Gestational Diabetes Mellitus and Obesity are Related to Persistent Hyperglycemia in the Postpartum Period

Abstract Objective To evaluate the obstetric and sociodemographic characteristics of gestational diabetic women who maintained hyperglycemia in the postpartum period (6–12 weeks postpartum). Methods This is a longitudinal cohort study with women who have had gestational diabetes and/or macrosomic children between March 1st, 2016 and March 1st, 2017. Between 6 and 12 weeks after birth, women who had gestational diabetes collected fasting glycemia, glucose tolerance test, and glycated hemoglobin results. The data were collected from medical records and during an interview in the first postpartum consultation. A statistical analysis was performed using frequency, percentage, Chi-Squared test, Fisher exact test, Mann-Whitney test, and multivariate Poisson regression. The significance level adopted for the statistical tests was 5%. Results One hundred and twenty-two women were included. Most of the women were younger than 35 years old (70.5%), white, multiparous, and with no history of gestational diabetes. Thirteen percent of the participants developed persistent hyperglycemia. A univariate analysis showed that maternal age above 35 years, being overweight, having grade 1 obesity and weight gain under 5 kg was related to the persistence of hyperglycemia in the postpartum period. Conclusion Maternal age above 35 years, obesity and overweight, and the diagnosis of gestational diabetes in the first trimester of pregnancy are associated with hyperglycemia during the postpartum period.

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Hubungan Pengetahuan Dan Sikap Ibu Hamil Dengan Kejadian Mual Muntah Pada Kehamilan Trimester Pertama Di Poskesdes Ampalu Kota Pariaman Bidan Helfiati, Amd. Keb.

Jurnal Surya Medika ◽

10.33084/jsm.v6i1.1620 ◽

2020 ◽

Vol 6 (1) ◽

pp. 70-76

Author(s):

Rika Armalini ◽

Prasetyaningsih Prasetyaningsih

Keyword(s):

Pregnant Women ◽

Significant Relationship ◽

Health Workers ◽

Statistical Tests ◽

Univariate Analysis ◽

First Trimester ◽

Nausea And Vomiting ◽

Cross Sectional ◽

Significance Level ◽

First Trimester Of Pregnancy

Nausea, vomiting in pregnancy is physiological that occurs in the first trimester, which starts 6 weeks after the first day of the last menstrual period, and disappears 6-12 weeks later. The report shows that almost 50-90% of pregnant women experience it. Nausea, vomiting if not treated can cause severe dehydration until poisoning occurs. The purpose of this study was to link the knowledge and attitudes of pregnant women with the occurrence of nausea and vomiting in the first trimester of pregnancy in the Poskesdes Ampalu Midwife Helfiati, Amd. Keb. The study was conducted in July 2019. This type of research is analytic survey research with a cross-sectional design. The population in this study were all pregnant women who visited Helfiati Amd.Keb polindes as many as 40 pregnant women with a total sampling technique. Data were analyzed by univariate and bivariate by computerized statistical tests using SPSS Ver. 17 with a significance level α = 0.05 and a degree of confidence of 95%. The results of the univariate analysis showed that 52.5% of mothers experienced nausea, vomiting, 62.5% of low-knowledge mothers and 42.5% of mothers were negative about how to deal with nausea and vomiting. there is a significant relationship between knowledge (p = 0,000) and attitude (p = 0,000) with the incidence of nausea and vomiting in the first trimester of pregnancy in the Poskesdes Ampalu Midwife Helfiati, Amd.Keb 2019. The results of this study can be concluded that there is a significant relationship between knowledge and attitude with the occurrence of nausea, vomiting. With this research it is expected that health workers provide IEC services and improve health care counseling in an effort to increase the knowledge of pregnant women about how to cope with nausea, and also expect mothers to be more active in seeking information about physiological complaints during pregnancy, especially how to deal with nausea vomiting by following counseling activities held by health workers so that in the future more knowledge from mothers.

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Risk of Stillbirth in Women with Gestational Diabetes and High Blood Pressure

Iranian Journal of Public Health ◽

10.18502/ijph.v49i4.3185 ◽

2020 ◽

Author(s):

Hamid Reza TABATABAEE ◽

Atefeh ZAHEDI ◽

Koorosh ETEMAD ◽

Tannaz VALADBEIG ◽

Sepideh MAHDAVI ◽

...

Keyword(s):

Blood Pressure ◽

Gestational Diabetes ◽

High Blood Pressure ◽

Maternal Age ◽

Maternal Education ◽

Healthcare Services ◽

Population Based ◽

Significance Level ◽

Quality Healthcare ◽

Increased Risk

Background: Both Gestational diabetes and hypertension almost affect 10.5% of the pregnancies. This study was conducted to investigate and compare the pregnancy outcomes in women with gestational diabetes or high blood pressure with outcomes belonging to healthy mothers. Methods: This population-based case-control study was conducted in 8 provinces and two cities of Iran on women referred to the public health centers during 2015 to 2018. Descriptive statistics for variables presented by percentages and frequencies and logistic regression analysis was used to analyze data at a significance level of less than 0.05. Results: Some variables such as ethnicity, maternal education and age, gestational diabetes, high blood pressure and previous pregnancy outcome were significantly associated with stillbirth. Maternal age greater than 35 yr (OR=1.78, CI: 1.29-2.48), maternal illiteracy (OR=3.67, CI: 2.25-5.98), a previous stillbirth (OR=9.92, CI: 4.98-19.78), gestational diabetes among women who had never had a screening test (OR =3.91, CI: 2.96-5.18) and high blood pressure (OR =1.95, CI: 1.38-2.77) were important factors associated with stillbirth. Maternal and paternal occupation, paternal education and age, place of residence, smoking and maternal BMI were significantly associated with stillbirth. Conclusion: Gestational diabetes, hypertension, a previous miscarriage, stillbirth, first pregnancy, low education level, advanced maternal age and ethnicity were associated with an increased risk of stillbirth. It is necessary to provide high-quality healthcare services before and during pregnancy particularly for those at heightened risk and improve knowledge of mothers on the side effects of each of the mentioned risk factors in order to control these factors more effectively and thus reducing the risk of stillbirth.

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HUBUNGAN ANTARA STATUS GRAVIDA DAN USIA IBU DENGAN KEJADIAN EMESIS GRAVIDARUM BULAN JANUARI-AGUSTUS 2017 DI BPM VERONIKA DAN BPM ENDANG SUTIKNO KOTA KEDIRI.

Jurnal Ilmu Kesehatan ◽

10.32831/jik.v7i2.213 ◽

2019 ◽

Vol 7 (2) ◽

pp. 342

Author(s):

Ira Titisari ◽

Kartika Chandra Suryaningrum ◽

Mika Mediawati

Keyword(s):

Maternal Age ◽

Sampling Technique ◽

Simple Random Sampling ◽

First Trimester ◽

Nausea And Vomiting ◽

Common Symptom ◽

Chi Square ◽

Cross Sectional ◽

Significance Level ◽

Natural Event

In pregnancy, pregnant women have experience with emesis gravidarum about 67.9%. Pregnancy is a natural event. Woman's body will change during pregnancy. Some uncomfortable thing will appear along with physiological changes during pregnancy such as nausea, vomiting, frequent urination, and lower back pain. The most uncomfortable one was nausea and vomiting. Nausea and vomiting were as known as emesis gravidarum. Nausea and vomiting during pregnancy is a common symptom and often occurs in the first trimester of pregnancy. Feelings of nausea occur because of increased levels of the hormone of estrogen and HCG in serum.; The purpose of this study is to determine the relationship between gravida status and maternal age with the incidence of emesis gravidarum in January-August 2017 at BPM Veronika and BPM Endang Sutikno Kediri. Methods in this research were an analytical survey with a cross-sectional approach. The population was 120 with a sample of 93 respondents, using simple random sampling technique.;The researcher was collecting the data using the recapitulation sheet from January to August 2017. The result of the gravida status that counted with Chi-Square obtained χ2 count value of 6,8 then at the χ2 table at significance level and df 1 is 3,841 so χ2 value ; χ2 table. The result of maternal age that counted with Chi-Square obtained a χ2 count of 4,26 then at the χ2 table at a significance level of df 1 is 3,841 so χ2 count; 2 table. It can be concluded that there was a relationship between gravida status and maternal age with the occurrence of emesis gravidarum in January-August 2017 at BPM Veronika and BPM Endang Sutikno Kediri.

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The Effects of Hyperemesis Gravidarum on the Oral Glucose Tolerance Test Values and Gestational Diabetes

Prague Medical Report ◽

10.14712/23362936.2021.26 ◽

2021 ◽

Vol 122 (4) ◽

pp. 285-293

Author(s):

Burak Bayraktar ◽

Meric Balikoglu ◽

Miyase Gizem Bayraktar ◽

Ahkam Goksel Kanmaz

Keyword(s):

Blood Glucose ◽

Gestational Diabetes ◽

Glucose Tolerance Test ◽

Hyperemesis Gravidarum ◽

First Trimester ◽

Tolerance Test ◽

Control Group ◽

Oral Glucose ◽

Second Trimester ◽

Oral Glucose Tolerance

This study is aimed at determination whether pregnant women who develop hyperemesis gravidarum in the first trimester have a tendency to develop gestational diabetes mellitus (GDM). It is also aimed at identification of effects of hyperemesis gravidarum and GDM on prenatal and neonatal status in case they were detected together. Hyperemesis gravidarum diagnose was based on the following signs and symptoms. To diagnose GDM, first trimester fasting blood glucose measurement and subsequent blood glucose monitoring and 75-g oral glucose tolerance test (OGTT) were performed in the second trimester. A total of 949 singleton pregnant women (95 with and 852 without hyperemesis gravidarum) who met our criteria were included in the study. In the first trimester, plasma blood glucose and positive GDM screening were found to be significantly higher in the hyperemesis gravidarum group compared to the control group (p=0.042 and p<0.001, respectively). However, actual GDM cases were similar between both groups. The positive predictive value was significantly lower in the hyperemesis gravidarum group (28.5% vs. 72.7%, p=0.003). In the second trimester, the prevalence of GDM was 6.6% in the hyperemesis gravidarum group and 7.3% in the control group, with no significant difference (p=0.218) between-groups. In this study, hyperemesis gravidarum was found to cause changes in maternal metabolism in the first trimester of pregnancy due to limited calorie intake and fasting; in the presence of hyperemesis gravidarum, it should be known that the positive predictive value of first trimester gestational diabetes screening may decrease and the diagnosis of pseudo-GDM may increase.

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Prevalence of pre-gestational diabetes among the antenatal women attending a tertiary care center

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20170466 ◽

2017 ◽

Vol 6 (3) ◽

pp. 797 ◽

Cited By ~ 1

Author(s):

Renji S. R. ◽

Sujatha Thankappan Lekshmi ◽

Nirmala Chellamma

Keyword(s):

Gestational Diabetes ◽

Pregnant Women ◽

Statistical Tests ◽

Care Center ◽

Tertiary Care ◽

First Trimester ◽

Adverse Outcomes ◽

Tertiary Care Center ◽

Family History Of Diabetes ◽

History Of

Background: Number of pregnant women with preexisting diabetes is increasing. Hence the detection and management of diabetes from the beginning of pregnancy itself will help to improve the fetal and maternal outcome. Aim of the study was to determine the prevalence of pre-gestational diabetes among the antenatal women attending a tertiary care center and to study the associated factors.Methods: This was a cross sectional study conducted in SAT hospital, Government Medical College, Trivandrum, Kerala, India for one year. HbA1C was the test used to diagnose diabetes. 400 women attending the OP in their first trimester were selected after informed consent. Socio demographic factors assessed by a structured questionnaire. Blood samples were taken for HbA1C. Diagnosis of diabetes was made at levels of HbA1C ≥6.5%. Statistical tests used were mean, standard deviation, chi-square and odds ratio.Results: Prevalence of pre-gestational diabetes was 3.8%.in our study. Main associations were age more than 25 years, body mass index, family history of diabetes, history of intra uterine death, gestational diabetes in previous pregnancy, candidiasis and thyroid disease.Conclusions: Screening of all pregnant women in first trimester itself for diabetes will help in early detection of pre-gestational diabetes, so that anticipation of adverse outcomes and proper management can be done in such cases.

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Performance and the Optimal Cut-Off Value of First-Trimester Fasting Plasma Glucose To Identify Gestational Diabetes Mellitus: A Retrospective Study From Southern China

10.21203/rs.3.rs-1067857/v1 ◽

2021 ◽

Author(s):

Jia-Ning Tong ◽

Lin-Lin Wu ◽

Yi-Xuan Chen ◽

Xiao-Nian Guan ◽

Kan Liu ◽

...

Keyword(s):

Diabetes Mellitus ◽

Retrospective Study ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Plasma Glucose ◽

Fasting Plasma Glucose ◽

Maternal Age ◽

First Trimester ◽

Fasting Plasma

Abstract Purpose Previous studies have suggested that first-trimester fasting plasma glucose (FPG) is associated with gestational diabetes mellitus (GDM) and is a predictor of GDM. The aim of the present study was to explore whether first-trimester FPG levels can be used as a screening and diagnostic test for GDM in pregnant women. Methods This retrospective study included pregnant women who had their first-trimester FPG recorded at 9-13+6 weeks and underwent screening for GDM using the 2-hour 75 g oral glucose tolerance test (OGTT) between 24th and 28th gestational weeks. The cut-off values were calculated using a receiver operating characteristic (ROC) curve. Results The medical records of 28,030 pregnant women were analysed, and 4,669 (16.66%) of them were diagnosed with GDM. The mean first-trimester FPG was 4.62 ± 0.37 mmol/L. The total trend in the optimal cut-off value of first-trimester FPG in pregnant women was 4.735 mmol/L, with a sensitivity of 49%, a specificity of 67.6% and AUC of 0.608 (95% CI: 0.598-0.617, p༜0.001). Moreover, as the maternal age increased, the optimal cut-off values increased, respectively. The results suggest that first-trimester FPG can be considered a marker for identifying pregnant women with GDM. Conclusion The level of first-trimester FPG increased slightly with maternal age and, as maternal age increased, the optimal cut-off values increased, especially after age 30. The first-trimester FPG should be considered a screening marker when diagnosing GDM in pregnant women.

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Is improvement in the Healthy Food Intake Index (HFII) related to a lower risk for gestational diabetes?

British Journal Of Nutrition ◽

10.1017/s0007114517001015 ◽

2017 ◽

Vol 117 (8) ◽

pp. 1103-1109 ◽

Cited By ~ 1

Author(s):

Jelena Meinilä ◽

Anita Valkama ◽

Saila B. Koivusalo ◽

Beata Stach-Lempinen ◽

Kristiina Rönö ◽

...

Keyword(s):

Food Intake ◽

Gestational Diabetes ◽

Lower Risk ◽

First Trimester ◽

Tolerance Test ◽

Healthy Food ◽

Oral Glucose ◽

Fat Percentage ◽

Exact Test ◽

The Mean

AbstractThe aim was to analyse whether changes in the Healthy Food Intake Index (HFII) during pregnancy are related to gestational diabetes (GDM) risk. The 251 pregnant women participating had a pre-pregnancy BMI≥30 kg/m2 and/or a history of GDM. A 75 g oral glucose tolerance test (OGTT) was performed during the first and second trimesters of pregnancy for assessment of GDM. A normal OGTT result at first trimester was an inclusion criterion for the study. FFQ collected at first and second trimesters served for calculating the HFII. A higher HFII score reflects higher adherence to the Nordic Nutrition Recommendations (NNR) (score range 0–17). Statistical methods included Student’s t test, Mann–Whitney U test, Fisher’s exact test and linear and logistic regression analyses. The mean HFII at first trimester was 10·1 (95 % CI 9·7, 10·4) points, and the mean change from the first to the second trimester was 0·35 (95 % CI 0·09, 0·62) points. The range of the HFII changes varied from –7 to 7. The odds for GDM decreased with higher HFII change (adjusted OR 0·83 per one unit increase in HFII; 95 % CI 0·69, 0·99; P=0·043). In the analysis of the association between HFII-sub-indices and GDM, odds for GDM decreased with higher HFII-Fat change (fat percentage of milk and cheese, type of spread and cooking fats) but it was not significant in a fully adjusted model (P=0·058). Dietary changes towards the NNR during pregnancy seem to be related to a lower risk for GDM.

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