BACKGROUND: Pregnancy in women aged 35 years or above is generally considered an advanced maternal age (AMA). AMA is associated with an increased rate of maternal and neonatal complications. OBJECTIVES: Assess the effect of AMA on maternal and neonatal outcomes. DESIGN: Analytical cross-sectional study of medical records. SETTINGS: In-patient hospital tertiary care setting in Jeddah. PATIENTS AND METHODS: All women who attended antenatal care and delivered at King Abdulaziz Medical City in Jeddah in the first half of 2018 were included in the study. Outcomes for women 35 years of age or older were compared with younger women. Significant factors in a univariate analysis were entered in a multiple logistic regression model to assess the association between AMA and outcomes. MAIN OUTCOME MEASURES: Rates of maternal neonatal complications, analysis of factors associated with advanced maternal, gestational diabetes mellitus (GDM), cesarean delivery. SAMPLE SIZE: 1586 women. RESULTS: Of the 1586 women, 406 were 35 years of age or older (25.6%), and 1180 were younger than 35 years. The AMA group had a significantly higher proportion of GDM (32.0% versus 13.2%, P <.001). The adjusted odds ratio (OR) for GDM was 2.6 (95% CI 2–3.5, P <.001.) compared with younger women in the multivariate logistic regression analysis. Older women had a higher rate of cesarean delivery (43.6% versus 30.8%, P <.001). The adjusted OR for cesarean vs. vaginal delivery was 1.5 (CI 1.2–1.9, P =.002). CONCLUSION: Pregnancy in women 35 years or older was associated with an increased risk of GDM and cesarean delivery. LIMITATIONS: Cross-sectional design, small sample size, single hospital. CONFLICT OF INTEREST: None.
Introduction: Crohn's disease (CD) and ulcerative colitis (UC) are chronic inflammatory bowel diseases (IBD) that affect the gastrointestinal tract with no identified etiology. IBD has been associated with several extraintestinal manifestations (EIMs), including renal involvement such as renal stones (nephrolithiasis), resulting in significant morbidity. This study aims to estimate the prevalence of renal stones among IBD patients in Saudi Arabia.Methods: This is a retrospective study conducted at King Abdulaziz University Hospital between January 2019 and December 2020. All IBD patients with abdominal imaging studies were included in the study regardless of their age. Data were collected from the electronic hospital information system and analyzed.Results: A total of 363 IBD patients fulfilled the study inclusion criteria. Nephrolithiasis was detected radiologically in 3.6% of the cohort (5.1% of UC and 2.7% of CD patients). Patients with renal stones are older (P=0.002) and more likely to be diabetic (P=0.047), have microscopic hematuria (P<0.001), and proteinuria (P=0.002). Binary logistic regression analysis showed that older age at diagnosis (P=0.003) and microscopic hematuria (P=0.02) are independent predictors for renal stones. Conclusion:The study reported that 3.6% of Saudi IBD patients had renal stones, with a higher prevalence of renal stones formation among UC patients than Crohn's. Older age at diagnosis and the presence of microscopic hematuria may predict the development of renal stones. Future studies should be conducted in a prospective manner at multiple centers across Saudi Arabia for further investigation.
Background: Inflammation is a recognized factor in cancer progression and resistance to treatments. Several studies correlated inflammatory-related peripheral blood indices to disease progression and poor survival in various cancer types and different populations. Nonetheless, inflammation is affected by the distinctive characteristics and environmental exposure of each people. Methods: We retrospectively analyzed the data of female patients with LABC undergoing neoadjuvant chemotherapy (NACT). Demographics, BMI, clinicopathologic characteristics, stage of the tumor, follow-up status, and response to treatment were collected. Outcomes were evaluated concerning the high and low groups of inflammatory markers based on the cut-off values of NLR and RDW. Results: A total of 172 patients met the eligibility criteria among patients diagnosed with breast cancer (BC) from January 2014 to December 2020. At the time of diagnosis, the mean age was (53.4± 11), BMI was (31.2 ± 6). Left BC accounted (54.7%) and the majority were moderately differentiated (51.2%), and ductal carcinoma (85.5%), ER-positive tumor in (79.1%), HER2-positive in (32%), TNBC in (9.8%). Only normal RDW and Low NLR were significantly associated with a type of response post NACT with P values (0.003) and (0.014) respectively, with significant response type complete remission (71.5%) based on the radiological evaluation. Conclusion: RDW and NLR could be applicable biomarkers to predict response after systemic therapy among LABC. The great advantage of these biomarkers depends on routine tests before treatment, and it is cost-effective in the diagnostic plan.
Background: Inflammation is a recognized factor in cancer progression and resistance to treatment. Several studies correlated inflammation-related peripheral blood indices (PBI) to disease progression and poor survival in various cancers and different populations. Nonetheless, inflammation is affected by the distinctive characteristics and environmental exposure of each population. There is no prior study addressing the association of pre-treatment inflammatory markers with outcomes in patients with BC from Saudi Arabia. In this study, we evaluated post-treatment response of LABC in relation to inflammation-related PBI. Methods: We retrospectively analyzed the data of female patients with LABC undergoing neoadjuvant chemotherapy (NACT). Demographics, BMI, clinicopathologic characteristics and stage of the tumor, follow-up status and response to treatment were collected. Outcomes were evaluated in relation to pre-treatment PBI that were grouped based on the local laboratory cutoff values. Response rate (RR) and type was assessed according to post-NACT radiologic evaluation of the breast and subcategorized into complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD). Results: A total of 172 female patients with BC met the eligibility criteria from January 2014 to December 2019. The mean age at diagnosis was 53±11, and BMI was 31±6. Left BC accounted for 55% and the majority was invasive ductal carcinoma in 85.5%, moderately differentiated in 51%, stage III (AJCC 8th edition) in 73%, and HR-positive tumor in 79%. HER2-positive BC was reported in 32% and TNBC in 10%. Radiologic (CR) accounted for the majority of RR (71.5%). A higher percentage of patients with normal red cell distribution width (RDW) and low neutrophil to lymphocyte ratio (NLR) had radiologic CR with a significant P-value of (0.003) and (0.014), respectively (Table 1). Conclusion: Among several peripheral blood indices, only RDW and NLR significantly influenced post-treatment response in this cohort. They can be explored further to potentially predict response after systemic therapy in patients with LABC. The great advantage of these biomarkers stems from their availability and affordability in routine clinical practice. Table 1.Post-treatment response type & distribution according to inflammation-related peripheral blood indicesVariablesCR(N=123)PR(N=20)SD(N=23)PD(N=6)P valueN=172N(%)N(%)N(%)N(%)NLR High >322(81%)2(7%)0(0%)3(11%)0.014Low ≤3101(70%)18(12%)23(15%)3(2%)RDW High >14.122(92%)2(8%)0(0%)0(0%)0.003Normal 11-14.1100(69%)18(12%)23(16%)5(3%)Low <111(50%)0(0%)0(0%)1(50%) Citation Format: Atlal Abusanad, Abdullah M Alghamdi, Ahmed M Saggaf, Tala Gazzaz, Rival Brika. The influence of pre-treatment peripheral blood inflammatory markers on post-treatment response in patients with locally advanced breast cancer (LABC) from Saudi Arabia [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P1-08-29.
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