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    Breastfeeding Throughout Pregnancy in Turkish Women
    (Mary Ann Liebert, Inc, 2014) Ayrim, Aylin; Gunduz, Suzan; Akcal, Banu; Kafali, Hasan
    Introduction: Around the world, as well as in Turkey, women breastfeed their infants as long as possible. There is, however, a strong cultural taboo against continuing breastfeeding while having a new pregnancy. The aim of this study was to evaluate the outcome of pregnancies occurring during the lactation period and to determine whether lactation throughout the pregnancy had any adverse effects. This is the first study in Turkey to provide data on the association between the practice of lactation throughout pregnancy and outcome. Subjects and Methods: One hundred sixty-five multiparous women with singleton pregnancies who were >= 18 years of age, breastfeeding the previous child, and did not have systemic disease were included. Forty-five of the 165 pregnant women continued lactating, whereas 120 did not. We compared weight gain during pregnancy, hemoglobin level alterations, pregnancy complications, neonatal weight, and Apgar scores between the two groups. Results: Lactating pregnant women gained less weight than the nonlactating group, and the decreased level of hemoglobin during pregnancy was significant in the lactating group. Between the two groups, there was no statistically significant difference in hyperemesis gravidarum, threatened abortion, preeclampsia, premature labor and birth, neonatal weight, or Apgar scores. Conclusions: Breastfeeding during pregnancy is not harmful, and health professionals should not advise weaning if overlapping occurs and should observe mother, infant, and fetus closely for negative effects, and if a negative effect occurs they should take precautions.
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    Can either oral glucose challenge test or oral glucose tolerance test parameters predict gestational diabetes mellitus?
    (Springer India, 2017) Yildirim, Melahat; Kosus, Aydin; Kosus, Nermin; Hizli, Deniz; Akcal, Banu; Kosger, Hatice
    This study aims to evaluate the relationship between the glucose challenge test (GCT) levels and any of the oral glucose tolerance test (OGTT) parameters (fasting plasma glucose (FPG), 1-, 2-, or 3-h plasma glucose levels) and their effect on predicting gestational diabetes mellitus (GDM). This analysis was carried out as a retrospective study at Obstetrics and Gynecology Clinic of Turgut A-zal University Hospital. Oral GCT were conducted on patients who are at 24-29 weeks' gestation. The study participants with positive GCT results underwent a 3-h, 100-g OGTT, and the resulting values were evaluated using Carpenter and Coustan diagnostic criteria to determine the gestational glucose tolerance status of patients. The data obtained from both tests (GCT, FPG, 1-, 2-, 3-h OGTT values) were analyzed to observe the effect of each group on predicting GDM. Although all of the GCT and OGTT values were found to be statistically significant (p < 0.001) in determining GDM, the 2-h values of OGTT detected almost all GDM cases with a very high sensitivity level (94.5 %). The 1-h values on the other hand identified 87.6 % of GDM (p < 0.001). The GCT value with the highest sensitivity and specificity for predicting GDM was calculated as 154.50 mg/dl (sensitivity and specificity rates were 79.2 and 72.8 %, respectively). A 2-h OGTT glucose level can detect GDM with 94.5 % sensitivity. This result can guide clinicians to evaluate the patients with GDM.
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    Sleep deprivation in the last trimester of pregnancy and inadequate vitamin D: Is there a relationship?
    (Lippincott Williams & Wilkins, 2016) Gunduz, Suzan; Kosger, Hatice; Aldemir, Secil; Akcal, Banu; Tevrizci, Hatice; Hizli, Deniz; Celik, Huseyin Tugrul
    Background: Disturbed sleep is a significant health issue for pregnant women. Inadequate vitamin D intake is common among pregnant women and can affect many bodily systems. The purpose of this cross-sectional study was to test the hypothesis that serum vitamin D levels are low in pregnant women who have poor sleep quality in their last trimester. Methods: We enrolled 92 pregnant women who were admitted to the Maternity Clinic of Turgut Ozal University (Ankara, Turkey) in their last trimester. Venous blood sampling was performed to determine serum 25-hydroxyvitamin D levels. Sleep quality was measured by the Pittsburgh Sleep Questionnaire. The Student t test and Chi-square test were used to evaluate the relationships between variables. Logistic regression analysis was used to identify independent predictors of the vitamin D level. Results: The median score of the Pittsburgh Sleep Questionnaire was 6.2 +/- 3.3 (range, 1-17). We determined that 43.5% (40) of participants had poor sleep quality. The mean number of sleep hours at night was 8.6 +/- 1 hours (range, 6.30-11 hours), and the mean sleep latency was 20.3 +/- 12.7 minutes (range, 5-60 minutes). Vitamin D levels were measured for 87 participants; the median serum level of 25 (OH) vitamin D was 22.9 +/- 16.2 ng/mL (range, 4.9-99 ng/mL). Among all patients, we did not determine any significance between the vitamin D-deficient group and the non vitamin D-deficient group with regard to the Pittsburgh Sleep Questionnaire Inventory (PSQI) total score and subcomponents scores of the questionnaire (p > 0.05). Among 37 patients with poor sleep quality and for whom the vitamin D level was measured, 56.8% (21) women had vitamin D deficiency, and 81% (30) women had vitamin D insufficiency. However, we did not find any significance between participants with poor sleep and participants with good sleep quality with regard to age, occupational status, relationship with her partner, prepregnancy body mass index (BMI), weight gain during pregnancy, being primiparus, length of labor, and mode of delivery. Our findings further showed that being in a low income family was associated with poor sleep quality. Conclusion: Inadequate vitamin D and poor sleep quality are prevalent in pregnant women, but low levels of vitamin D are not associated with poor sleep quality. Further studies with larger sample sizes and studies that include preterm deliveries and special sleep disorders should be performed to understand this issue better. Copyright (C) 2015 Elsevier Taiwan LLC and the Chinese Medical Association. All rights reserved.
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    The Effect of Body Mass Index on Acne, Hirsutism and Menstrual Irregularity Symptoms in Turkish Adolescent Girls
    (Gazi Univ, Fac Med, 2013) Hizli, Deniz; Kosger, Hatice; Hacivelioglu, Servet; Kosus, Nermin; Kosus, Aydin; Kamalak, Zeynep; Akcal, Banu
    Purpose: The aim of the present study was to determine whether body mass index (BMI) influences polycystic ovary syndrome (PCOS) related symptoms such as acne, hirsutism and menstrual irregularity in a large healthy adolescent population. Methods: Self-administered questionnaires were distributed to all volunteer female students at 15 different secondary schools. The subjects' BMI, birthweight, age at menarche, pattern of menstrual cycle and presence of acne or hirsutism complaints were recorded. Subjects with BMI of = 18.4 kg/m 2, 18.5-24.9 kg/m(2), 25-29.9 kg/m(2) and > 30 kg/m(2) were defined as group 1, group 2, group 3 and group 4, respectively. The relation between BMI and the symptoms of acne, hirsutism and menstrual irregularity was analyzed. Results: A total of 1309 students filled the questionnaires properly and included in the study. Of these students, 314 were in group 1, 899 in group 2, 81 in group 3 and 15 in group 4. The median ages of participants were 16 years (range 13-20 years) and median age at menarche was 13 years (range of 11-16 years). A total of 106 (8.1%) participants reported various menstrual irregularity. Underweighed girls had significantly less acne (p= 0.001) and hirsutism problems (p<0.001) compared to normo weighed girls. Hirsutism incidence was significantly higher in overweighed girls than in normo weighed subjects (p<0.001). Conclusion: The present study provided the prevalence of PCOS related symptoms in population, including menstrual irregularity, acne and hirsutism according to BMI in a large adolescent population. Our results showed that menstrual irregularity was not significantly increased as BMI increased, however acne and hirsutism problems were significantly increased as BMI increased.