scholarly journals The influence of maternal blood glucose during pregnancy on weight outcomes at birth and preschool age in offspring exposed to hyperglycemia first detected during pregnancy, in a South African cohort

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258894
Author(s):  
Tawanda Chivese ◽  
Magret C. Haynes ◽  
Hetta van Zyl ◽  
Una Kyriacos ◽  
Naomi S. Levitt ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Gestational Age ◽  
Maternal Blood ◽  
Overweight And Obesity ◽  
Preschool Age ◽  
Postprandial Blood Glucose ◽  
Third Trimester ◽  
Weight Outcomes ◽  
Z Scores ◽  
In Pregnancy

Introduction Little is known about the influence of hyperglycemia first detected in pregnancy (HFDP) on weight outcomes in exposed offspring in Africa. We investigated the influence of maternal blood glucose concentrations during pregnancy on offspring weight outcomes at birth and preschool age, in offspring exposed to HFDP, in South Africa. Research design and methods Women diagnosed with HFDP had data routinely collected during the pregnancy and at delivery, at a referral hospital, and the offspring followed up at preschool age. Maternal fasting, oral glucose tolerance test 1 and 2-hour blood glucose were measured at diagnosis of HFDP and 2-hour postprandial blood glucose during the third trimester. Offspring were classified as either those exposed to diabetes first recognized in pregnancy (DIP) or gestational diabetes (GDM). At birth, neonates were classified into macrosomia, low birth weight (LBW), large for gestational age (LGA), appropriate (AGA) and small for gestational age (SGA)groups. At preschool age, offspring had height and weight measured and Z-scores for weight, height and BMI calculated. Results Four hundred and forty-three neonates were included in the study at birth, with 165 exposed to DIP and 278 exposed to GDM. At birth, the prevalence of LGA, macrosomia and LBW were 29.6%, 12.2% and 7.5%, respectively, with a higher prevalence of LGA and macrosomia in neonates exposed to DIP. At pre-school age, the combined prevalence of overweight and obesity was 26.5%. Maternal third trimester 2-hour postprandial blood glucose was significantly associated with z-scores for weight at birth and preschool age, and both SGA and LGA at birth. Conclusion In offspring exposed to HFDP, there is a high prevalence of LGA and macrosomia at birth, and overweight and obesity at preschool age, with higher prevalence in those exposed to DIP, compared to GDM. Maternal blood glucose control during the pregnancy influences offspring weight at birth and preschool age.

scholarly journals Pengaruh Teknik Akupressure Terhadap Nyeri Punggung Pada Ibu Hamil Di Wilayah Puskesmas Jogonalan I Klaten

2018 ◽  
Vol 3 (1) ◽  
Author(s):  
Niken Tri Sukeksi ◽  
Gita Kostania ◽  
Emy Suryani
Keyword(s):  
Back Pain ◽  
Data Analysis ◽  
Experimental Design ◽  
Pregnant Women ◽  
Test Data ◽  
Gestational Age ◽  
Severe Pain ◽  
Third Trimester ◽  
Labour Process ◽  
In Pregnancy

Abstract: Acupressure, Back Pain, Pregnancy. Acupressure is effective to relieve back pain in Meridian point. Acupressure technique is done to help pregnant women in relieving complaints in pregnancy such as nausea and vomiting. In labour process, this technique can be an induction of labor, and can reduce anxiety. The purpose is to know the influence of acupressure technique to relieve back pain for pregnant women in Puskesmas Jogonalan I area of Klaten. Research is pre experimental design with one group pretest posttest approach. The population is all pregnant women in Puskesmas Jogonalan I area of Klaten. The population target is all third trimester of pregnant women in Puskesmas Jogonalan I area of Klaten. Technique sampling is purposive sampling with 30 peopole, ang using t-test data analysis. The characteristics of respondents showed that most of them are 20-35 years old, their gestational age are 3137 weeks, their occupation are housewives, and most of them have 2-3 children. Degree of back pain in pregnant women before acupressure as many as 21 people (70%) are in severe pain. Degree of back pain in pregnant women after given acupressure as many as 24 people (80%) are in mild pain. There is influence of acupressure technique to relieve back pain for pregnant women in Puskesmas Jogonalan I area of Klaten (t =9,893; p=0,001<0,05).

scholarly journals May Circulating Steroids Reveal a Predisposition to Intrahepatic Cholestasis of Pregnancy in Non-Pregnant Women?

2018 ◽  
pp. S499-S510
Author(s):  
P. ŠIMJÁK ◽  
M. HILL ◽  
A. PAŘÍZEK ◽  
L. VÍTEK ◽  
M. VELÍKOVÁ ◽  
...  
Keyword(s):  
Gestational Age ◽  
Intrahepatic Cholestasis ◽  
Liver Disorder ◽  
Maternal Blood ◽  
Gas Chromatography Mass Spectrometry ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Third Trimester ◽  
Umbilical Blood ◽  
Subject Factor ◽  
Cholestasis Of Pregnancy

Intrahepatic cholestasis of pregnancy (ICP) is a frequent liver disorder, mostly occurring in the third trimester. ICP is not harmful to the mothers but threatens the fetus. The authors evaluated steroid alterations in maternal and mixed umbilical blood to elucidate their role in the ICP development. Ten women with ICP were included in the study. Steroids in the maternal blood were measured by Gas Chromatography-Mass Spectrometry (GC-MS) (n=58) and RIA (n=5) at the diagnosis of ICP, labor, day 5 postpartum, week 3 postpartum and week 6 postpartum. The results were evaluated by ANOVA consisting of the subject factor, between subject factors ICP, gestational age at the diagnosis of ICP and gestational age at labor, within-subject factor Stage and ICP × Stage interaction. The 17 controls were firstly examined in the week 36 of gestation. ICP patients showed reduced CYP17A1 activity in the C17,20 lyase step thus shifting the balance between the toxic conjugated pregnanediols and harmless sulfated 5α/β-reduced-17-oxo C19 steroids. Hence, more toxic metabolites originating in maternal liver from the placental pregnanes may penetrate backward to the fetal circulation. As these alterations persist in puerperium, the circulating steroids could be potentially used for predicting the predisposition to ICP even before next pregnancy.

scholarly journals Glycaemic profile in the second and third trimesters of normal pregnancy compared to non-pregnant adult females

2019 ◽  
Vol 13 (1) ◽  
pp. 30-36 ◽  
Author(s):  
Aruna Nigam ◽  
Neha Varun ◽  
Sumedha Sharma ◽  
YP Munjal ◽  
Anupam Prakash
Keyword(s):  
Blood Glucose ◽  
Pregnant Women ◽  
Normal Pregnancy ◽  
Postprandial Blood Glucose ◽  
Second Trimester ◽  
Third Trimester ◽  
Glycaemic Variability ◽  
The Third ◽  
Data Points ◽  
Mean Blood Glucose

Aim To assess the glycaemic profile and glycaemic variation in the second and third trimesters of normal pregnancies. Methodology Healthy pregnant women aged 19–35 years between 24 and 36 weeks of gestation were recruited for ambulatory glucose profile monitoring. A total of 18 women in the second trimester, 15 women in the third trimester and 9 healthy non-pregnant women were recruited providing, respectively, 205 days (19,680 data points), 147 days (14,112 data points) and 100 days (9,600 data points) for analysis. Results Mean blood glucose level was 20.2% lower in the second trimester and 10.6% lower in the third trimester than non-pregnant women (p < 0.001). In pregnancy, it took 15 to 20 minutes more to reach peak postprandial blood glucose levels compared to non-pregnant women (p = 0.003). Glycaemic variability was more in the third trimester (p < 0.001). Conclusion There is tight blood sugar control along with lower mean blood glucose in healthy pregnant women compared to non-pregnant women. Despite this tight glycaemic control, glycaemic variability is higher during pregnancy.

scholarly journals No Effect of Lifestyle Intervention during Third Trimester on Brain Programming in Fetuses of Mothers with Gestational Diabetes

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 556
Author(s):  
Franziska Schleger ◽  
Katarzyna Linder ◽  
Louise Fritsche ◽  
Jan Pauluschke-Fröhlich ◽  
Martin Heni ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Gestational Diabetes ◽  
Lifestyle Intervention ◽  
Fetal Brain ◽  
Postprandial Blood Glucose ◽  
Measurement Time ◽  
Third Trimester ◽  
Time Points ◽  
Maternal Metabolism

Maternal metabolism and intrauterine conditions influence development of health and disease in offspring, leading to metabolic, physiologic, and/or epigenetic adaptation of the fetus. Maternal gestational diabetes (GDM) leads to higher incidence of obesity and type 2 diabetes in offspring. We have previously shown that fetuses of insulin-resistant mothers with GDM have a delayed reaction to auditory stimuli in the postprandial state, indicating a fetal central insulin resistance. We tested whether this effect could be influenced by a lifestyle intervention in mothers with GDM, including diet counselling and regular blood glucose measurements. We measured fetal brain activity over the course of a maternal glucose challenge, at two measurement time points (baseline at an average of 29 weeks of gestation and follow-up after 4 weeks) in mothers with GDM and mothers with normal glucose tolerance (NGT). Data from eight mothers were able to be included. Fetuses of GDM mothers showed longer latencies than those of NGT mothers postprandially at both measurement time points during the third trimester and did not show a difference in response patterns between baseline and after 4 weeks. Maternal postprandial blood glucose and insulin values did not change from baseline to follow-up either. While the overall intervention seems to have been effective, it does not appear to have influenced the fetal postprandial brain responses. This might have been because interventions for GDM take place relatively late in pregnancy. Future research should focus on maternal lifestyle interventions as early as possible during gestation, or even prenatally.

scholarly journals Maternal Oxidative Stress Biomarkers in Pregnancy and Child Growth from Birth to Age 6

2021 ◽  
Author(s):  
Olufunmilayo Arogbokun ◽  
Emma Rosen ◽  
Alexander P Keil ◽  
Ginger L Milne ◽  
Emily Barrett ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Weight Gain ◽  
Prostaglandin F2α ◽  
Third Trimester ◽  
Oxidative Stress Biomarkers ◽  
Child Weight ◽  
Stress Biomarkers ◽  
Childhood Weight ◽  
Z Scores ◽  
In Pregnancy

Abstract Context Maternal oxidative stress in pregnancy can arise through a multitude of sources and may have lifelong consequences for the child. Animal studies suggest that prenatal oxidative stress may contribute to metabolic dysfunction and excessive weight gain in the offspring. However, this relationship has been studied minimally in humans. Objective Determine the association between prenatal oxidative stress biomarkers and child weight and body mass index (BMI) z-scores from birth to age 6. Methods Within The Infant Development and the Environment Study (TIDES) prospective pregnancy cohort, we calculated age- and sex-specific Z-scores for child weight and BMI, measured between birth and age 6 (N = 736). Three oxidative stress biomarkers were quantified in third-trimester urine, including 8-iso-prostaglandin F2α (8-iso-PGF2α), its primary metabolite, and prostaglandin F2α (PGF2α). We examined associations between each biomarker and Z-scores using linear regression as well as group-based trajectory modeling. Results Prenatal 8-iso-PGF2α and its metabolite were associated with lower birth weight and higher weight at age 4. For example, an ln-unit increase in 8-iso-PGF2α was associated with 0.17 SD higher weight at age 4 (95% CI 0.01, 0.33). These biomarkers were also associated with higher BMI at age 4. Finally, within 4 unique weight trajectories (low, normal, high, and low–high), children of mothers with higher 8-iso-PGF2α were 2.56 times more likely (95% CI 1.22, 5.41) to be in the low–high trajectory than children in the normal group. Conclusion We observed associations between third-trimester oxidative stress and lower birth weight as well as higher early childhood weight and BMI. These findings have important implications for understanding the developmental origins of childhood weight gain and metabolic disease.

Third Trimester Umbilical Artery Doppler in Low-Risk Pregnancies and its Correlation to Estimated Fetal Weight and Birthweight

2019 ◽  
Author(s):  
Angelo Sirico ◽  
Anke Diemert ◽  
Peter Glosemeyer ◽  
Kurt Hecher
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Gestational Age ◽  
Umbilical Artery ◽  
Fetal Weight ◽  
Reference Ranges ◽  
Third Trimester ◽  
Z Scores ◽  
The Mean ◽  
Estimated Fetal Weight

Abstract Purpose This study investigated the correlation between the umbilical artery (UA) pulsatility index (PI) and the estimated fetal weight percentile and birthweight (BW) percentile, respectively. Materials and Methods We included low-risk pregnancies, in which UA Doppler investigations after 28 weeks were performed. Cases were allocated according to BW percentiles: small for gestational age (SGA) with BW < 10th percentile; appropriate for gestational age (AGA) and large for gestational age (LGA) with BW > 90th percentile. We analyzed differences in the mean UA-PI and UA-PI z-score for gestational age according to the three groups. Linear regression was performed to evaluate any relationship between Doppler indices and BW percentiles. Multiple logistic regression analysis was performed to determine the independent association of UA-PI with LGA babies. In a second step, we considered data on estimated fetal weight (EFW) percentiles and performed the same analysis. Results We analyzed 14 554 pregnancies from 2004 to 2015. The mean UA-PI and mean UA-PI z-scores in the LGA group were lower than in the AGA and SGA groups (p < 0.001). UA-PI and UA-PI z-scores were linearly related to birthweight percentiles (p < 0.001) and to EFW percentiles (p < 0.001). Logistic regression analysis showed that low UA-PI was independently associated with neonatal LGA (p < 0.001). Conclusion The higher the EFW and BW percentiles, the lower the UA-PI. However, reference ranges for UA Doppler are only based on gestation weeks. Further studies are needed to clarify whether customized reference ranges based on EFW percentiles are more appropriate for the evaluation of fetal wellbeing in the third trimester.

Increased serum sulfate in pregnancy: relationship to gestational age.

1985 ◽  
Vol 31 (6) ◽  
pp. 866-867 ◽  
Author(s):  
D E Cole ◽  
L S Baldwin ◽  
L J Stirk
Keyword(s):  
Ion Chromatography ◽  
Gestational Age ◽  
Physiological Process ◽  
Third Trimester ◽  
The Third ◽  
Controlled Flow ◽  
Serum Sulfate ◽  
In Pregnancy ◽  
Inorganic Sulfate

Abstract Controlled-flow ion chromatography has significantly improved the precision with which inorganic sulfate (SO4) can be measured in serum. In this study, we have shown that serum SO4 is increased in pregnancy. The increase appears to follow gestational age, resulting in a 39% higher value by the middle of the third trimester. We suggest that this increase is a natural physiological process, which enhances SO4 availability to the growing fetus and placenta.

scholarly journals Early Screening for Gestational Diabetes Using IADPSG Criteria May Be a Useful Predictor for Congenital Anomalies: Preliminary Data from a High-Risk Population

2020 ◽  
Vol 9 (11) ◽  
pp. 3553
Author(s):  
Agnieszka Zawiejska ◽  
Katarzyna Wróblewska-Seniuk ◽  
Paweł Gutaj ◽  
Urszula Mantaj ◽  
Anna Gomulska ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Gestational Diabetes ◽  
Early Pregnancy ◽  
Gestational Age ◽  
Congenital Malformations ◽  
Fasting Blood Glucose ◽  
High Risk Population ◽  
Oral Glucose ◽  
Iadpsg Criteria ◽  
In Pregnancy

Background: Our aim was to investigate whether the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) glycemic thresholds used for detecting hyperglycemia in pregnancy can be predictive for malformations in women with hyperglycemia detected in early pregnancy. Methods: a single-center, retrospective observational trial of 125 mother-infant pairs from singleton pregnancies with hyperglycemia according to the IADPSG criteria diagnosed at the gestational age below 16 weeks. Glucose values obtained from 75-g OGTT (oral glucose tolerance test) were investigated as predictors for congenital malformations in newborns. Results: Characteristics of the cohort: maternal age: 31.5 ± 5.2, pre-pregnancy body mass index (BMI) ≥ 30 kg/m2: 42.0%, gestational age at diagnosis (weeks): 12.0 ± 4.0, and newborns with congenital malformations: 8.8%. Fasting blood glycemia (FBG) and HbA1c (Haemoglobin A1c) at baseline significantly predicted the outcome (expB: 1.06 (1.02–1.1), p = 0.007 and expB: 2.05 (1.24–3.38), p = 0.005, respectively). Both the fasting blood glucose (FBG) value of 5.1 mmol/dL (diagnostic for gestational diabetes mellitus (GDM)) and 5.5 mmol/dL (upper limit for normoglycemia in the general population) significantly increased the likelihood ratio (LR) for fetal malformations: 1.3 (1.1; 1.4) and 1.5 (1.0; 2.4), respectively. Conclusions: (1) Fasting glycemia diagnostic for GDM measured in early pregnancy is associated with a significantly elevated risk for congenital malformations. (2) Our data suggest that women at elevated risks of GDM/diabetes in pregnancy (DiP) should have their fasting blood glucose assessed before becoming pregnant, and the optimization of glycemic control should be considered if the FBG exceeds 5.1 mmol/dL.

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