ACTA ENDOCRINOLOGICA (BUC)

Background. High-risk-HPV, metabolic disorders, and prior cesarean scar have been linked with adverse obstetric outcomes, but their combined effects are unclear. Methods. Retrospective cohort of 185 pregnancies at a Romanian tertiary center (2021–2024) with highrisk HPV DNA testing ≤24 weeks and thyroid profiling. Exposures: HPV status and comorbidities (gestational hypertension, gestational diabetes, prior cesarean scar). Primary outcome: cesarean delivery; secondary: preterm birth <37 weeks, major placental pathology, NICU admission. Multilevel logistic regression adjusted for age, BMI, parity, smoking, and twin gestation; interaction terms assessed HPV×comorbidity. Results. 41/185 (22.2%) HPV-positive. Cesarean odds were higher for HPV-negative with any comorbidity (aOR 2.9, 95% CI 1.5–5.6) and highest for HPV-positive with comorbidity (aOR 4.3, 1.8–10.2) versus HPV-negative without comorbidity. HPV-positive status was associated with a modest TSH increase (max Δ+0.25 mIU/L in T3, 95% CI 0.05–0.44; p = 0.013), with similar FT4/FT3 and values largely within pregnancy-specific ranges. A significant interaction was observed for HPV × prior cesarean scar on preterm birth (p_interaction = 0.008; aOR 2.9, 1.2–7.2); interactions with gestational hypertension or diabetes were non-significant. Conclusions. High-risk HPV combined with maternal comorbidity was associated with increased cesarean and preterm-birth risk. Findings support incorporating HPV status into antenatal risk assessment and warrant larger prospective studies.

Context. Diabetes insipidus (DI) is rare in the neonatal period but of great importance due to increased renal risk and mental retardation despite treatment. Objective. This report describes the case of a patient with congenital nephrogenic diabetes insipidus (NDI). Detection of this pathology during the neonatal period, especially in premature newborns, is difficult because of the electrolyte variations that occur as a result of the immature kidney function. Subjects and methods. The subject was a preterm infant with very low birth weight (VLBW) and persistent hypernatremic hyperosmolarity that developed polyuria and polydipsia in the first weeks of life. Results. Taking into account blood and urine laboratory tests, vasopressin levels, as well as family history, the infant was diagnosed with congenital NDI. Early treatment allowed a good development, proving that the prevention of long-term complications is possible through multidisciplinary care and frequent monitoring. The particularity of this case was the presence of persistently elevated presepsin levels. This association prompted the investigation into underlying renal hypernatremia. Conclusions. NDI is a rare condition and the onset in the neonatal period is a sign of severity and hereditary causality. Early diagnosis, symptomatic treatment and multidisciplinary monitoring may decrease the risk of longterm complications.