scholarly journals Plasma Glycated CD59 Predicts Early Gestational Diabetes and Large for Gestational Age Newborns

2020 ◽  
Vol 105 (4) ◽  
pp. e1033-e1040 ◽  
Author(s):  
DongDong Ma ◽  
Miguel Angel Luque-Fernandez ◽  
Delia Bogdanet ◽  
Gernot Desoye ◽  
Fidelma Dunne ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Early Pregnancy ◽  
Gestational Age ◽  
International Association ◽  
Adverse Outcomes ◽  
Large For Gestational Age ◽  
Blood Levels ◽  
Oral Glucose ◽  
Index Test

Abstract Context Gestational diabetes mellitus (GDM) diagnosed in early pregnancy is a health care challenge because it increases the risk of adverse outcomes. Plasma-glycated CD59 (pGCD59) is an emerging biomarker for diabetes and GDM. The aim of this study was to assess the performance of pGCD59 as a biomarker of early GDM and its association with delivering a large for gestational age (LGA) infant. Objectives To assess the performance of pGCD59 to identify women with GDM in early pregnancy (GDM < 20) and assess the association of pGCD59 with LGA and potentially others adverse neonatal outcomes linked to GDM. Methods Blood levels of pGCD59 were measured in samples from 693 obese women (body mass index > 29) undergoing a 75-g, 2-hour oral glucose tolerance test (OGTT) at <20 weeks’ gestation in the Vitamin D and Lifestyle Intervention study: the main analyses included 486 subjects who had normal glucose tolerance throughout the pregnancy, 207 who met criteria for GDM at <20 weeks, and 77 diagnosed with GDM at pregnancy weeks 24 through 28. Reference tests were 75-g, 2-hour OGTT adjudicated based on International Association of Diabetes and Pregnancy Study Group criteria. The index test was a pGCD59 ELISA. Results Mean pGCD59 levels were significantly higher (P < 0.001) in women with GDM < 20 (3.9 ± 1.1 standard peptide units [SPU]) than in those without (2.7 ± 0.7 SPU). pGCD59 accurately identified GDM in early pregnancy with an area under the curve receiver operating characteristic curves of 0.86 (95% confidence interval [CI], 0.83-0.90). One-unit increase in maternal pGCD59 level was associated with 36% increased odds of delivering an LGA infant (odds ratio for LGA vs non-LGA infant: 1.4; 95% CI, 1.1-1.8; P = 0.016). Conclusion Our results indicate that pGCD59 is a simple and accurate biomarker for detection of GDM in early pregnancy and risk assessment of LGA.

Comparison of the effectivity of two internationally recommended screening methods for the recognition of gestational diabetes

2013 ◽  
Vol 154 (20) ◽  
pp. 776-783
Author(s):  
Mónika Salamon ◽  
Zsuzsanna Soós ◽  
Roland Oláh ◽  
Máté Hazai ◽  
László Sóvágó ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
International Association ◽  
World Health ◽  
Large For Gestational Age ◽  
Screening Methods ◽  
Oral Glucose ◽  
Adverse Pregnancy

Introduction: Early diagnosis and adequate care of gestational diabetes is of great importance for both the mother and her fetus. Although several national and international guidelines are known on the methodology for screening gestational diabetes, a not negligible part of the cases remain unrecognized when applying even the most widely used criteria recommended by the World Health Organization (1st recommendation). A connection has been found between the maternal blood glucose values and the prevalence of still-birth, preeclampsia and large for gestational age neonates in several studies, from which the Hyperglycaemia and Adverse Pregnancy Outcomes study has come into prominence. According to conclusions of this study the International Association of Diabetic Pregnancy Study Groups suggested new numeric criteria for the evaluation of the 75-gramm oral glucose tolerance test (2nd rercommendation), which differs from the evaluation used in the afore mentioned screening system. Aims: The aim of the study was to compare the effectiveness of the two screening systems by evaluation of the pregnancy outcomes. Methods: By following non-twin pregnancies of 1107 pregnant mothers (831 with normal glucose tolerance, 276 with gestational diabetes based on any of the applied screening methods) the maternal (pre- and postterminal birth, caesarean section, toxaemia) and newborns pregnancy outcomes (infants small and large for gestational age, hypoglycaemia) were analysed. Results: With the exception of the prevalence of large for gestational age infants – which was higher among women screened by the new evaluation – no substantial difference in the efficacy of the two investigated methods was found. Conclusion: The decision whether the screening of gestational diabetes using the new criteria results in safer recognition of the disturbances of glucose metabolism during pregnancy requires further investigations including a large number of cases. Orv. Hetil., 2013, 154, 776–783.

Neonatal outcomes among offspring of obese women diagnosed with gestational diabetes mellitus in early versus late pregnancy

2018 ◽  
Vol 41 (3) ◽  
pp. 535-542 ◽  
Author(s):  
N E Grotenfelt ◽  
K Rönö ◽  
J G Eriksson ◽  
A Valkama ◽  
J Meinilä ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Early Pregnancy ◽  
Gestational Age ◽  
Late Pregnancy ◽  
Neonatal Outcomes ◽  
Large For Gestational Age ◽  
Oral Glucose ◽  
Diabetes Diagnosis ◽  
Obese Women ◽  
Diabetes Group

Abstract Background Maternal metabolic derangements associated with early pregnancy gestational diabetes may affect the fetus differently compared with gestational diabetes diagnosed later in pregnancy. The aim of this observational study was to assess neonatal outcomes according to timing of gestational diabetes diagnosis in obese women. Methods Women ≥18 years of age with a pre-pregnancy body mass index ≥30 kg/m2 were grouped according to the results of a 75 g 2-h oral glucose tolerance test performed at 13.1 weeks of gestation and repeated at 23.4 weeks if normal at first testing. The main outcomes were birthweight and large for gestational age. Results Out of 361 women, 164 (45.4%) were diagnosed with gestational diabetes, 133 (81.1%) of them in early pregnancy. The mean offspring birthweight was 3673 g (standard deviation (SD) 589 g) in the early and 3710 g (SD 552 g) in the late gestational diabetes group. In a multivariate logit model, the odds ratio for large for gestational age was 2.01 (95% CI: 0.39–10.39) in early compared with late gestational diabetes. Conclusions We observed no statistically significant differences in neonatal outcomes according to timing of gestational diabetes diagnosis. In addition to lack of power, early treatment of hyperglycemia may partly explain the results.

scholarly journals Maternal Body Mass Index and Ethnicity in Relation to The Adverse Outcomes of Large for Gestational Age and Gestational Diabetes Mellitus in a Retrospective Cohort of Australian Pregnant Women.

2021 ◽  
Author(s):  
Catherine Knight-Agarwal ◽  
Jani Rati ◽  
Meisa Al-Foraih ◽  
Dionne Eckley ◽  
Carrie Ka Wai Lui ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Body Mass Index ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Body Mass ◽  
Gestational Age ◽  
Retrospective Cohort ◽  
Adverse Outcomes ◽  
Large For Gestational Age ◽  
Maternal Body Mass Index

Abstract Background: The prevalence of maternal overweight and obesity has been increasing. This research explored the association between maternal body mass index and ethnicity in relation to the adverse outcomes of large for gestational age and gestational diabetes mellitus. Method: A retrospective cohort study was undertaken with 27 814 Australian women of various ethnicities, who gave birth to a singleton infant between 2008 and 2017. Variables were examined using logistic regression. Results: A significantly higher proportion of large for gestational age infants were born to overweight and obese women compared to those who were classified as underweight and healthy weight. Asian-born women with a body mass index of ≥ 40kg/m2 had an adjusted odds ratio of 9.926 (3.859 - 25.535) for birthing a large for gestational age infant whereas Australian-born women had an adjusted odds ratio of 2.661 (2.256 - 3.139) for the same outcome. Women born in Australia were at high risk of birthing a large for gestational age infant in the presence of insulin controlled gestational diabetes mellitus, but this risk was not significant for those with the diet-controlled type. Asian-born women did not present an elevated risk of birthing a large for gestational infant, in either the diet controlled, or insulin controlled gestational diabetes mellitus groups. Conclusion: Large for gestational age and gestational diabetes mellitus are adverse pregnancy outcomes that can lead to significant maternal and neonatal morbidity. Women who are overweight or obese, and considering a pregnancy, are encouraged to seek culturally appropriate nutrition and weight management advice during the periconception period.

Influence of Gestational Diabetes Mellitus on Weight Discrepancy in Twin Pregnancies

2010 ◽  
Vol 13 (4) ◽  
pp. 393-397 ◽  
Author(s):  
Katharina Klein ◽  
Mariella Mailath-Pokorny ◽  
Heinz Leipold ◽  
Elisabeth Krampl-Bettelheim ◽  
Christof Worda
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Gestational Diabetes Mellitus ◽  
Gestational Age ◽  
Relative Weight ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Gestational Age At Delivery ◽  
Twin Pregnancies

AbstractObjective:To evaluate the influence of gestational diabetes mellitus on weight discrepancy in twin pregnancies.Methods:200 twin pregnancies were included in the study. 157 nondiabetic pregnant women with twin gestations and 43 twin pregnancies with gestational diabetes mellitus (GDM) with viable fetuses born after 24 weeks of gestation were enrolled. Influence of maternal age, body-mass-index at the time of the oral glucose tolerance test, parity, smoking, chorionicity, gestational age at delivery and diagnosis of GDM on weight discrepancy of the twins was evaluated.Results:Mean weight discrepancy of all analyzed twin pregnancies was 285 grams (± 231), relative weight discrepancy was 11.3% (± 8.6). Univariate regression analyses showed that GDM, chorionicity and gestational age at delivery were significantly associated with weight discrepancy. In the multivariate model only diagnosis of GDM was significantly associated with weight discrepancy.Conclusion:Twin pregnancies with insulin requiring gestational diabetes seem to have less birth weight discrepancy than twin pregnancies with normal glucose tolerance.

scholarly journals ADCY5, CAPN10 and JAZF1 Gene Polymorphisms and Placental Expression in Women with Gestational Diabetes

Life ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 806
Author(s):  
Przemysław Ustianowski ◽  
Damian Malinowski ◽  
Patrycja Kopytko ◽  
Michał Czerewaty ◽  
Maciej Tarnowski ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Pregnant Women ◽  
International Association ◽  
Study Groups ◽  
Oral Glucose ◽  
Iadpsg Criteria ◽  
Capn10 Gene

Gestational diabetes mellitus (GDM) is carbohydrate intolerance that occurs during pregnancy. This disease may lead to various maternal and neonatal complications; therefore, early diagnosis is very important. Because of the similarity in pathogenesis of type 2 diabetes and GDM, the genetic variants associated with type 2 diabetes are commonly investigated in GDM. The aim of the present study was to examine the associations between the polymorphisms in the ADCY5 (rs11708067, rs2877716), CAPN10 (rs2975760, rs3792267), and JAZF1 (rs864745) genes and GDM as well as to determine the expression of these genes in the placenta. This study included 272 pregnant women with GDM and 348 pregnant women with normal glucose tolerance. The diagnosis of GDM was based on a 75 g oral glucose tolerance test (OGTT) at 24–28 weeks gestation, according to International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. There were no statistically significant differences in the distribution of the ADCY5 gene (rs11708067, rs2877716) and CAPN10 gene (rs2975760, rs3792267) polymorphisms between pregnant women with normal carbohydrate tolerance and pregnant women with GDM. We have shown a lower frequency of JAZF1 gene rs864745 C allele carriers among women with GDM CC + CT vs. TT (OR = 0.60, 95% CI = 0.41–0.87, p = 0.006), and C vs. T (OR = 0.75, 95% CI = 0.60–0.95, p = 0.014). In addition, ADCY5 and JAZF1 gene expression was statistically significantly increased in the placentas of women with GDM compared with that of healthy women. The expression of the CAPN10 gene did not differ significantly between women with and without GDM. Our results indicate increased expression of JAZF1 and ADCY5 genes in the placentas of women with GDM as well as a protective effect of the C allele of the JAZF1 rs864745 gene polymorphism on the development of GDM in pregnant women.

scholarly journals Maternal body mass index and country of birth in relation to the adverse outcomes of large for gestational age and gestational diabetes mellitus in a retrospective cohort of Australian pregnant women

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Catherine R. Knight-Agarwal ◽  
Rati Jani ◽  
Meisa Al Foraih ◽  
Dionne Eckley ◽  
Carrie Ka Wai Lui ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Body Mass Index ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Body Mass ◽  
Gestational Age ◽  
Adverse Outcomes ◽  
Large For Gestational Age ◽  
Maternal Body Mass Index ◽  
Country Of Birth

Abstract Background The prevalence of gestational diabetes mellitus in Australia has been rising in line with the increased incidence of maternal overweight and obesity. Women with gestational diabetes mellitus, high body mass index or both are at an elevated risk of birthing a large for gestational age infant. The aim was to explore the relationship between country of birth, maternal body mass index with large for gestational age, and gestational diabetes mellitus. In addition to provide additional information for clinicians when making a risk assessment for large for gestational age babies. Method A retrospective cohort study of 27,814 women residing in Australia but born in other countries, who gave birth to a singleton infant between 2008 and 2017 was undertaken. Logistic regression analysis was used to examine the association between the aforementioned variables. Results A significantly higher proportion of large for gestational age infants was born to overweight and obese women compared to those who were classified as underweight and healthy weight. Asian-born women residing in Australia, with a body mass index of ≥40 kg/m2, had an adjusted odds ratio of 9.926 (3.859–25.535) for birthing a large for gestational age infant. Conversely, Australian-born women with a body mass index of ≥40 kg/m2 had an adjusted odds ratio of 2.661 (2.256–3.139) for the same outcome. Women born in Australia were at high risk of birthing a large for gestational age infant in the presence of insulin-requiring gestational diabetes mellitus, but this risk was not significant for those with the diet-controlled type. Asian-born women did not present an elevated risk of birthing a large for gestational age infant, in either the diet controlled, or insulin requiring gestational diabetes mellitus groups. Conclusions Women who are overweight or obese, and considering a pregnancy, are encouraged to seek culturally appropriate nutrition and weight management advice during the periconception period to reduce their risk of adverse outcomes.

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