scholarly journals Altered maternal metabolism during mild gestational hyperglycemia as a predictor of adverse perinatal outcomes: A comprehensive analysis

2020 ◽  
Vol 1866 (2) ◽  
pp. 165478 ◽  
Author(s):  
Marilza Vieira Cunha Rudge ◽  
Angélica Mercia Pascon Barbosa ◽  
Luis Sobrevia ◽  
Rafael Bottaro Gelaleti ◽  
Raghavendra Lakshmana Shetty Hallur ◽  
...  
Keyword(s):  
Perinatal Outcomes ◽  
Comprehensive Analysis ◽  
Maternal Metabolism ◽  
Mild Gestational Hyperglycemia ◽  
Gestational Hyperglycemia ◽  
Adverse Perinatal Outcomes

scholarly journals Gestational hyperglycemia on diet and medication: impact on placental pathology and pregnancy outcomes

2019 ◽  
Vol 8 (8) ◽  
pp. 3350
Author(s):  
Lalitha Natarajan ◽  
G. UmaMaheswari
Keyword(s):  
Gestational Diabetes ◽  
Perinatal Outcome ◽  
Perinatal Outcomes ◽  
Diabetic Control ◽  
Placental Pathology ◽  
Foetal Death ◽  
Mild Gestational Hyperglycemia ◽  
Gestational Hyperglycemia ◽  
Adverse Perinatal Outcomes ◽  
Oral Hypoglycemic Drugs

Background: To evaluate the placental morphology and perinatal outcome in patients with gestational hyperglycemia on diet and medication.Methods: Placental examinations performed at the Department of Pathology between August 2016 to August 2018 were retrospectively reviewed. Of the received 140 placentas, 35 of gestational diabetes (GDM) and pre gestational diabetes were identified and segregated into hyperglycemia on diet and on medication. The clinical details, placental findings and perinatal outcome of patients in both the groups (gestational hyperglycemia on diet and medication) were collected and analyzed.Results: Among the 35 cases, there were 24 cases of mild gestational hyperglycemia controlled with diet and 11 cases of hyperglycemia on medication (oral hypoglycemic drugs ± insulin).Most of the placentae in both the groups weighed less than tenth centile. The cord abnormalities such as hyper coiling, velamentous /marginal insertion and furcate cord were observed more in women with GDM on diet. There was no significant gross placental lesion in those on medication. Placental histological features most consistently associated with both the groups include, disturbances of villous maturation (DVM), Derangements in uteroplacental / foetoplacental circulation and villous capillary lesions. Small for gestational age and intrauterine foetal death were found in both the groups, but more commonly in patients with hyperglycemia on medication.Conclusions: Villous maturation defects, uteroplacental / foetoplacental malperfusion are the essential placental changes which can result in adverse perinatal outcomes in women with hyperglycemia irrespective of the diabetic control.

scholarly journals Epigenome-wide association study of maternal hemoglobin A1c in pregnancy and cord blood DNA methylation

Epigenomics ◽  
2021 ◽  
Author(s):  
Diana L Juvinao-Quintero ◽  
Anne P Starling ◽  
Andres Cardenas ◽  
Camille E Powe ◽  
Patrice Perron ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Cord Blood ◽  
Hemoglobin A1c ◽  
Mendelian Randomization ◽  
Statistical Significance ◽  
Perinatal Outcomes ◽  
Gestational Hyperglycemia ◽  
Adverse Perinatal Outcomes ◽  
Hba1c Levels

Background: Gestational hyperglycemia is associated with adverse perinatal outcomes and long-term offspring metabolic programming, likely through dysregulation of DNA methylation (DNAm). Materials & methods: We tested associations between maternal HbA1c and cord blood DNAm among 412 mother–child pairs in the genetics of glucose regulation in gestation and growth (Gen3G) and implemented Mendelian randomization to infer causality. We sought replication in an independent sample from Healthy Start. Results: Higher second trimester HbA1c levels were associated with lower DNAm at cg21645848 (p = 3.9 × 10-11) near URGCP. Mendelian randomization and replication analyses showed same direction of effect between HbA1c and DNAm at cg21645848, but did not reach statistical significance. Conclusion: We found that higher maternal glycemia reflected by HbA1c is associated with cord blood DNAm at URGCP, a gene related with inflammatory pathways.

scholarly journals Pregnancy Outcomes and SARS-CoV-2 Infection: The Spanish Obstetric Emergency Group Study

Viruses ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 853
Author(s):  
Sara Cruz Melguizo ◽  
María Luisa de la Cruz Conty ◽  
Paola Carmona Payán ◽  
Alejandra Abascal-Saiz ◽  
Pilar Pintando Recarte ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Perinatal Outcomes ◽  
Preterm Births ◽  
Hypertensive Disorder ◽  
Obstetric Emergency ◽  
Increased Risk ◽  
Emergency Group ◽  
Adverse Perinatal Outcomes ◽  
Maternal Disease ◽  
The Relationship

Pregnant women who are infected with SARS-CoV-2 are at an increased risk of adverse perinatal outcomes. With this study, we aimed to better understand the relationship between maternal infection and perinatal outcomes, especially preterm births, and the underlying medical and interventionist factors. This was a prospective observational study carried out in 78 centers (Spanish Obstetric Emergency Group) with a cohort of 1347 SARS-CoV-2 PCR-positive pregnant women registered consecutively between 26 February and 5 November 2020, and a concurrent sample of PCR-negative mothers. The patients’ information was collected from their medical records, and the association of SARS-CoV-2 and perinatal outcomes was evaluated by univariable and multivariate analyses. The data from 1347 SARS-CoV-2-positive pregnancies were compared with those from 1607 SARS-CoV-2-negative pregnancies. Differences were observed between both groups in premature rupture of membranes (15.5% vs. 11.1%, p < 0.001); venous thrombotic events (1.5% vs. 0.2%, p < 0.001); and severe pre-eclampsia incidence (40.6 vs. 15.6%, p = 0.001), which could have been overestimated in the infected cohort due to the shared analytical signs between this hypertensive disorder and COVID-19. In addition, more preterm deliveries were observed in infected patients (11.1% vs. 5.8%, p < 0.001) mainly due to an increase in iatrogenic preterm births. The prematurity in SARS-CoV-2-affected pregnancies results from a predisposition to end the pregnancy because of maternal disease (pneumonia and pre-eclampsia, with or without COVID-19 symptoms).

scholarly journals Fetal movement counting is associated with the reduction of delayed maternal reaction after perceiving decreased fetal movements: a prospective study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shigeki Koshida ◽  
Shinsuke Tokoro ◽  
Daisuke Katsura ◽  
Shunichiro Tsuji ◽  
Takashi Murakami ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Maternal Behavior ◽  
Multivariable Analysis ◽  
Perinatal Outcomes ◽  
Fetal Movement ◽  
Post Intervention ◽  
Fetal Movements ◽  
Adverse Perinatal Outcomes ◽  
The Impact ◽  
Maternal Reaction

AbstractMaternal perception of decreased fetal movement is associated with adverse perinatal outcomes. Although there have been several studies on interventions related to the fetal movements count, most focused on adverse perinatal outcomes, and little is known about the impact of the fetal movement count on maternal behavior after the perception of decreased fetal movement. We investigated the impact of the daily fetal movement count on maternal behavior after the perception of decreased fetal movement and on the stillbirth rate in this prospective population-based study. Pregnant women in Shiga prefecture of Japan were asked to count the time of 10 fetal movements from 34 weeks of gestation. We analyzed 101 stillbirths after the intervention compared to 121 stillbirths before the intervention. In multivariable analysis, maternal delayed visit to a health care provider after the perception of decreased fetal movement significantly reduced after the intervention (aOR 0.31, 95% CI 0.11–0.83). Our regional stillbirth rates in the pre-intervention and post-intervention periods were 3.06 and 2.70 per 1000 births, respectively. Informing pregnant women about the fetal movement count was associated with a reduction in delayed maternal reaction after the perception of decreased fetal movement, which might reduce stillbirths.

scholarly journals Sneathia: an emerging pathogen in female reproductive disease and adverse perinatal outcomes

2021 ◽  
pp. 1-26
Author(s):  
Kevin R. Theis ◽  
Violetta Florova ◽  
Roberto Romero ◽  
Andrei B. Borisov ◽  
Andrew D. Winters ◽  
...  
Keyword(s):  
Perinatal Outcomes ◽  
Emerging Pathogen ◽  
Reproductive Disease ◽  
Adverse Perinatal Outcomes

Maternal nativity and risk of adverse perinatal outcomes among Black women residing in California, 2011–2017

2021 ◽  
Author(s):  
Safyer McKenzie-Sampson ◽  
Rebecca J. Baer ◽  
Bridgette E. Blebu ◽  
Deborah Karasek ◽  
Scott P. Oltman ◽  
...  
Keyword(s):  
Black Women ◽  
Perinatal Outcomes ◽  
Maternal Nativity ◽  
Adverse Perinatal Outcomes

scholarly journals 1033: Obesity-induced epigenetic changes associated with adverse perinatal outcomes

2020 ◽  
Vol 222 (1) ◽  
pp. S642
Author(s):  
WeiBin Shen ◽  
Jingxiang Ni ◽  
Penghua Yang ◽  
Ruofan Yao ◽  
Christopher Harman ◽  
...  
Keyword(s):  
Perinatal Outcomes ◽  
Epigenetic Changes ◽  
Adverse Perinatal Outcomes

The effect of maternal position on fetal middle cerebral artery Doppler indices and its association with adverse perinatal outcomes: a pilot study

2020 ◽  
Vol 48 (4) ◽  
pp. 317-321
Author(s):  
Rodney McLaren ◽  
Bharati Kalgi ◽  
Chima Ndubizu ◽  
Peter Homel ◽  
Shoshana Haberman ◽  
...  
Keyword(s):  
High Risk ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Repeated Measures ◽  
Adverse Outcome ◽  
Perinatal Outcomes ◽  
Low Risk ◽  
Doppler Velocity ◽  
Chronic Hypertension ◽  
Adverse Perinatal Outcomes

AbstractObjectiveThe aim of this study was to compare position-related changes in fetal middle cerebral artery (MCA) Doppler pulsatility indices (PI).MethodsA prospective study of 41 women with conditions associated with placental-pathology (chronic hypertension, pregestational diabetes, and abnormal analytes) and 34 women without those conditions was carried out. Fetal MCA Doppler velocity flow waveforms were obtained in maternal supine and left lateral decubitus positions. MCA PI Δ was calculated by subtracting the PI in the supine position from the PI in the left lateral position. Secondary outcomes included a composite of adverse perinatal outcomes (fetal growth restriction, oligohydramnios, and preeclampsia). χ2 and Student t-tests and repeated-measures analysis of variance were used.ResultsMCA PI Δ was significantly less for high-risk pregnant women ([P = 0.03]: high risk, left lateral PI, 1.90 ± 0.45 vs. supine PI, 1.88 ± 0.46 [Δ = 0.02]; low risk, left lateral PI, 1.90 ± 0.525 vs. supine PI, 1.68 ± 0.40 [Δ = 0.22]). MCA PI Δ was not significantly different between women who had a composite adverse outcome and women who did not have a composite adverse outcome (P = 0.843).ConclusionOur preliminary study highlights differences in position-related changes in fetal MCA PI between high-risk and low-risk pregnancies. These differences could reflect an attenuated ability of women with certain risk factors to respond to physiologic stress.

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