scholarly journals MON-LB8 A Preconception Lifestyle Intervention Maintained Throughout Pregnancy Improves Some Gestational and Neonatal Outcomes in Women With Obesity and Infertility

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Mehdi Rouissi ◽  
Marie-Andrée Lévesque ◽  
Marie-Christine Hébert ◽  
Farrah Jean-Denis ◽  
Matea Belan ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Clinical Outcomes ◽  
Healthy Lifestyle ◽  
Neonatal Outcomes ◽  
Control Group ◽  
Childbearing Age ◽  
Neonatal Complications ◽  
Gestational Weight ◽  
Lifestyle Program ◽  
Significant Difference

Abstract Background : Obesity in women of childbearing age is associated with infertility and increases significantly the risks of many pregnancy and neonatal complications. Adopting a healthy lifestyle prior conception and maintaining it during pregnancy may reduce these complications. Our aim was therefore to determine whether a lifestyle program targeting women with obesity and infertility and maintained during pregnancy improves gestational and neonatal outcomes. Methods : We report on 46 women who became pregnant and had available outcome data during pregnancy and at birth, among 127 women with infertility and obesity (body mass index, BMI ≥30 kg/m²), or overweight with PCOS (BMI ≥27 kg/m²), who were enrolled in a lifestyle randomized-controlled trial. Participants were randomized to the control group (CG, n=20), who received standard of care, or the lifestyle group (LSG, n=26), who followed a lifestyle program alone for 6 months, and then in combination with usual fertility care for 18 months or until the end of pregnancy. Pregnancy and neonatal outcomes were retrospectively retrieved from mothers’ and newborns’ medical records. Results : At enrollment, both groups were similar for age (29.3 vs 31.0 years), BMI (38.7 vs 38.4 kg/m2) and waist circumference (113.7 vs 112.7 cm). Preconception weight loss was significantly higher in the LSG compared to the CG (4.86 kg vs 1.21 kg, p=0.013), but gestational weight gains were similar (+10.83 vs +10.52 kg, p=0.987). During pregnancy, groups did not differ for the rates of preeclampsia, gestational diabetes or other clinical outcomes, but significantly less women in the LSG required insulin for treatment of their gestational diabetes (12.5% vs 42.1%, p=0.027) as well as urgent cesarean section due to failure of vaginal delivery (0.0% vs 21.1%, p=0.021). Regarding neonatal outcomes, there was no significant difference between groups for gestational age, weight at birth and head circumference, as well as rates of prematurity, LGA, SGA, birth defects or other clinical outcomes, but babies from the LSG displayed significantly lower tricipital skinfolds (4.73 mm vs 5.72 mm, p=0.031) and trends for lower sum of four skinfolds (16.61 mm vs 19.06 mm, p=0.056) and increased length at birth (50.82 cm vs 49.63 cm, p=0,053). Conclusion : In women with obesity and infertility, our lifestyle program initiated prior to fertility treatments and maintained throughout pregnancy improved their preconception weight and lifestyle, but not their gestational weight gain. Such intervention was nonetheless effective to reduce significantly some clinically relevant pregnancy and neonatal complications. If these results are replicated in a larger sample, it would strongly suggest that women with obesity should be supported to adopt a healthy lifestyle prior conception in order to increase their likelihood of giving birth to a healthy baby.

Thyroid Dysfunction in Pregnant Women with Gestational Diabetes Mellitus

2020 ◽  
Vol 16 (8) ◽  
pp. 895-899 ◽  
Author(s):  
Shahin Safian ◽  
Farzaneh Esna-Ashari ◽  
Shiva Borzouei
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Thyroid Dysfunction ◽  
Control Group ◽  
Thyroid Peroxidase ◽  
Free T4 ◽  
Significant Difference ◽  
Experimental Group

Aims: Investigation thyroid dysfunction and autoimmunity in pregnant women with gestational diabetes mellitus. Background: This article was written to evaluate the thyroid function and anti-thyroid peroxidase (anti- TPO) antibodies in pregnant women with gestational diabetes mellitus (GDM). Method: A total of 252 women with GDM and 252 healthy pregnant women were enrolled. Thyroid tests, including TSH, FreeT3, Free T4, and anti-TPO were performed for all women at 24–28 weeks of gestation. Data analysis was then carried out using SPSS ver. 22. Result: There was a significant difference between the experimental group (38.4%) and the control group (14.06%) in terms of the prevalence of subclinical hypothyroidism (p= 0.016). The frequency of anti-TPO was higher in the experimental group than the control group and positive anti-TPO was observed in 18.6% of women with GDM and 10.3% of healthy pregnant women (P= 0.008). Conclusion: Thyroid disorders are observed in pregnant women with GDM more frequently than healthy individuals and it may be thus reasonable to perform thyroid tests routinely.

scholarly journals The effect of oat bran consumption on gestational diabetes: a randomized controlled clinical trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zahra Barati ◽  
Mina Iravani ◽  
Majid Karandish ◽  
Mohammad Hosein Haghighizadeh ◽  
Sara Masihi
Keyword(s):  
Clinical Trial ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Fasting Blood Glucose ◽  
Intervention Group ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Standard Diet ◽  
Oat Bran ◽  
Significant Difference

Abstract Background Gestational diabetes is the most common medical complication in pregnancy, and it has many side effects for the mother and the fetus. The aim of this study was to evaluate the effect of oat bran consumption on gestational diabetes. Methods This study is a randomized clinical trial that was performed on 112 women with gestational diabetes treated with diet. Participants were randomly divided into two groups of 56. Participants in both groups were given a diet for gestational diabetes. In addition to the diet, the intervention group received 30 g of oat bran daily for 4 weeks at lunch and dinner. Tests of fasting blood glucose and two-hour postprandial (2hpp) glucose were taken from both groups: before the intervention, and 2 and 4 weeks after the start of the intervention. Data analysis was performed using SPSS statistical software (version 22) using independent t-test, as well as Chi-square and Mann-Whitney tests. P values less than 0.05 were considered statistically significant. Results There was no statistically significant difference between the two groups in terms of mean blood glucose before the intervention, while 2 and 4 weeks after the intervention, mean fasting blood glucose and two-hour postprandial (2hpp) glucose decreased significantly in the intervention group compared with the control group (P < 0.001). Conclusion Based on the results of this study, the addition of oat bran to the standard diet for pregnant women with gestational diabetes reduced fasting blood glucose and two-hour postprandial (2hpp) glucose. More detailed studies with higher sample sizes are recommended to prove the effectiveness of this valuable dietary supplement. Trial registration IRCT registration number:IRCT20191220045828N1. Registration date: 2020-04-18. Registered while recruiting.

Neonatal outcomes in case of euglycemic control in gestational diabetes using insulin versus metformin. Randomized controlled trial

2021 ◽  
Vol 04 (01) ◽  
pp. 01-08
Author(s):  
Ahmed Mansour
Keyword(s):  
Randomized Controlled Trial ◽  
Birth Weight ◽  
Gestational Diabetes ◽  
Controlled Trial ◽  
Insulin Injection ◽  
Neonatal Outcomes ◽  
Insulin Group ◽  
Randomized Controlled ◽  
Metformin Group ◽  
Significant Difference

Background: Gestational diabetes mellitus (GDM) is a major global public health issue, with prevalence increasing in recent years due to the epidemic of obesity and type 2 diabetes. Aim of the Work: to compare different neonatal outcomes according to the different treatment modalities used in the management of GDM. Our hypothesis was that Metformin is as effective and safe as insulin in patients with gestational diabetes. Patients and Methods: The current non inferiority-Randomized controlled trial was conducted at Ain Shams Maternity hospital between June 2020 to February 2021. The study included 140 outpatient cases or admitted patients for antenatal care: Group A: women were given Metformin (Total 70) and Group B: Women were given insulin. (Total 70). Results: there was no significant difference between Metformin and Insulin groups regarding age, enrollment BMI, parity and family history of DM. There was no significant difference between Metformin and Insulin groups regarding gestational age at enrollment and delivery as well as pregnancy duration after intervention. BMI at delivery, BMI increase as well as BMI increase rate were significantly lower in Metformin group. There were no significant differences between Metformin and Insulin groups regarding fasting, two-hour postprandial and HbA1c blood glucose at enrollment and throughout treatment as well as their reduction after intervention. Maternal complications as hypoglycemia, hyperglycemia and preeclampsia were non-significantly less frequent among Metformin group than among Insulin group. Compliance to treatment was significantly more frequent among Metformin group than among Insulin group. Cesarean delivery was non­significantly less frequent among Metformin group than among Insulin group. There was no significant difference between Metformin and Insulin regarding birth weight APGAR-1, but APGAR-5 was significantly higher in Metformin group. Neonatal complications as IUFD, IUGR, macrosomia, congenital anomalies, neonatal hypoglycemia, respiratory distress and NICU admission were non-significantly less frequent among Metformin group. Conclusions: From the results of current study we can conclude that: Oral metformin was effective as insulin injection in control and management of GDM. BMI was controlled with oral metformin better than insulin injection. Maternal and neonatal complications specially birth weight were the same with both types of treatment. Women had better compliance to metformin treatment. Type of delivery wasn’t affected by type of treatment.

scholarly journals Effectiveness of Nursing Intervention on Health Locus of Control and Self-Efficacy in Women with Gestational Diabetes

2021 ◽  
Vol 3 (1) ◽  
pp. 12
Author(s):  
Sabah R. H. Ahmed ◽  
Safaa G. Salem ◽  
Nahed M. Saber ◽  
Reda T. A. Abou Elazab ◽  
Merfat M. Atia
Keyword(s):  
Locus Of Control ◽  
Gestational Diabetes ◽  
Self Efficacy ◽  
Health Locus Of Control ◽  
Intervention Group ◽  
Nursing Intervention ◽  
Outpatient Clinics ◽  
Control Group ◽  
Significant Difference ◽  
And Control

the offspring in prenatal and postnatal periods and later life.  Lack of self-care is the most important reason for mortality in diabetic patients. Self-efficacy has a significant role in enhancing successful adherence to healthy behaviors, lifestyle modifications, and diabetes control among gestational diabetes pregnant women. Aim:  The current study aimed to evaluate the nursing intervention (NI) effectiveness on health locus of control (HELOC) and self-efficacy in women with gestational diabetes (GD). Methods: A quasi-experimental design (study and control group) was used. The researchers conducted this study at the Antenatal Outpatient Clinics of Shebin El-Kom Teaching Hospital, Menoufia Governorate, Egypt. A purposive sample of 120 women with GD was carefully chosen from the nominated setting and dispersed accidentally into two identical groups (study and control group). Three tools were used for collecting the study data: A structured self-administered questionnaire, the Multidimensional Health Locus of Control Scale-C Form, and the General Self-efficacy Scale. Results: There is a statistically significant difference between the intervention and control groups in their internal health locus of control (HELOC) scores after the intervention, with a mean difference of 4.70 at CI 95% for the intervention group p<0.001. A non-statistically significant difference was found between the intervention group and the control group in the external health locus of control (HELOC) mean scores before and after the intervention, although there was a significant difference between the change in both groups p=0.032. Also, there is a highly statistically significant difference between the intervention group and the control group in the self-efficacy scores after the intervention in the intervention group, where p<0.001 compared to a non-significant difference between them before the intervention group intervention (p=0.555). Conclusion: The study concluded that the women with GD who attended NI sessions obtained higher HELOC scores (internal and external) and higher self-efficacy scores than those who do not. Educational nursing intervention should become a fundamental part of the total management of gestational diabetes in antenatal outpatient clinics.

scholarly journals ESTILO DE VIDA E SUAS RELAÇÕES COM HIPERTENSÃO ARTERIAL SISTÊMICA E DIABETES MELLITUS

2018 ◽  
Vol 7 (1) ◽  
pp. 361-373
Author(s):  
Elias Ferreira Porto ◽  
Claudia Kumpel ◽  
Anselmo Cordeiro de Souza ◽  
Izabel Maria de Oliveira ◽  
Karoline Mayara de Aquiles Bernardo ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
General Health ◽  
Healthy Lifestyle ◽  
Cross Sectional Study ◽  
Health Perception ◽  
Control Group ◽  
Healthy Individuals ◽  
Cross Sectional ◽  
Significant Difference ◽  
The Individual

Avaliar o estilo de vida e percepção do estado geral de saúde em pacientes com Diabetes Mellitus tipo 2 - DM, Hipertensão Arterial Sistêmica - HAS e indivíduos saudáveis. Métodos: Estudo transversal, com grupo controle. Avaliado estilo de vida com Questionário Fantástico, e percepção geral de saúde via uma pergunta âncora de diabéticos do tipo 2 (n = 37), hipertensos (n = 60), e indivíduos saudáveis (n = 43). Análise estatística descritiva, analise de variância, e razão de chance (Odds Rattio – OR). Resultados: Verificou-se diferença significante (p0,0001) na pontuação do Questionário Fantástico entre os indivíduos saudáveis em relação DM e HAS. O pior desempenho no estilo de vida para os três grupos foi nos domínios de atividade física e alimentação. O risco do indivíduo com HAS afirmar que sua saúde é pior do que indivíduos da mesma faixa etária foi OR 1.8 (1.415 a 2.419) e para os indivíduos diabéticos OR de 2.8 (1.776 a 4.579) em relação a indivíduos saudáveis. Conclusão: Diabéticos e hipertensos têm um pior estilo de vida e percepção geral de saúde do que indivíduos saudáveis. Assim o estilo de vida saudável pode reduzir a prevalência e auxiliar no controle de doenças já estabelecidas.Palavras-chave: Estilo de vida. Hipertensão Arterial. Diabetes Mellitus. ABSTRACT: To evaluate the lifestyle and perception of general health status in patients with type 2 diabetes mellitus - DM, systemic arterial hypertension - SAH and healthy individuals. Methods: Cross-sectional study with control group. (N = 37), hypertensive (n = 60), and healthy subjects (n = 43) were assessed using a Fantastic Questionnaire, and general health perception via an anchor question. Descriptive statistical analysis, analysis of variance, and odds ratio (Odds Rattio - OR). Results: There was a significant difference (p 0.0001) in the score of the Fantastic Questionnaire among healthy individuals in relation to DM and SAH. The worst lifestyle performance for the three groups was in the physical activity and feeding domains. The risk of the individual with SAH to state that their health is worse than individuals of the same age group was OR 1.8 (1.415 to 2.419) and for the diabetic individuals OR of 2.8 (1.776 to 4.579) in relation to healthy individuals. Conclusion: Diabetics and hypertensives have a worse lifestyle and overall health perception than healthy individuals. Thus the healthy lifestyle can reduce the prevalence and help in the control of already established diseases.Keywords: Lifestyle. Hypertension. Diabetes Mellitus.

scholarly journals A Digital Lifestyle Program in Outpatient Treatment of Type 2 Diabetes: A Randomized Controlled Study

2020 ◽  
pp. 193229682094228
Author(s):  
Eva Hilmarsdóttir ◽  
Árún K. Sigurðardóttir ◽  
Ragnheiður Harpa Arnardóttir
Keyword(s):  
Type 2 Diabetes ◽  
Outpatient Treatment ◽  
Healthy Lifestyle ◽  
Intervention Group ◽  
Well Being ◽  
Smartphone Application ◽  
Controlled Study ◽  
Control Group ◽  
Lifestyle Program

Background: Lifestyle is important in type 2 diabetes mellitus (T2DM). This study’s aim was to investigate whether a healthy-lifestyle-supporting smartphone application could affect treatment outcomes at an endocrinology outpatient clinic. Methods: Consecutively invited patients were randomly assigned to an intervention or control group after age and gender stratification. In addition to standard care, intervention group participants used a smartphone application to access a lifestyle program (SidekickHealth) through which they received personalized recommendations and education about healthy lifestyles. Tests at baseline and every other month for six months included body weight and blood tests for glycated hemoglobin (HbA1c) and blood lipids, as well as questionnaires about distress related to diabetes, health-related quality of life, depression, and anxiety. Statistics included comparisons both within and between groups. Results: A total of 37 patients (23 women) were included, whereof 30 finished, 15 in each group (19% dropout); the average age was 51.2 ± 10.6 (25-70) years. No significant differences emerged between groups, but within the intervention group, there was a significant decrease in HbA1c from 61 ± 21.4 to 52.7 ± 15.2 mmol/mol, in disease-specific distress from 19.5 ± 16.5 to 11.7 ± 13.4, and in anxiety symptoms from 5.4 ± 4.0 to 4.1 ± 3.8. No significant changes occurred within the control group. The application usage was most frequent during the first months and differed interpersonally. Conclusions: Our results indicate that the SidekickHealth digital lifestyle program could potentially enhance outpatient treatment in T2DM, in terms of both glycemic control and psychological well-being but larger confirmative studies are needed.

Comparison of two different treatments in depressed pregnant women: fetal growth characteristics and neonatal outcomes

2018 ◽  
Vol 47 (1) ◽  
pp. 134-137
Author(s):  
Lisa Giardinelli ◽  
Lorenzo Lelli ◽  
Valentina Ugolini ◽  
Lisa Lazzeretti ◽  
Iuliia Burian ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Fetal Growth ◽  
Psychological Intervention ◽  
Growth Characteristics ◽  
Psychological Support ◽  
Prenatal Depression ◽  
Neonatal Outcomes ◽  
Control Group ◽  
Treatment Groups ◽  
Significant Difference

Abstract Background In this pilot study, the effects of selective serotonin reuptake inhibitors (SSRIs) and psychological intervention on fetal growth characteristics and neonatal outcomes were evaluated in two different groups of women affected by prenatal depression. Methods Forty-seven pregnant women diagnosed with major depression were divided into two different treatment groups according to the severity of their depression. The first group was treated with a combination of pharmacotherapy and psychological support. The second group (milder depression) was treated with psychological support only. The control group (CG) was made up of 26 healthy pregnant women. All of the patients and controls were assessed by means of a structured clinical interview and different self-reported questionnaires. Fetal ultrasonography assessments were performed in the second and third trimesters. Neonatal outcomes were evaluated at delivery. Results The infants of both treatment groups showed significant alterations in fetal biometry and a higher rate of low birth weight (LBW) with respect to controls. The infants of the patients treated with psychological support showed only a significantly higher rate of head circumference, <10th percentile with respect to controls. No significant difference was found between the two patient groups when fetal growth characteristics and neonatal outcomes were taken into account. Conclusion The data obtained from this study shed light on the effects of pharmacological and psychological treatment of prenatal depression on fetal growth.

scholarly journals Primary Repair for Injury of Medial Collateral Ligament During Total Knee Arthroplasty

2020 ◽  
Vol 8 (5_suppl5) ◽  
pp. 2325967120S0005
Author(s):  
Cheng Jin ◽  
Jia-yi Zhao ◽  
Jong-Keun Seon ◽  
Asep Santoso
Keyword(s):  
Clinical Outcomes ◽  
Suture Anchor ◽  
Primary Repair ◽  
Hospital Length Of Stay ◽  
Functional Score ◽  
Control Group ◽  
Subjective Feeling ◽  
Valgus Stress ◽  
Ambulatory Ability ◽  
Significant Difference

This study, we aim to determine whether intraoperative over-release of MCL that is treated with primary repair can achieve satisfactory clinical results when compared to those who did not have over-release of MCL. At the same time, we seek to look into the difference between two methods of primary repair (anchor suture and staple) in terms of clinical outcomes. Purposes: We determined whether, after TKA, patients with CIA versus patients with CACB demonstrated (1) decreased pain scores (2) greater ambulatory ability postoperatively (3) decreased daily opioid consumption and hospital length of stay Methods: 3897 TKAs were performed from year 2003-2014. Sixty-five patients with MCL injury due to over-release during TKA who were repaired with suture anchor or staple (suture anchor: 36 vs. staple: 29) were studied whereas matched group of 65 patients without MCL injury were selected and served as the control group. Subjective feeling of instability and functional score were assessed using Knee Society Score (KSS) and Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC). Objective stability was evaluated through measurement of opening angles in extension and 30° of knee flexion on valgus stress radiographs. The clinical and stability results of repair between the suture anchor and staple were compared. Results: The KSS and WOMAC scores in patients with primary repair of MCL during TKA from 50.6±14.8 to 87.3±8.3 and 65.9±16.3 to 17.7±8.3, respectively. However, there were neither statistical nor clinical significant difference when comparing between the group with primary repair and the control group. Radiographic stability also showed no differences between repair and control groups in extension and 30° of flexion (p= .63 and p= .37). Regarding the subgroups, There were no significant differences between the suture anchor and staple in terms of the stability and clinical outcomes Conclusion: Primary repair either with suture anchor or with staple for injury of the MCL in varus gonarthrosis during TKA provides a good stability and clinical outcomes as those of result with no MCL injury.

scholarly journals A Comparative Study of Relationship between Micronutrients and Gestational Diabetes

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Farideh Akhlaghi ◽  
Seyyed Majid Bagheri ◽  
Omid Rajabi
Keyword(s):  
Gestational Diabetes ◽  
Pregnant Women ◽  
Gestational Age ◽  
Control Group ◽  
Study Group ◽  
Inclusion Criteria ◽  
Control Groups ◽  
Significant Difference ◽  
Micronutrient Concentration ◽  
And Control

In this paper, we studied the relation between the micronutrient and gestational diabetes. Therefore, we measured micronutrient concentration including Ni, Al, Cr, Mg, Fe, Zn, Cu, and Se in serum of women with gestational diabetes between 24 and 28 weeks of gestational age (study group) who had inclusion criteria and comparison with micronutrient levels in normal pregnant women with same gestational age (control group). Results showed that there was no significant difference between the serum micronutrient level (Ni, Al, Cr, Mg, Zn, Cu, Se) in study and control groups except serum level of iron which in serum of gestational diabetic women was lower than normal pregnant women and difference was significant.

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