title: Can different geographic conditions affect the formation of striae gravidarum? A multicentric study.
abstract: OBJECTIVE
  Striae gravidarum (SG) is a most common physiological skin change that many pregnant women experience during pregnancy. We investigated the effects of geographic conditions and altitude on the formation of SG.
  
  
  METHODS
  A total of 508 nulliparous women with singleton gestation were included in the study from three different geographic locations. The first city is located in the mountainous area at an altitude of approximately 1900 m (approximately 6233 ft). The second city is located on a plain in the middle of the country at an altitude of 900 m (approximately 2952 ft). The third city is located by the seaside (altitude 26 m, 85 ft). Twelve variables were recorded for each woman in the prepartum period, and striae were scored using the numerical scoring system of Atwal et al.
  
  
  RESULTS
  We found that striae formation was significantly more common in higher areas. According to the regression analyses, when the third region, located at sea level, was taken as a reference point, the appearance of SG was 2.1- and 1.8-fold more common in the first region (altitude 1900 m) and the second region (altitude 900 m), respectively (P = 0.020).
  
  
  CONCLUSIONS
  To the best of our knowledge, this study is the first to evaluate the effect of environmental factors on SG formation. Moreover, our study group is one of the largest in the published work. Environmental factors can affect the formation of striae gravidarum. Further studies with different ethnic groups are needed.
authors.affiliation: Department of Obstetrics and Gynecology, Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Raziye
authors.initials: R
authors.lastname: Narin
authors.affiliation: Department of Obstetrics and Gynecology, Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Nazik
authors.affiliation: Department of Obstetrics and Gynecology, Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Narin
authors.affiliation: Department of Obstetric and Gynecologic Nursing, Health School, Çukurova University, Adana, Turkey.
authors.forename: Evşen
authors.initials: E
authors.lastname: Nazik
authors.affiliation: Health Science Faculty, Nursing Department, Ankara University, Ankara, Turkey.
authors.forename: Funda
authors.initials: F
authors.lastname: Özdemir
authors.affiliation: Department of Obstetric and Gynecologic Nursing, Health School, Kafkas University, Kars, Turkey.
authors.forename: Özlem
authors.initials: Ö
authors.lastname: Karabulutlu
authors.affiliation: Health Science Faculty, Midwifery Department, Ankara University, Ankara, Turkey.
authors.forename: İlknur Münevver
authors.initials: İM
authors.lastname: Gönenç
authors.affiliation: Department of Obstetrics and Gynecology, Yeditepe University, Istanbul, Turkey.
authors.forename: Rukset
authors.initials: R
authors.lastname: Attar
authors.affiliation: Department of Obstetrics and Gynecology, Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Cevdet
authors.initials: C
authors.lastname: Adıgüzel
authors.affiliation: Department of Obstetrics and Gynecology, Mersin University, Mersin, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Aytan
mesh_terms: D000293:Adolescent; D000328:Adult; D000531:Altitude; D003430:Cross-Sectional Studies; D004777:Environment; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*; D012307:Risk Factors; D057896:Striae Distensae / Q000209:etiology*; D055815:Young Adult
keywords: geographic conditions; pregnancy; striae gravidarum