scholarly journals The factors affecting the physical development of neonates in pregnant women with or without gestational diabetes mellitus

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0251024
Author(s):  
Xiaodi Zhao ◽  
Nana Li ◽  
Runping Jia ◽  
Shumin Chen ◽  
Ling Wang

Objectives To explore the factors affecting neonatal physical development in pregnant women with or without gestational diabetes mellitus (GDM). Methods The subjects were selected from the pregnant woman giving birth in 2nd Affiliated Hospital of Zhengzhou University, from November 2015 to May 2016. The age, occupation, education level, gestational age, body weight before pregnancy, body weight at delivery, body height, delivery pattern, GDM status of pregnant women and neonatal gender, birth weight (BW), chest circumference (CC), head circumference (HC) and birth length (BL) were collected through medical records and questionnaires. The clinical data were retrospectively analyzed and studied. Results The significant differences were found between women with GDM and without GDM in following neonatal variables (P<0.05): BW, CC, and HC. GDM status increased the incidence of macrosomia (OR = 2.241, 95% CI: 1.406–3.573), large CC (OR = 2.470, 95% CI: 1.687–3.6153). Gestational weight gain (GWG) above IOM guideline was risk factor for macrosomia (OR = 1.763, 95% CI:1.098–2.833), large HC (OR = 1,584, 95% CI: 1.093–2.296) and large CC (OR = 1.707, 95% CI:1.163–2.506). Underweight was risk factor for short BL (OR = 2.543, 95% CI:1.161–5.571) and small CC (OR = 1.901, 95% CI:1.064–3.394). Female neonate was prone to appear short BL(OR = 2.831, 95% CI: 1.478–5.422) and small HC (OR = 2.750, 95% CI: 1.413–5.350), and not likely to macrosomia (OR = 0.538, 95% CI: 0.343–0.843), longer BL (OR = 0.584, 95% CI: 0.401–0.850), large HC (OR = 0.501, 95% CI: 0.352–0.713), and (OR = 0.640, 95% CI: 0.446–0.917). For women with GDM, gestational age was an risk factor of neonatal BW (low BW: OR = 0.207, 95% CI: 0.085–0.503; macrosomia: OR = 1.637, 95% CI: 1.177–2.276), BL (short BL: OR = 0.376, 95% CI: 0.241–0.585; long BL: OR = 1.422, 95% CI: 1.054–1.919), HC (small HC: OR = 0.343, 95% CI: 0.202–0.583; large HC: OR = 1.399, 95% CI: 1.063–1.842) and CC (small CC: OR = 0.524, 95% CI: 0.374–0.733; large CC: OR = 1.485, 95% CI: 1.138–1.936). Conclusions In our study, gestational age, GDM status, neonatal gender, GWG and pre-pregnancy body mass index (BMI) are associated the abnormal physical development of neonates. In women with GDM, gestational age was correlate with neonatal abnormal physical developments.

2021 ◽  
Vol 8 ◽  
Author(s):  
Tai-Ho Hung ◽  
Chung-Pu Wu ◽  
Szu-Fu Chen

Background: Dysregulation of placental mechanistic target of rapamycin (mTOR) activity has been implicated in the pathophysiology of pregnancies complicated by idiopathic fetal growth restriction (FGR) and gestational diabetes mellitus (GDM) with large-for-gestational-age (LGA) infants. However, the underlying mechanisms remain unclear.Methods: We obtained placentas from women with normal pregnancies (n = 11) and pregnancies complicated by FGR (n = 12) or GDM with LGA infants (n = 12) to compare the levels of total and phosphorylated forms of Akt, AMPK, TSC2, and mTOR among the three groups and used primary cytotrophoblast cells isolated from 30 normal term placentas to study the effects of oxygen–glucose deprivation (OGD) and increasing glucose concentrations on the changes of these factors in vitro.Results: Placentas from FGR pregnancies had lower phosphorylated Akt (p-Akt) levels (P &lt; 0.05), higher p-AMPKα levels (P &lt; 0.01), and lower mTOR phosphorylation (P &lt; 0.05) compared to that of normal pregnant women. Conversely, women with GDM and LGA infants had higher p-Akt (P &lt; 0.001), lower p-AMPKα (P &lt; 0.05), and higher p-mTOR levels (P &lt; 0.05) in the placentas than normal pregnant women. Furthermore, primary cytotrophoblast cells subjected to OGD had lower p-Akt and p-mTOR (both P &lt; 0.05) and higher p-AMPKα levels (P &lt; 0.05) than those cultured under standard conditions, but increasing glucose concentrations had opposite effects on the respective levels. Administering compound C, an AMPK inhibitor, did not significantly affect Akt phosphorylation but partially reversed mTOR phosphorylation. Administering LY294002, an Akt inhibitor, decreased p-mTOR levels, but did not change the levels of total and phosphorylated AMPKα.Conclusion: These results suggest that Akt and AMPK are involved in the regulation of trophoblast mTOR activity in the placentas of pregnancies complicated by FGR and GDM with LGA infants.


Author(s):  
Kondapuram Veena ◽  
Srilakshmi Ambarkar ◽  
Srilakshmi Ambarkar

Background: To study the prevalence of gestational diabetes mellitus among antenatal mothers and to assess the importance of universal screening to detect gestational diabetes mellitus (GDM).Methods: A total of 300 antenatal women irrespective of gestational age were screened for GDM at their antenatal visit during the period of January 2020 to June 2020. All women were screened with 75gm oral glucose load irrespective of last meal followed by blood glucose estimation by glucose oxidase peroxidase method 2 hours following glucose load. A cut-off of 140mg/dl or more were labelled as gestational diabetes mellitus as per DIPSI guidelines.Results: Out of 300 antenatal women tested, 24 women (8%) were positive for gestational diabetes mellitus. During the first, second and third trimesters 12.5%, 33.33% and 54.17% were diagnosed with gestational diabetes mellitus respectively. The number of gestational diabetes mellitus patients for the age groups ≤20 years, 21-25 years, 26-30 years and >30 years are 2 (8.33%), 3 (12.5%), 8 (33.33%) and 11 (45.83%) respectively. The number of pregnant women tested positive for gestational diabetes mellitus with BMI ≤18.5, 18.6-24.9, 25-29.9 and 30-35 are 2 (8.33%), 4(16.67%), 8(33.33%) and 10(41.67%) respectively.Conclusions: Prevalence of GDM in our study is 8%. About 29.16% of GDM did not have any risk factors. This emphasizes the importance of universal screening for GDM of all pregnant women irrespective of gestational age. There is an increased association of GDM with age, BMI, family history and parity according to our study.


Author(s):  
D. H. John ◽  
P. A. Awoyesuku ◽  
D. A. MacPepple ◽  
N. J. Kwosah

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.


2019 ◽  
Vol 10 (2) ◽  
pp. 26-30
Author(s):  
Vivek Sinha ◽  
Poonam Kachhawa

Background: Gestational diabetes mellitus (GDM) is a common medical condition that complicates pregnancies..Gestational diabetes mellitus (GDM) is a diabetic metabolic disorder that occurs in 4% of all pregnant women and 14% of ethnic groups with more prevalence of type II diabetes. It can be defined as increased or abnormal insulin resistance, decreased insulin sensitivity or glucose intolerance with first diagnosis during pregnancy. Aims and Objectives: The purpose of this study was to evaluate the diagnostic screening value of the HbA1c, prevalence of GDM and associated risk factors. Materials and Methods: The study was conducted at the metabolic clinic; in the department of Biochemistry located at SIMS, Hapur. A semi-structured pretested questionnaire was used for data collection. Following the DIPSI guidelines, patients with plasma glucose values >140 mg/dl were labeled as GDM. Statistical methods used were OR (CI95%), percentage, Chi square. Results: Out of 500, 6.72% had GDM. Among all GDM patients, 64.71% had age more than 30 years, 70.59% had BMI more than 25, 41.18% had gravida more than 3 and p- value was significant with regard to age and BMI. P value was found to be significant for risk factors namely positive family history of Diabetes Mellitus, history of big baby and presence of more than one risk factor. Conclusion: GDM is associated with high BMI, early pregnancy loss, family history of DM and previous history of big baby and there could be more than one risk factor. Thus universal screening followed by close monitoring of the pregnant women for early detection of GDM may help improving maternal and fetal outcomes.


2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Zeynab Farsangi ◽  
Ghazal Zoghi ◽  
Masoumeh Kheirandish ◽  
Roghayeh Shahbazi ◽  
Masoumeh Mahmoudi ◽  
...  

Background: Gestational diabetes mellitus (GDM), the most common metabolic disorder of pregnancy, is associated with alterations in circulating lipids. Objectives: The aim of this study was to compare lipid profiles in women with and without GDM. Methods: This study was performed on 84 pregnant women at 26 - 30 weeks of gestation (42 pregnant women with GDM as cases and 42 healthy pregnant women as controls). After obtaining informed consent and gathering demographic data, subjects underwent a 75 g oral glucose tolerance test, and lipid profile was also measured in all subjects. Results: We found that high-density lipoprotein (HDL) levels were significantly higher in the GDM group (53.10 ± 1.72 vs. 46.64 ± 1.70 mg/dL, P = 0.008). Total cholesterol (228.96 ± 52.03 vs. 211.59 ± 41.83 mg/dL) and triglyceride (TG) levels (225.58 ± 89.84 vs 208.38 ± 80.66 mg/dL) were also higher in the GDM group; however, the differences were not statistically significant (P = 0.770 and P = 0.327, respectively). On the contrary, low-density lipoprotein was found to be non-significantly higher in the healthy group (144.54 ± 26.01 vs 122.41 ± 4.82 mg/dL, P = 0.709). Besides, there was a significant association between HDL levels and GDM (OR 1.049; CI 95% (1.009 - 1.090), P = 0.015). This association remained significant when adjusted for age, BMI, and gestational age (OR 1.010; CI 95% (1.002 - 1.017), P = 0.009). No significant association was found between GDM and TG, cholesterol, and LDL levels. Conclusions: HDL levels are significantly higher in pregnant women with GDM compared to pregnant women without GDM. HDL level is significantly associated with GDM even after adjustment for age, BMI, and gestational age.


2018 ◽  
Vol 11 (3) ◽  
pp. 121-125 ◽  
Author(s):  
J Balani ◽  
SL Hyer ◽  
H Shehata ◽  
F Mohareb

Objective To develop a model to predict gestational diabetes mellitus incorporating classical and a novel risk factor, visceral fat mass. Methods Three hundred two obese non-diabetic pregnant women underwent body composition analysis at booking by bioimpedance analysis. Of this cohort, 72 (24%) developed gestational diabetes mellitus. Principal component analysis was initially performed to identify possible clustering of the gestational diabetes mellitus and non-GDM groups. A machine learning algorithm was then applied to develop a GDM predictive model utilising random forest and decision tree modelling. Results The predictive model was trained on 227 samples and validated using an independent testing subset of 75 samples where the model achieved a validation prediction accuracy of 77.53%. According to the decision tree developed, visceral fat mass emerged as the most important variable in determining the risk of gestational diabetes mellitus. Conclusions We present a model incorporating visceral fat mass, which is a novel risk factor in predicting gestational diabetes mellitus in obese pregnant women.


2019 ◽  
Vol 17 (1) ◽  
pp. 15-18
Author(s):  
Maria Ghafoor ◽  
Najma Farhat ◽  
Firdous Khatoon ◽  
Asifa Ghazi ◽  
Fauzia Anbreen ◽  
...  

Background: In developing countries, miscarriage is one of the common and increasing problems of pregnancy. The objectives of this study were to determine the frequency of pre-gestational diabetes mellitus among pregnant women with miscarriage in our population. Materials & Methods: This descriptive, cross-sectional study was conducted in the Department of Gynecology and Obstetrics, Khyber Teaching Hospital, Peshawar, Pakistan from 3rd November 2015 to 2nd May 2016. Sample size was 268 pregnant women with miscarriage selected through consecutive sampling technique. Inclusion criteria were all pregnant women with miscarriage. Exclusion criteria were molar pregnancy, ectopic pregnancy and diabetics. HbA1c levels of ≤6% was taken as normal, whereas a level >6 was taken as raised level or pre-gestational diabetes. Variables were age, pre-gestational diabetes mellitus, number of pregnancies and duration of pregnancy (≤24, >24). Mean and SD were calculated for quantitative while frequency and percentages for qualitative variables. Descriptive analysis was performed by using SPSS version 16. Results: Mean age of the patients was 27.66 ±4.93 years. Out of 268 participants, 81(30.22%) were having pre-gestational diabetes mellitus and 187(69.78) were normal, 234(87.31%) were having first pregnancy whereas 34 were having >1 pregnancies, the pre-gestational age ≤ 24 weeks were 130(48.51%) and >24 weeks were 138(51.49%). Conclusion: One third of the patients with miscarriage were having pre-gestational diabetes mellitus. Almost half of the patients were having gestational age of


Author(s):  
Linda Yanti ◽  
Surtiningsih Surtiningsih

Diabetes mellitus in pregnancy will cause a bad influence on the mother, among others, with hidramnion pregnancy, toxemia gravidarum, infection, and ketoacidosis. The effect on the children, is a congenital disorder, respiratory failure syndrome, fetal death in utero, hyperbilirubinemia, macrosomia, hypoglycemia, and hypocalcemia. On labor may occur atonic uterus, uterine inseria, shoulder dystocia, stillbirth, termination of labor with action. This study aims to identify factors that influence maternal whether the occurrence of gestational diabetes mellitus. This study was an observational analytic study with case control method, the entire population is pregnant women who visited the hospital Goeteng Tarunadibrata Purbalingga in 2015. The sample in this study were all pregnant women aged over 24 weeks of pregnancy were divided into groups of cases are mothers pregnant gestational diabetes and control groups, namely pregnant women who did not have gestational diabetes. The sample size in this study was calculated using the formula rule of thumb and diadaptkan each group of 50 samples. Data were analyzed using Chi-square test. The results showed factors parity over a significantly (p <0.005) risk 3,622 times the incidence of gestational diabetes mellitus, factor the number of pregnancies was significantly (p <0.005) at risk of 4.827 times the incidence of gestational diabetes mellitus, obesity factor did not have a significant influence (p> 0.005) on the incidence of gestational diabetes mellitus, factors of recurrent infections was significantly (p <0.005) risk 3,273 times the incidence of gestational diabetes mellitus, factor family history of diabetes was significantly (p <0.005) risk 2,935 times the incidence of gestational diabetes mellitus Keywords: Factors pregnant women, gestational diabetes


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