Examining the effect of COVID-19 vaccines on the menstrual cycle: A study from Turkey.

Concerns about a possible relationship between vaccination against Coronavirus Disease 2019 (COVID-19) and menstrual disorders have been raised in the media. In addition, different studies have shown that the COVID-19 vaccine may be associated with menstrual changes. This study was conducted to investigate the effects of COVID-19 vaccines on the menstrual cycle in women. This cross-sectional descriptive study was conducted between August 16 and September 17, 2021. Data were collected through a self-administered questionnaire via an online form sent to the participants through social media. Data of 586 women were included in this study. A total of 82.4% (n = 483) of the participants were aged between 31 and 50 years. The BioNTech vaccine (2 doses) was administered to 75.8% (n = 444), Sinovac (3 doses) to 9.0% (n = 53) of the participants. 53.1% (n = 311) of the women experienced changes in their menstrual cycles. The most common menstrual changes after vaccination were delayed menstruation (n = 176; 30.0%) and prolonged menstrual duration (n = 132; 22.5%). Menstrual delay, prolonged menstrual duration, heavy bleeding, and early menstruation were more common in women than prior to receiving the vaccine (P < .05). More than half of the women experienced menstrual cycle changes after receiving the COVID-19 vaccine. Women experienced significantly higher rates of menstruation delay, prolonged menstrual duration, heavy bleeding, and early bleeding compared to before vaccination.

Retinol Depletion in COVID-19.

Background and aims: COVID-19 has been a devastating pandemic. There are indications that vitamin A is depleted during infections. Vitamin A is important in development and immune homeostasis. It has been used successfully in measles, RSV and AIDS infections. In this study, we aimed to measure the serum retinol levels in severe COVID-19 patients to assess the importance of vitamin A in the COVID-19 pathogenesis. Methods: The serum retinol level was measured in two groups of patients: the COVID-19 group, which consisted of 27 severe COVID-19 patients hospitalized in the intensive care unit with respiratory failure, and the control group, which consisted of 23 patients without COVID-19 symptoms. Results: The mean serum retinol levels were 0.37 mg/L in the COVID-19 group and 0.52 mg/L in the control group. The difference between the serum retinol levels in the two groups was statistically significant. There was no significant difference in retinol levels between different ages and genders within the COVID-19 group. Comorbidity did not affect serum retinol levels. Conclusion: The serum retinol level was significantly lower in patients with severe COVID-19, and this difference was independent of age or underlying comorbidity. Our data show that retinol and retinoic acid signaling might be important in immunopathogenesis of COVID-19.

The relationship between CEA and CA 15-3 positivity and metabolic and volumetric 18F-FDG PET/CT parameters in preoperative evaluation of breast cancer.

OBJECTIVE: We aimed to examine the relationship between tumor marker (Cancer Antigen 15-3 [CA15-3] and Carcinoembryonic Antigen [CEA]) positivity and metabolic (standardized uptake value [SUV]) and volume-based (metabolic tumor volume [MTV] and total lesion glycolysis [TLG]) 18F-Fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) parameters of the primary tumor and lymph node. MATERIAL AND METHODS: Our study group consisted of 91 female patients, who underwent PET/CT between January 2018 and December 2019 in our clinic with a diagnosis of breast cancer. These patients had no distant metastasis or supraclavicular and internal mammarian lymph node metastasis. MTV, TLG, and SUVmax values were obtained from the primary breast lesion and axillary lymph nodes. RESULTS: The mean age of the patients, who participated in the study, was 52,19±14,57, and the median values of the primary tumor MTV, TLG, and total MTV values were found to be statistically significantly higher in those who were CEA positive compared to those who were CEA negative. The median SUVmax value of the axillary lymph node was found to be statistically significantly higher in those who were CEA positive compared to those who were CEA negative (p: 0.004). There was no statistically significant difference between the other parameters. CONCLUSION: There was a statistically significant correlation between CEA positivity in preoperative primary breast cancer and primary tumor volume MTV, TLG, and total MTV values, which are volume-based PET parameters. CEA positivity evaluation may indicate increased tumor load in preoperative. KEY WORDS: Breast Cancer, CEA, CA 15-3, MTV, TLG, FDG PET/CT.

The effect of empagliflozin on P wave peak time and other P wave parameters in patients with diabetes mellitus.

BACKGROUND: Empagliflozin is a selective SGLT2 inhibitor and provides a significant reduction in hospitalizations in heart failure patients and a reduction in combined cardiovascular deaths regardless of diabetes. The mechanisms of favorable effects remain unclear. Improvement in left ventricular diastolic function and a decrease in filling pressure are any mechanisms of positive effects. These effects may show themselves with some changes on the electrocardiography (ECG). So, we aimed to evaluate the effect of empagliflozin on P wave parameters in type 2 diabetes mellitus patients without HF. METHOD: Fifty-three patients were included in the study. The electrocardiographic and echocardiographic evaluations were examined at the baseline and end of the third month for all patients. RESULTS: The median age of all patients was 55 (45-64 IQR). After treatment, LA volume (p <.001) and diameter (p = .001) in both the parasternal long-axis (p = .001) and the apical four-chamber view decreased. E/e' and systolic pulmonary arterial pressure were significantly decreased after treatment. P wave duration max,min, PWDmin, and PWdis were significantly shorter after treatment. The P wave peak time (PWPT) in lead Dii and V1 were significantly shorter after treatment. CONCLUSION: We found shortening of PWPT, PWdis, and PWD as reflections of improvements in left atrial volume and LV diastolic function on ECG after empagliflozin treatment.

Investigation of corneal topographic and densitometric properties of Wilson's disease patients with or without a Kayser-Fleischer ring.

BACKGROUND: To investigate the topographic measurements and densitometry of corneas in Wilson's disease (WD) patients with or without a Kayser-Fleischer ring (KF-r) compared to healthy individuals. METHODS: This cross-sectional study included 20 WD patients without a KF-r (group I), 18 WD patients with a KF-r (group II), and 20 age-matched controls (group III). The Pentacam high resolution imaging system is used to determine corneal topographic measurements and densitometry. RESULTS: Mean age for groups I, II and III was 25.40 ± 6.43 years (14-36 years), 25.38 ± 6.96 years (16-39 years), 23.60 ± 6.56 years (17-35 years), respectively (P = 0.623). There was no significant difference between the groups in terms of the anterior corneal densitometry values (P > 0.05), while the 6-10 mm and 10-12 mm mid stroma and the 2-6 mm, 6-10 mm, and 10-12 mm posterior corneal densitometry values in group II were significantly higher than those in groups I and III (for all values, P <  0.05). However, the 10-12 mm posterior corneal densitometry values in group I were also significantly higher than those in group III (P = 0.038). The central corneal thickness (CCT), thinnest corneal thickness (tCT), and corneal volume (CV) values in groups I and II were significantly lower than those in group III (for CCT values, P = 0.011 and P = 0.009; for tCT values, P = 0.010 and P = 0.005; for CV values, P = 0.043 and P = 0.029). CONCLUSION: In WD patients with a KF-r, corneal transparency decreased in the peripheral posterior and mid stromal corneal layers; for these patients, corneal transparency may be impaired not only in the peripheral cornea but also in the paracentral cornea.

Estimation of bone mineral density with hounsfield unit measurement.

OBJECTIVE: Although dual-energy x-ray absorptiometry (DXA) remains the gold standard for the measurement of bone mineral density (BMD), degenerative spine and spinal instrumentation yields inaccurate results, warranting the need for optional methods. METHODS: Surgical options depend on the BMD of the patients, and to accommodate this need, we compared Hounsfield unit (HU) measurements obtained from computed tomography (CT) scans with the T-scores obtained from DXA scans to inquire whether HU measurements can screen for BMD. In this study, we also evaluated the relationship between body mass index and spontaneous fractures. RESULTS: Based on the findings described in this study, we provide evidence that HU measurements obtained from CT scans can predict BMD. CONCLUSIONS: This, therefore, allows HU measurements to be used as an effective diagnostic method in lieu of DXA scans when deciding on appropriate management of therapy for patients with spinal instrumentation or degenerative spines.

Effect of isotretinoin (13-cis-retinoic acid) on levels of soluble VEGF receptors (sVEGFR1, sVEGFR2, sVEGFR3) in patients with acne vulgaris.

BACKGROUND/AIM: The effect of isotretinoin on soluble VEGFRs has not been previously investigated. This study evaluate the effects of isotretinoin (13-cis-retinoic acid) on soluble VEGFR1 (sVEGFR1), soluble VEGFR2 (sVEGFR2) and soluble VEGFR3 (sVEGFR3). METHODS: The study included 38 patients (28 females, 10 males) receiving systemic isotretinoin treatment and 38 healthy individuals (28 females, 10 males) with similar age and gender characteristics. The blood samples of the patient group at third months and blood samples of the control group were compared in terms of sVEGFR1, sVEGFR2 and sVEGFR3 concentrations. RESULTS: It was significant that sVEGFR1 was low and sVEGFR3 was high in patients receiving isotretinoin (p: .038, p: .021, respectively). There was no significant change in sVEGFR2 levels between the groups (p: .519). CONCLUSIONS: We think that the effect of isotretinoin on sVEGFR1, sVEGFR2 and sVEGFR3 may be secondary to its effects on the VEGF family. However, after clarifying the effect of isotretinoin on the VEGF family, we think that it can be used in some tumors and vascular diseases.

Evaluation of the subfoveal choroidal and outer retinal layer thickness in obese women.

CLINICAL RELEVANCE: Obesity has become one of the most important health problems of today with its increasing prevalence. With the development of retinal imaging systems, obesity has been observed to be associated with changes in outer retinal layers and choroid in women. BACKGROUND: The aim of this study was to examine retinal layer parameters and their relationship with body mass index in obese women. METHODS: The study included 197 eyes of 197 women, of whom 44 were normal-weight, 40 were overweight, 40 were class 1 obese, 38 were class 2 obese, and 35 were morbidly obese. The thickness of the choroid was measured manually using an enhanced-depth imaging optical coherence tomography scanning program. RESULTS: The mean choroidal thickness values in five locations were lower than those of normal-weight, overweight, class 1, and class 2 obese women, in morbidly obese women (p < 0.05 for all). Subfoveal outer retinal layer thickness and specific sublayer thickness of the photoreceptor layer values were significantly lower in morbidly obese women than in normal-weight women, but there were no statistically significant differences between the groups in retinal pigment epithelium thickness and Bruch's membrane thickness (p = 0.001, p < 0.001, p = 1.00, and p = 0.101, respectively). Furthermore, there were significant negative relationships between body mass index and subfoveal choroidal thickness, subfoveal outer retinal layer thickness, and specific sublayer thickness of the photoreceptor layer values (r = -0.327, p < 0.001; r = -0.259, p < 0.001; and r = -0.281, p < 0.001, respectively). CONCLUSIONS: Morbid obesity was associated with a thinner choroid, subfoveal outer retinal layer, and specific sublayer thickness of the photoreceptor layer in women. Furthermore, retinal hypoxia associated with morbid obesity may be related to a decrease in photoreceptor layer thickness. Thinning of the outer retinal layer may also lead to atrophy of the cone sheath.

Changes in choroidal thickness after vitamin D supplementation in patients with vitamin D deficiency.

OBJECTIVE: To determine the relationship between vitamin D (vit D) deficiency and choroidal thickness and to investigate changes in choroidal thickness after vit D treatment. METHODS: Sixty-five patients diagnosed with vit D deficiency (group 1) and 60 healthy individuals with normal vit D levels (group 2) were included in the study. The choroidal thickness in the subfoveal, nasal, and temporal regions of the fovea were measured manually using enhanced depth imaging optical coherence tomography. The choroidal thickness in the patients in group 1 was re-evaluated after treatment with vit D. RESULTS: The groups were similar in terms of age and sex (p = 0.138 and p = 0.198, respectively). The subfoveal, temporal (500 and 1.500 µm), and nasal (500 and 1.500 µm) choroidal thickness values in group 1 were statistically significantly lower than those in group 2 (p < 0.001 for all). After vit D replacement therapy, there was a significant increase in the choroidal thicknesses compared with the pretreatment measurements (p < 0.001 for all). There was a positive correlation between vit D values and subfoveal, temporal (500 and 1.500 µm), and nasal (500 and 1.500 µm) choroidal thickness values (r = 0.558 and p < 0.001, r = 0.415 and p < 0.001, r = 0.352 and p < 0.001, r = 0.349 and p < 0.001, and r = 0.294 and p = 0.001, respectively). CONCLUSION: The choroidal thickness decreased in patients with vit D deficiency. The choroidal thickness values increased after vit D replacement therapy. Serum vit D levels should be assessed in studies evaluating choroidal thickness.

Isotretinoin does not alter VEGF-A and VEGF-C levels: do retinoids behave differently in dose-dependent and/or in vivo/in vitro conditions?

BACKGROUND: It is seen that various forms of retinoids have different results on VEGF-A and VEGF-C levels when tested at different dosages, in different diseases and under different conditions such as in vivo or in vitro. OBJECTIVE: To evaluate the effects of isotretinoin on VEGF-A and VEGF-C levels in humans. METHODS: Blood samples at the third month of the patient group and blood samples of the control group were compared in terms of VEGF-A and VEGF-C concentrations. RESULTS: No statistically significant difference was observed between the patient group and the control group in terms of VEGF-A and VEGF-C levels. LIMITATIONS: Most of the patients discontinued treatment and could not reach the required number, the study was converted to case-control. CONCLUSIONS: We think that 0.5 mg/kg/day isotretinoin has no effect on blood concentrations of VEGF-A and VEGF-C in humans. Therefore, there is a need for studies using isotretinoin in different doses and durations in humans in order to better evaluate its effects.

Evaluation of prognosis and nephrotoxicity in patients treated with colistin in intensive care unit.

INTRODUCTION: Nephrotoxicity is the most important adverse effect of colistin therapy. We investigated the frequency of nephrotoxicity, risk factors related to nephrotoxicity, and its relationship with mortality in patients who received intravenous colistin in intensive care units (ICUs). MATERIALS AND METHODS: We retrospectively reviewed the data of patients who received intravenous colistin in ICUs between 2011 and 2017. Acute kidney injury (AKI) diagnosis and staging were made based on the Kidney Disease Improving Global Outcome criteria. RESULTS: There were 149 patients included in the study with 61% being male. The mean age was 58.7 ± 20.3 years. AKI was detected in 96 (64.4%) patients. There were 25 patients with AKI stage 1 (16.8%) and 71 patients with AKI stage 2 or 3 (47.7%). Advanced age (65.0 vs. 47.4 years; p < .001), diabetes mellitus (p < .001), heart failure (p = .01), high APACHE II score (31.7 vs. 28.08, p = .019), and inotrope usage (p = .01) were found as risk factors for AKI. The 14-day mortality rate was higher in the AKI group (p = .027). DISCUSSION: Higher AKI and mortality rates are observed in patients with diabetes, heart failure, advanced age and the hemodynamically impaired. However, it is a fact that there are no alternative therapies other than colistin in the treatment of multidrug-resistant Gram-negative bacterial infections. Therefore, the development of AKI in this patient group should not be considered a sufficient reason for discontinuing colistin treatment. Understanding the risk factors in this potential nephrotoxic treatment can provide a more careful patient follow-up.

Associations of volumetric whole-body 18F-FDG PET/CT parameters with the CA 19-9 level and haemogram parameters in pancreatic adenocarcinoma.

OBJECTIVE: The present study compared metabolic and volumetric fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) parameters [metabolic tumour volume (MTV), total lesion glycolysis (TLG), and maximum standardized uptake value (SUVmax)] with carbohydrate antigen (CA) 19-9 tumour marker levels and haemogram parameters [(neutrophil-lymphocyte ratio, mean platelet volume (MPV), and platelet-lymphocyte ratio] as prognostic and diagnostic markers of pancreatic cancer. MATERIAL AND METHODS: A total of 66 patients who underwent 18F-FDG PET/CT in our nuclear medicine clinic between February 2017 and March 2019, and had a diagnosis of pancreatic adenocarcinoma, were included in this retrospective study. The enrolled patients had not been administered steroids or operated on. Among these patients, whose haemogram parameters and tumour markers could not be assessed by PET/CT within the same week were excluded. The MTV, TLG, and SUVmax values were calculated from primary tumours and metastases in all patients. RESULTS: Spearman's rho correlation, used to examine the relationship between the CA 19-9 level and PET parameters, revealed a statistically significant positive correlation of CA 19-9 with the whole-body MTV (MTVWB) (P<0.001) and whole-body TLG (TLGWB) (P<0.001). Although no significant relationship was found between the neutrophil count and TLGWB according to Spearman's rho correlation, in an artificial neural network using the hidden layer activation function, the neutrophil count showed the strongest association with MTVWB among all included variables. The primary pancreatic tumour MTV and TLG values showed statistically significant positive correlations with the metastases MTV, metastases TLG, MTVWB, and TLGWB values. CONCLUSION: The CA 19-9 level is considered an important marker of tumour load; it shows a statistically significant positive correlation with parameters such as MTVWB and TLGWB, which provide a measure of the whole-body tumour load. It appears that the MTV and TLG values of the primary pancreatic tumour could also be used as markers of the whole-body tumour load, given their associations with MTVWB and TLGWB.

Evaluation of catalase, myeloperoxidase and ferroxidase values in pregnant women with hyperemesis gravidarum.

OBJECTIVES: To investigate maternal serum catalase, myeloperoxidase and ferroxidase levels in pregnant women withHyperemesis Gravidarum and to compare the results with healthy pregnancies. MATERIAL AND METHODS: In this study, 60 female patients admitted to the Health Sciences University, Gazi Yasargil Trainingand Research Hospital, Gynecology and Obstetrics Department were evaluated. The patients were divided into two groups:Group 1 included 30 pregnant women with hyperemesis gravidarum; Group 2 included 30 healthy pregnant women.Pregnancies over 14 weeks were excluded from the study. RESULTS: The laboratory and laboratory characteristics of both groups are shown in Table 1. No significant differences werefound between the groups in terms of the maternal age, gestational age, gravidity, parity, fasting glucose level, and BMI.The maternal blood CAT levels were significantly higher in the HG group (219.6 ± 111.3 kU/L) when compared to the controlgroup (71.5 ± 52.5 kU/L) (p < 0.001). The maternal blood MPO levels were lower in the control group (121.5 ± 36.3 U/L)than in the study group (90.9 ± 56.4 U/L) (p = 0.016). However, the ferroxidase levels were similar between the twogroups. The independent variables BMI, age, parity, gravidity and gestational week effects were adjusted according to thelogistic regression method with groups. Significant differences were observed between the two groups in the levels ofCAT (0.001), MPO (0.005) values. CONCLUSIONS: This study suggests that antioxidants in response to oxidative stress gave different reactions with differentmechanisms; Also, we believe that insufficient food intake suppresses the immune system and this has an important roleon antioxidants.

[Evaluation of Infections in Intensive Care Units: A Multicentre Point-Prevalence Study]. / Yogun Bakim Ünitelerindeki Enfeksiyonlarin Degerlendirilmesi: Çok Merkezli Nokta Prevalans Çalismasi.

Infection control is a top priority for hospitals, especially in intensive care units (ICU). In intensive care units, prevalence of infection is estimated to be 30% worldwide, which is a major cause of morbidity and mortality. Many factors are known to increase the risk of infection in ICU patients. Since each of these may lead to different infections, it is important to recognize and identify predisposing factors for early diagnosis and treatment. The regional health care-associated infections (HCAI) prevalence and distribution of risk factors are important strategies in infection control. In this regard, the aim of this point prevalence study was to obtain data related to infections, the prevalence of HCAI among these infections, the epidemiology, agents and antibiotics used among adult ICU patients in the university hospitals, training and research hospitals and public hospitals located in eight of the cities of our region. In the light of these data, we aimed to review and emphasize the guidelines on HCAI prevention. The study included adult ICU patients followed up in nine hospitals in the Eastern and South-eastern Anatolia Regions of eight different cities (Sivas, Erzurum, Mardin, Batman, Diyarbakir Elazig, Van, Adiyaman) in Turkey. Of the hospitals six were university hospitals, one was training and research hospital, and two were public hospitals. The number of beds ranged from 358 to 1418. A specific day was determined on which the researchers concurrently carried out a prospective surveillance in all adult intensive care unit patients. The researchers collected data and recorded the demographic characteristics (age, gender), underlying diseases, length of hospital stay, presence of invasive intervention (urinary catheter, central venous catheter, external ventricular drainage, mechanical ventilator, presence of risk factors such as burn, trauma and surgery, number of infection cases, type of infection (hospital-acquired, community-acquired), type of microorganisms and whether polymicrobial or monomicrobial, which antibiotics were administered, and duration of antibiotic treatment. Our study assessed data of 429 inpatients in the adult ICU of nine hospitals in eight different cities. There were a total of 881 intensive care beds in these hospitals, and 740 (84%) beds were occupied. Of the study group 49.7% was male with a mean age (min-max) of 64.08 ± 18.78 (2-97) years. The point prevalence of HCAI was 21.7% (n= 93). Of the patients who were followed-up 182 (42.4%) presented infections. Of these infections, 21.4% were diagnosed as community-acquired pneumonia, 18.6% were ventilator-associated pneumonia (VAP), 16.3% were communityacquired urinary tract infection (UTI), and 16.3% were bloodstream infection. In addition, the most commonly administered antibiotics in the study group were piperacillin/tazobactam, carbapenem, quinolone and ceftriaxone, respectively. The most common types of HCAI were community-acquired pneumonia (10.7%), ventilator-associated pneumonia (8.9%) and bloodstream infections (8.2%). The mean length of hospital stay was 32.05 ± 66.85 (1-459) days and the mean duration of antibiotic therapy in patients with HCAIs was 7.76 ± 7.11 (1-41) days. The most widely accepted method to handle infection is to carry out active, prospective and patient-based surveillance studies on a regular basis, and to take control measures and arrange appropriate treatment in the light of the data obtained. We attribute the high prevalence of HCAI in our region to lack of personnel, lack of materials, inappropriate use of antibiotics, insufficiency of physical conditions, and little support for infection control committees. In conclusion, we emphasize that it is of importance to work closely with the hospital administration to take measures and that necessary assistance is provided.

Can clomiphene citrate resistance be predicted by RDW-CV levels in infertile women with PCOS?

OBJECTIVE: To identify whether red blood cell distribution width coefficient of variation (RDW-CV) and mean platelet volume (MPV) levels can predict clomiphene citrate resistance (CC-R) in infertile, anovulatory females with polycystic ovarian syndrome (PCOS). METHODS: A total of 89 infertile patients who were admitted to a tertiary center diagnosed with non-obese PCOS were included in this study. The patients were divided into two groups: the first group comprised 53 non-obese patients with PCOS and CC-R, and the second group included 36 non-obese patients with PCOS and CC-S. RDW-CV, RDW-SD, and MPV values, along with routine whole blood count parameters were compared between the groups. RESULTS: RDW-CV values were found to be significantly higher in the patients with CC-R compared to those with CC-S (P < 0.05). The sensitivity, specificity, positive, and negative predictive values were found to be 69%, 58.1%, 34.5%, and 12.5%, respectively, at an RDW-CV level of 12.85. The odds ratio was calculated as 3.077 (95% CI 1.245-7.603) in terms of the cut-off point. CONCLUSION: We think that RDW-CV which is a marker of inflammation is a simple, cheap, and accessible marker for the prediction of CC resistance.

Maternal hypoglycaemia on the 50 g oral glucose challenge test - evaluation of obstetric and neonatal outcomes.

OBJECTIVES: To discuss obstetric and neonatal outcomes of maternal hypoglycaemia observed after the 50 g oral glucose challenge test. MATERIAL AND METHODS: A retrospective evaluation was made of the results of patients at 24-28 weeks gestation of a live singleton pregnancy who underwent a 50 g OGCT at the Health Sciences University Gazi Yasargil Training and Research Hos-pital, between September 2016 and August 2017. In the 50 g OGCT, 1-hour blood glucose results were divided into Low OGCT (< 90 mg/dL) and Normal OGCT (90-139 mg/dL). The groups were compared in respect of obstetrics and neonatal outcomes. RESULTS: Of 2623 pregnant patients applied with the 50 g OGCT, blood glucose was < 140 mg/dL in 77.16% (n = 2024), with 11.9% (n = 312) in the Low OGCT group, and the remaining 65.26% (n = 1712) in the Normal OGCT group. Based on the comparison of the groups, the SGA rate was 7% in the Low OGCT group and 4% in the Normal OGCT group; the 5th minute APGAR score was < 7 in 2% of the Low OGCT group and in 1% of the Normal OGCT group, while caesarean section rates were 25% and 32% respectively (p < 0.05). CONCLUSIONS: The results of the study showed a significant association between maternal hypoglycaemia and increased SGA rate, decreased 5-minute APGAR scores and reduced caesarean section rates, and this relationship should be confirmed with further comprehensive studies.