The Role of Inflammation and Psychological Distress in Habitual Abortion: Analysis of Cytokines, Coagulation Markers, and DASS-21 Scores Psikolojik Stres ve İnflamasyonun Habituel Abortus ile İlişkisi: DASS-21 ve Proinflamatuar Belirteçler Üzerine Bulgular

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Özkaya A., GÜRBÜZER N., YÖRÜK N., KADIOĞLU B. G., Çörek M. C., Akgül B. N.

Journal of Midwifery and Health Sciences, cilt.8, sa.4, ss.318-325, 2025 (Scopus, TRDizin)

Özet

Objective: Habitual abortion (HA) is defined as two or more consecutive miscarriages occurring before the 20th week of pregnancy and before the fetus reaches 500 grams, affecting approximately 1-2% of all pregnancies. Inflammation is a crucial factor in HA pathophysiology, with proinflammatory cytokines like Tumor Necrosis Factor-alpha (TNF-alpha) and Interleukin-8 (IL-8) potentially disrupting fetoplacental function. Psychological distress, particularly chronic stress, may also contribute by increasing inflammatory responses. This study investigates the relationship between inflammatory markers, hematological parameters, and psychological distress, as measured by the Depression Anxiety Stress Scales-21 (DASS-21), in HA patients. Methods: The study included 66 participants (34 HA patients, 32 healthy controls). Blood samples were analyzed for TNF-alpha, IL-8, Protein C, and Protein S levels, along with hematological parameters. Psychological distress was assessed using the DASS-21 scale. Data analysis involved independent t-tests, Pearson correlation, and logistic regression. Results: HA patients had significantly higher TNF-alpha (p=.023) and IL-8 (p=.034) levels and lower Protein C (p=.009) and Protein S (p=.026) levels than controls. DASS-21 scores were significantly higher in HA patients, positively correlating with TNF-alpha and IL-8. A one-unit increase in DASS-21 total score increased HA risk by 3.8 times (OR: 3.8, p=.024), while a one-unit increase in Protein C reduced HA risk by 0.8 times (OR: 0.8, p=.028). Conclusion: These findings suggest that inflammation and psychological distress play key roles in HA. Addressing inflammation and stress management may improve pregnancy outcomes in HA patients.