scholarly journals Childhood maltreatment and inflammation among pregnant women with gestational diabetes mellitus: A pilot study

2017 ◽  
Vol 10 (3) ◽  
pp. 120-124 ◽  
Author(s):  
Margaret Bublitz ◽  
Suzanne De La Monte ◽  
Susan Martin ◽  
Lucia Larson ◽  
Ghada Bourjeily
Keyword(s):  
Diabetes Mellitus ◽  
Pilot Study ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Birth Outcomes ◽  
Childhood Maltreatment ◽  
Secondary Data ◽  
Past Research ◽  
Increased Risk

Background Women with childhood maltreatment histories are at increased risk for adverse birth outcomes. Mechanisms explaining this link are poorly understood. Past research is limited by sampling pregnant women at low risk for adverse maternal and neonatal outcomes. Methods This pilot study was a secondary data analysis of 24 women with gestational diabetes mellitus; 17% of the sample also reported a maltreatment history. Women provided a blood sample to measure inflammatory cytokines and insulin resistance, and saliva samples to measure diurnal cortisol. Birth outcomes for past and current pregnancies were recorded. Results Histories of maltreatment were associated with elevated interleukin-15 and a marginally greater incidence of preterm delivery in current and past pregnancies. Conclusions This pilot study was the first to demonstrate an association between childhood maltreatment history and inflammatory cytokine levels in pregnant women diagnosed with gestational diabetes mellitus.

scholarly journals The Role of HIV Infection in the Pathophysiology of Gestational Diabetes Mellitus and Hypertensive Disorders of Pregnancy

2021 ◽  
Vol 8 ◽  
Author(s):  
Wendy N. Phoswa
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Hiv Infection ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Post Exposure Prophylaxis ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
Hiv Aids

Purpose of the Review: The main objective of this study is to investigate mechanisms associated with gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) in HIV infected pregnant women by looking how placental hormones such as (progesterone and prolactin) and basic haemostatic parameters are regulated in HIV infected pregnancies.Recent Findings: HIV/AIDS are a major global obstetric health burden that lead to increased rate of morbidity and mortality. HIV/AIDS has been associated with the pathophysiology of GDM and HDP. Increased risk of GDM due to highly active antiretroviral therapy (HAART) usage has been reported in HIV infected pregnancies, which causes insulin resistance in both pregnant and non-pregnant individuals. HAART is a medication used for lowering maternal antepartum viral load and pre-exposure and post-exposure prophylaxis of the infant. In pregnant women, HAART induces diabetogenic effect by causing dysregulation of placental hormones such as (progesterone and prolactin) and predispose HIV infected women to GDM. In addition to HIV/AIDS and GDM, Studies have indicated that HIV infection causes haemostatic abnormalities such as hematological disorder, deregulated haematopoiesis process and the coagulation process which results in HDP.Summary: This study will help on improving therapeutic management and understanding of the pathophysiology of GDM and HDP in the absence as well as in the presence of HIV infection by reviewing studies reporting on these mechanism.

Predictive Value of Immunological Parameters in the Risk of Gestational Diabetes Mellitus: A Pilot Study

2020 ◽  
Author(s):  
Adnette Fagninou ◽  
Magloire Pandoua Nekoua ◽  
Salomon Ezéchiel Mahougnon Fiogbe ◽  
Kabirou Moutairou ◽  
Akadiri YESSOUFOU
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Biochemical Parameters ◽  
Predictive Power ◽  
Glycosylated Hemoglobin ◽  
Operating Characteristics ◽  
Immunological Parameters ◽  
Increased Risk

Abstract Background : Immunological and biochemical parameters are gaining more and more importance in the prognosis of diabetes and its complications. Here we assessed the predictive power of immunological parameters correlated with biochemical ones in gestational diabetes mellitus (GDM). Material and Methods : 217 pregnant women were screened for GDM between the 2 nd and the 3 rd trimester of gestation, based on IAGDP methods in this cross-sectional descriptive study. Immunological and biochemical parameters were determined using appropriate methods. Receiver operating characteristics (ROC) curve analyses were conducted to assess the optimal cutoff and value of immunological to biochemical parameter ratios for predicting GDM. Results : 11.90% of pregnant women were diagnosed GDM positive. Serum glucose levels, total cholesterol, LDL-cholesterol, triglycerides and total proteins were significantly increased while HDL-cholesterol decreased in women with GDM compared to controls. The levels of glycosylated hemoglobin and creatinine, as well as transaminase (AST and ALT) activities did not significantly differ between GDM and pregnant controls. Total leucocytes (white blood cell), lymphocyte and platelet numbers were significantly higher in women with GDM than in pregnant controls. We also found that the lymphocyte:HDL-C, monocyte:HDL-C and granulocyte:HDL-C ratios were significantly higher in women with GDM than in pregnant controls ( p = 0.001; p = 0.009 and p = 0.004 respectively). Women with a lymphocyte:HDL-C ratio greater than 3.66 had a 4-fold increased risk of developing GDM than those with lower ratios (odds ratio 4.00; 95% CI: 1.094 – 14.630; p =0.041). Conclusion : The lymphocyte:HDL-C, monocyte:HDL-C and granulocyte:HDL-C ratios may represent valuable makers, and the lymphocyte:HDL-C ratio in particular may have strong predictive power for GDM. This ratio can be easily assessed in patients.

scholarly journals Prevalence of Gestational Diabetes Mellitus and Maternal and Fetal Outcomes at the Rivers State University Teaching Hospital (RSUTH), Port Harcourt, Nigeria

2020 ◽  
pp. 1-16
Author(s):  
D. H. John ◽  
P. A. Awoyesuku ◽  
D. A. MacPepple ◽  
N. J. Kwosah
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factor ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Exposed Group ◽  
Fetal Outcomes ◽  
Previous Pregnancy ◽  
Increased Risk ◽  
History Of

Background: Gestational diabetes mellitus (GDM) is a common cause of hyperglycaemia in pregnancy accounting for about 90% of all diabetic pregnancies. Women with GDM are at increased risk of maternal and fetal morbidity and mortality which are preventable through early diagnosis and treatment. Objective: The aim was to determine the prevalence of GDM, compare the maternal and neonatal complications among GDM and non-GDM pregnant women, and the risk factors associated with GDM. Methodology: A prospective cohort study was carried out among 105 pregnant women attending the antenatal clinic of RSUTH between February and August 2017. They were interviewed using a pre-structured questionnaire that covered variables related to socio-demographic factors and family, medical, and social history. Fasting blood sugar (FBS) was done after an overnight fast. Women who had FBS less than 7 mmol/L had 75 g Oral Glucose Tolerant Test (OGTT) done. Those diagnosed with gestational diabetes mellitus were the exposed group while those negative for GDM were the non-exposed group. Both groups were followed up to delivery, and maternal and fetal outcomes were noted. Statistical analysis was carried out using SPSS version 20 and significance set at p < 0.05. Results: The prevalence of GDM was 10.5%. Positive history of GDM in previous pregnancy was the only independent risk factor (p=0.04, Adj OR: 26.89, 95% CI 2.86 to 252.61). GDM mothers had a significantly higher risk of developing pre-eclampsia (RR=7.48; 95% CI =3.36 to 16.63). Neonates of GDM mothers were at increased risk of fetal macrosomia (RR =9.00; 95% CI=1.36 to 59.4) and neonatal admissions (RR=8.00; C.I =1.19 to 53.67). Conclusion: The study revealed that the prevalence of GDM was high and that those with GDM were at increased risk of developing fetal and maternal complications. A history of GDM in previous pregnancy was an essential risk factor for subsequent GDM.

scholarly journals Spontaneous Abortions and Gestational Diabetes Mellitus- A Study from Pakistan

2021 ◽  
Vol 2 (2) ◽  
pp. 58-63
Author(s):  
Aasia Kanwal ◽  
Asma Salam ◽  
Aisha Bashir
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Fasting Blood Glucose ◽  
Categorical Variables ◽  
Spontaneous Abortions ◽  
Rural And Urban ◽  
Increased Risk

Background: Gestational diabetes mellitus leads to adverse pregnancy outcomes. Objectives: The objective of the study was to explore the relationship of spontaneous abortions with gestational diabetes mellitus in pregnant women from rural and urban Lahore. Methods: This cross-sectional study was conducted at University of Health Sciences, Lahore in 2019. Among 60 pregnant women sampled, 30 had gestational diabetes mellitus (GDM) and 30 were normal pregnant controls. Pregnant women were sampled from different hospitals of rural and urban areas of Lahore. Independent sample t-test was applied for analyzing the data. Chi- square test was used to analyze the categorical variables. Association of fasting blood glucose (FBG) and abortions was checked. Odd ratio and relative risk were calculated. Results: Mean fasting blood sugar levels were significantly higher in GDM group (105 mg/dL) as compared to non-GDM group (80.50 mg/dL) at p<0.001. The proportions of the women with increased number of abortions had significantly higher blood glucose levels (OR 5.091, 95% CI, RR 1.27). Conclusions: Gestational diabetes mellitus is associated with an increased risk of spontaneous abortions.

scholarly journals Diabetes in Pregnancy and Risk of Antepartum Depression: A Systematic Review and Meta-Analysis of Cohort Studies

2020 ◽  
Vol 17 (11) ◽  
pp. 3767 ◽  
Author(s):  
Kai Wei Lee ◽  
Siew Mooi Ching ◽  
Navin Kumar Devaraj ◽  
Seng Choi Chong ◽  
Sook Yee Lim ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Cohort Studies ◽  
Pregnant Women ◽  
Meta Analysis ◽  
Diabetes In Pregnancy ◽  
Antepartum Depression ◽  
Increased Risk ◽  
In Pregnancy

Previous literature has reported that patients with diabetes in pregnancy (DIP) are at risk of developing antepartum depression but the results have been inconsistent in cohort studies. We conducted a systematic review and performed a meta-analysis to quantify the association between DIP and risk of antepartum depression in cohort studies. Medline, Cinahl, and PubMed databases were searched for studies investigating DIP involving pregnant women with pre-existing diabetes and gestational diabetes mellitus and their risk of antepartum depression that were published in journals from inception to 27 December 2019. We derived the summary estimates using a random-effects model and reported the findings as pooled relative risks (RR) and confidence interval (CI). Publication bias was assessed using a funnel plot and was quantified by Egger and Begg’s tests. Ten studies, involving 71,036 pregnant women were included in this meta-analysis. The pooled RR to develop antepartum depression was (RR = 1.430, 95% CI: 1.251–1.636) among women with gestational diabetes mellitus. Combining pregnant women with pre-existing diabetes mellitus and gestational diabetes mellitus, they had a significant increased risk of developing antepartum depression (RR = 1.431, 95% CI: 1.205–1.699) compared with those without it. In comparison, we found no association between pre-existing diabetes mellitus in pregnancy (RR = 1.300, 95% CI: 0.736–2.297) and the risk of developing antepartum depression. This study has a few limitations: first, different questionnaire and cut-off points were used in evaluation of depression across the studies. Second, there was a lack of data on history of depression prior to pregnancy, which lead to confounding bias that could not be solved by this meta-analysis. Third, data were dominated by studies in Western countries; this is due to the studies from Eastern countries failing to meet our inclusion criteria for statistical analysis. Women with gestational diabetes mellitus have an increased risk of developing antepartum depression compared to those without the disease. Therefore, more attention on the mental health status should be given on pregnant women diagnosed with pre-existing diabetes mellitus and gestational diabetes mellitus.

scholarly journals Short term effects of maternal obesity on mother and fetus: a prospective study

2018 ◽  
Vol 7 (8) ◽  
pp. 3097
Author(s):  
Amrutha R. Thota ◽  
Ambarisha Bhandiwad ◽  
Vineet Sakhireddy
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Maternal Obesity ◽  
Control Group ◽  
Antenatal Visit ◽  
Female Population ◽  
Risk Pregnancy ◽  
Increased Risk

Background: Obesity is such a common health care problem of female population that have major impact on pregnancy. The worldwide prevalence of obesity is more than doubled in between 1980 and 2015. The objectives of present study are to observe whether obese women have an increased risk of pregnancy related complications and adverse fetal outcome and also to compare pregnancy outcomes in different classes of BMI in obese group.Methods: A prospective observational study conducted in OBG department JSS Hospital, Mysore from November 2014 to July 2016. All pregnant women attending OPD and inpatients of antenatal wards were screened for pre-pregnancy BMI. Total number of singleton births were 5727 in our institution. Out of which 314 obese pregnant women were included in the study group, remaining 5413 non-obese pregnant mothers were taken as control group respectively. They are closely monitored in every antenatal visit for development of complications such as pre-eclampsia, gestational diabetes mellitus, increased rate of caesarean section and presence of macrosomia (B.wt >3.5kg).Results: In comparison to normal BMI pregnant women, obese mothers had an increased risk of gestational hypertension (16.9% versus 2.0%, OR-2.3) gestational diabetes mellitus (35.7% versus 3.1%, OR-2.84), preeclampsia (23.9% versus 5%,0R-1.64) cesarean sections (75.2% versus 65.4%), macrosomia (45.9% versus 22%, OR-1.64), it was also found that as BMI increases the incidence of these complications increase as seen in different classes of obese population.Conclusions: Pregnancy associated with obesity is considered as a high-risk pregnancy and obesity being a modifiable risk factor, educating women in early pregnancy and preconceptional counseling regarding harmful effects of obesity and information regarding appropriate gestational weight gain is essential. 

scholarly journals Vitamin D status and association with gestational diabetes mellitus in a pregnant cohort in Iceland

2021 ◽  
Author(s):  
Kristin S. Magnusdottir ◽  
Ellen A. Tryggvadottir ◽  
Ola K. Magnusdottir ◽  
Laufey Hrolfsdottir ◽  
Thorhallur I. Halldorsson ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Vitamin D ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
First Trimester ◽  
Vitamin D Status ◽  
Increased Risk ◽  
Vitamin D Levels ◽  
25Ohd Concentration

Background: Vitamin D deficiency has been associated with an increased risk of gestational diabetes mellitus (GDM), one of the most common pregnancy complications. The vitamin D status has never previously been studied in pregnant women in Iceland. Objective: The aim of this research study was to evaluate the vitamin D status of an Icelandic cohort of pregnant women and the association between the vitamin D status and the GDM incidence. Design: Subjects included pregnant women (n = 938) who attended their first ultrasound appointment, during gestational weeks 11–14, between October 2017 and March 2018. The use of supplements containing vitamin D over the previous 3 months, height, pre-pregnancy weight, and social status were assessed using a questionnaire, and blood samples were drawn for analyzing the serum 25‑hydroxyvitamin D (25OHD) concentration. Information regarding the incidence of GDM later in pregnancy was collected from medical records. Results: The mean ± standard deviation of the serum 25OHD (S-25OHD) concentration in this cohort was 63±24 nmol/L. The proportion of women with an S-25OHD concentration of ≥ 50 nmol/L (which is considered adequate) was 70%, whereas 25% had concentrations between 30 and 49.9 nmol/L (insufficient) and 5% had concentrations < 30 nmol/L (deficient). The majority of women (n = 766, 82%) used supplements containing vitamin D on a daily basis. A gradual decrease in the proportion of women diagnosed with GDM was reported with increasing S-25OHD concentrations, going from 17.8% in the group with S-25OHD concentrations < 30 nmol/L to 12.8% in the group with S-25OHD concentrations ≥75 nmol/L; however, the association was not significant (P for trend = 0.11). Conclusion: Approximately one-third of this cohort had S-25OHD concentrations below adequate levels (< 50 nmol/L) during the first trimester of pregnancy, which may suggest that necessary action must be taken to increase their vitamin D levels. No clear association was observed between the vitamin D status and GDM in this study.

scholarly journals DETERMINANTS OF GESTATIONAL DIABETES MELLITUS

2021 ◽  
Vol 17 (37) ◽  
pp. 48-56
Author(s):  
Yuli Puspita DEVI ◽  
Rumaisah ABDILLAH ◽  
Muthmainnah MUTHMAINNAH
Keyword(s):  
Diabetes Mellitus ◽  
Birth Weight ◽  
Family History ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Secondary Data ◽  
Perinatal Complications ◽  
Family History Of Diabetes ◽  
History Of

Background: Gestational Diabetes Mellitus (GDM) is a glucose tolerance disorder that first appears during pregnancy. GDM can cause a variety of obstetric and perinatal complications for pregnant women and their fetuses. The prevalence of GDM in the city of Surabaya in 2015 amounted to 2.29%, increasing to 3.88% in 2018. Aim: The purpose of this study was to analyze the determinants (family history of diabetes mellitus, BMI, history of birth weight, parity, and the age of the pregnant woman) that influence the GDM. Methods: This research is an analytical study with an observational approach. The research design was carried out using a case-control study. In this study, the number of samples was 36 people, 6 cases, and 30 people as controls, and were taken randomly. The data source obtained from secondary data (medical records of pregnant women) at Mulyorejo Health Center Surabaya. The analysis used in this study was a simple logistic regression test. Results and Discussion: The result showed an effect of a family history of diabetes mellitus (p = 0.035) on the incidence of GDM. Parity was a potential variable (p = 0.077) on the incidence of GDM. Meanwhile, BMI, history of birth weight, and mother's age did not affect the incidence of GDM. Conclusion: Pregnant women with a family history of diabetes who are not balanced with maintaining a good lifestyle can experience complications of developing GDM.

scholarly journals Screening and Management of Gestational Diabetes Mellitus after Bariatric Surgery

Nutrients ◽  
2018 ◽  
Vol 10 (10) ◽  
pp. 1479 ◽  
Author(s):  
Katrien Benhalima ◽  
Caro Minschart ◽  
Dries Ceulemans ◽  
Annick Bogaerts ◽  
Bart Van Der Schueren ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Bariatric Surgery ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Screening Tests ◽  
Oral Glucose ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Increased Risk

Gestational diabetes mellitus (GDM) is a frequent medical complication during pregnancy. This is partly due to the increasing prevalence of obesity in women of childbearing age. Since bariatric surgery is currently the most successful way to achieve maintained weight loss, increasing numbers of obese women of childbearing age receive bariatric surgery. Bariatric surgery performed before pregnancy significantly reduces the risk to develop GDM but the risk is generally still higher compared to normal weight pregnant women. Women after bariatric surgery therefore still require screening for GDM. However, screening for GDM is challenging in pregnant women after bariatric surgery. The standard screening tests such as an oral glucose tolerance test are often not well tolerated and wide variations in glucose excursions make the diagnosis difficult. Capillary blood glucose measurements may currently be the most acceptable alternative for screening in pregnancy after bariatric surgery. In addition, pregnant women after bariatric surgery have an increased risk for small neonates and need careful nutritional and foetal monitoring. In this review, we address the risk to develop GDM after bariatric surgery, the challenges to screen for GDM and the management of women with GDM after bariatric surgery.

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