimed to evaluate the association between maternal creatinine-to-body weight (Cre/BW) and urea-to-creatinine (Urea/Cre) ratios and GDM, with a particular focus on their potential role as renal–metabolic indicators during pregnancy. Methods: This retrospective case–control study included 1,064 pregnant women (532 with GDM and 532 matched controls) who underwent a 75 g oral glucose tolerance test between 24 and 28 weeks of gestation. Propensity score matching was applied to reduce baseline differences between groups. Maternal serum creatinine, urea, and body weight were recorded in the first and second trimesters, and Cre/BW and Urea/Cre ratios were calculated. Group comparisons, receiver operating characteristic (ROC) analyses, and multivariate logistic regression were performed. Results: In the second trimester, the Cre/BW ratio was significantly lower, and the Urea/Cre ratio was significantly higher in women with GDM compared with controls (both P<0.001). The Cre/BW ratio demonstrated moderate discriminatory ability for distinguishing GDM status (Area under the curve [AUC]=0.774), whereas the Ure/Cre ratio showed modest performance (AUC=0.614). In multivariate analysis, second-trimester Cre/BW and Urea/Cre ratios remained independently associated with GDM after adjustment for clinically relevant covariates. These results suggest a potential association; however, the discriminatory performance of the Cre/BW and Urea/Cre ratios should be regarded as exploratory rather than diagnostically definitive. Conclusions: Lower Cre/BW and higher Urea/Cre ratios were associated with GDM in this retrospective cohort. These findings suggest that simple renal-related biochemical ratios may reflect metabolic–renal adaptations in pregnancies complicated by GDM. However, given the modest diagnostic performance and retrospective design, these parameters should be considered exploratory indicators rather than standalone clinical tools. Further prospective studies are required to clarify their clinical relevance.

OBJECTIVES: This study evaluated the diagnostic performance of gamma-glutamyltransferase-to-platelet (GGT/PLT), aspartate aminotransferase-to-alanine aminotransferase (AST/ALT), and aspartate aminotransferase-to-platelet (AST/PLT) ratios in intrahepatic cholestasis of pregnancy (ICP), and their association with composite adverse perinatal outcomes (CAPO). STUDY DESIGN: A retrospective cohort analysis was conducted of 329 pregnant women (156 with ICP, 173 controls) who delivered at a tertiary center between November 2022 and November 2024. ICP was diagnosed in the presence of pruritus and fasting serum bile acid levels ≥10 μmol/L. Maternal demographics, liver enzymes, platelet counts, and perinatal outcomes were retrieved from hospital records. Ratios were calculated from second-trimester laboratory results. Diagnostic performance was evaluated using receiver operating characteristic (ROC) analysis. CAPO was defined as at least one of the following: preterm birth, fetal growth restriction, oligohydramnios/polyhydramnios, premature rupture of membranes, or intrapartum fetal distress. RESULTS: Compared with controls, the ICP group had higher GGT/PLT (0.05 [0.07] vs. 0.04 [0.07], p<0.001) and AST/PLT ratios (0.19 [0.30] vs. 0.07 [0.04], p<0.001), and a lower AST/ALT ratio (0.76 [0.55] vs. 1.09 [0.91], p0.083; sensitivity 77.3%; specificity 74.8%), followed by AST/ALT (AUC=0.788; cut-off 0.044; sensitivity 67.5%; specificity 64.1%). The ICP group had increased rates of preterm birth (33.3% vs. 10.8%, p<0.001), NICU admission (22.4% vs. 10.4%, p=0.003), and CAPO (50.0% vs. 13.9%, p<0.001), but none of the assessed ratios were significantly associated with CAPO in ICP cases. CONCLUSIONS: Among the indices evaluated, AST/ALT and AST/PLT ratios showed moderate-to-good accuracy in diagnosing ICP, while the GGT/PLT ratio exhibited moderate accuracy. These indices can be useful, cost-effective, and accessible adjunctive tools for ICP diagnosis, particularly in settings where bile acid testing is unavailable. However, their ability to predict perinatal outcomes is limited.

Asemptomatik bakteriüri varlığı, gebelerde taranması önerilen bir klinik durumdur. Bu çalışmada, asemptomatik gebelerde idrar kültürlerinde izole edilen mikroorganizmalar ve bu bakterilerin antibiyotik duyarlılık profillerinin değerlendirilmesi amaçlanmıştır. Kadın Hastalıkları ve Doğum Kliniği’nde Ocak 2023-Aralık 2023 tarihleri arasında ilk trimesterde başvuran asemptomatik gebelere ait idrar kültürü sonuçları retrospektif olarak incelendi. Kültürde üreme saptanan olgularda üreyen bakteriler ve antibiyotik duyarlılık sonuçları değerlendirildi. İncelenen 13827 kültür örneğinin 1283’ünde (%9.27) üreme saptandı. En sık izole edilen patojen Escherichia coli (%51.1) olup, bunu Streptococcus agalactiae (%21.8), Klebsiella pneumoniae (%11.0) ve Enterococcus faecalis (%6.4) izledi. Gram negatif bakteriler arasında amikasin, imipenem, meropenem ve gentamisin en etkili antibiyotiklerdi. E. coli izolatlarının amikasine %99.4, imipeneme %98.6 ve meropeneme %98.3 oranında duyarlı olduğu belirlendi. Gram pozitif bakterilerden E. faecalis, nitrofurantoine (%97.5) ve amoksisilin-klavulanik aside (%95.1) yüksek duyarlılık gösterdi. Çalışmamızda elde edilen veriler, gebelerde asemptomatik bakteriüri etkenlerinin dağılımı ve antibiyotik duyarlılık profilleri açısından ulusal ve uluslararası literatürle uyumlu bulunmuştur. Çalışmamıza göre fosfomisin ve nitrofurantoin gibi gebelikte güvenli ajanların yüksek duyarlılık oranları nedeniyle ampirik tedavide öncelikle tercih edilmesi önerilmektedir.