scholarly journals Oxidative stress in pregnant women with diabetes mellitus

2018 ◽  
Vol 20 (6) ◽  
pp. 461-471 ◽  
Author(s):  
Roman V. Kapustin ◽  
Olga N. Arzhanova ◽  
Alena V. Tiselko
Keyword(s):  
Oxidative Stress ◽  
Diabetes Mellitus ◽  
Pregnant Women ◽  
Asymmetric Dimethylarginine ◽  
Malonic Dialdehyde ◽  
Perinatal Outcomes ◽  
Abnormal Development ◽  
Different Types ◽  
Anti Oxidant ◽  
Adverse Perinatal Outcomes

Oxidative stress (OS) plays an important role in embryo development, implantation, placentation, fetal development and labour. Diabetes mellitus (DM) is associated with an increase in OS processes. However, the expression of OS biomarkers in pregnant women with DM remains unclear. Based on a literature review, the features of the pro- and anti-oxidant systems of pregnant women with different types of DM have been established. Pregnancy in patients with DM has been shown to be characterised by an activation of OS processes. This leads to an overexpression of free radicals (peroxynitrite), toxic derivatives (malonic dialdehyde, 8-isoprostane) and specific enzymes (asymmetric dimethylarginine, catalase) and a decrease in the synthesis of antioxidants (superoxide dismutase, glutathione peroxidase and uric acid). The modified expression of these biomarkers is observed both in the blood and the placenta of pregnant women. These disorders can cause an unfavourable course of pregnancy, abnormal development of the placenta and development of adverse perinatal outcomes in pregnant women with DM. Nevertheless, given the inconsistency of data obtained, further scientific studies are needed to clarify this issue.

scholarly journals Dynamic thiol/disulfide homeostasis in gestational diabetes mellitus: Is it related with adverse perinatal outcomes?

2019 ◽  
Vol 6 (9) ◽  
pp. 198-204 ◽  
Author(s):  
Beril Gürlek ◽  
Murat Alan ◽  
Sabri Çolak ◽  
Özgür Önal ◽  
Özcan Erel ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Characteristic Curve ◽  
Perinatal Outcomes ◽  
Oral Glucose ◽  
Total Thiol ◽  
Adverse Perinatal Outcomes

Objective: Aims of the study is to specify the significance of thiol/disulfide homeostasis in the aspect of gestational diabetes mellitus (GDM) and GDM-related complications. Material and Methods: This study is a prospective review of the data of 61 healthy and non-pregnant women, 58 healthy pregnant women, and 62 pregnant women with GDM. Results: The patients with gestational diabetes mellitus had significantly higher disulfide/native thiol and disulfide/total thiol concentrations than non-pregnant patients (p<0.001 for both) and healthy pregnant patients (p: 0.015 and p: 0.018, respectively). Besides, in GDM group had significantly lower native thiol/total thiol concentrations than non-pregnant patients and healthy pregnant patients (p<0.001 and p: 0.016, respectively). There were positive and significant correlations between disulfide levels and HbA1c concentrations (r=0.26, p: 0.042), and between disulfide and oral glucose tolerance test first hour concentrations (r=0.26, p: 0.039). The receiver operating characteristic curve analyses for native thiol, total thiol, and disulfide were unable to predict adverse perinatal outcomes in this cohort. Conclusion: The significantly higher concentrations of disulfide/native thiol and disulfide/total thiol in women with GDM could be considered as the presence of increased oxidative stress.  However, these markers failed to predict adverse perinatal outcomes. Keywords: gestational diabetes mellitus; oxidative stress; perinatal outcome; pregnancy; thiol/disulfide homeostasis

Insulin Dosing, Glycemic Control, and Perinatal Outcomes in Pregnancies Complicated by Type-2 Diabetes

2020 ◽  
Author(s):  
Hugh C.G. Nadeau ◽  
Marta E. Maxted ◽  
Devika Madhavan ◽  
Stephanie L. Pierce ◽  
Maisa Feghali ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Pregnant Women ◽  
Perinatal Outcomes ◽  
Severe Insulin Resistance ◽  
Adverse Perinatal Outcomes

Objective This study aimed to evaluate the prevalence of severe insulin resistance (insulin requirements ≥2 units/kg) at delivery and the relationship between severe insulin resistance, glycemic control, and adverse perinatal outcomes in pregnant women with type-2 diabetes mellitus. Study Design This is a retrospective cohort study of women with type-2 diabetes mellitus who delivered between January 2015 and December 2017 at a tertiary academic medical center. Maternal demographic information, self-monitored blood sugars, and insulin doses were abstracted from the medical record. Multivariable logistic regression was used to identify maternal baseline characteristics associated with severe insulin resistance at delivery. Results Overall 72/160 (45%) of women had severe insulin resistance. Women in the severe insulin resistance group demonstrated evidence of suboptimal glycemic control as evidenced by higher mean hemoglobin A1c (HbA1c) values (7.2 [ ±  1.1] vs. 6.6 [ ±  1.3%], p = 0.003), higher mean fasting (104.0 [ ±  17.4] vs. 95.2 [ ±  11.7 mg/dL], p < 0.001) and postprandial glucose values (132.4 [ ±  17.2] vs. 121.9 [ ± 16.9 mg/dL]), p < 0.001), and a higher percentage of total glucose values that were elevated above targets (37.7 [95% confidence interval (CI): 26.8–50] vs. 25.6 [95% CI: 13.3–41.3%], p < 0.001). Maternal HbA1c ≥6.5% and insulin use prior to pregnancy were associated with a higher prevalence of severe insulin resistance, while Hispanic ethnicity and non-White race were associated with a lower prevalence of severe insulin resistance. The rates of adverse perinatal outcomes including large for gestational age (LGA) birth weight, cesarean delivery, and hypertensive disorders of pregnancy did not differ between groups. Conclusion Severe insulin resistance is common among pregnant women with type-2 diabetes, and it is associated with suboptimal glycemic control. Future studies are necessary to develop strategies to identify women with severe insulin resistance early in pregnancy and facilitate adequate insulin dosing. Key Points

Comparison of Salivary Antioxidants and Oxidative Stress Status in Gestational Diabetes Mellitus and Healthy Pregnant Women

2020 ◽  
Vol 20 ◽  
Author(s):  
Fatemeh Ahmadi-Motamayel ◽  
Shima Fathi ◽  
Mohammad Taghi Goodarzi ◽  
Shiva Borzouei ◽  
Jalal Poorolajal ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Pregnant Women ◽  
Oxidative Stress Markers ◽  
Blood Samples ◽  
Stress Markers ◽  
Total Antioxidant ◽  
Total Oxidative Stress ◽  
And Oxidative Stress

Background: One of the most common complications of pregnant women is gestational diabetes mellitus (GDM). Oxidative stress can play an important role in GDM. Objective: The aim of this study was to evaluate salivary antioxidants and oxidative stress markers in GDM. Method: Twenty pregnant women with GDM and 20 healthy pregnant women with normal blood glucose test participated in this study. Five mL of unstimulated saliva samples were collected. Spectrophotometric assay was carried out for sialochemical analysis. Stata software was used for data analysis. Results: The GDM group exhibited no significant difference in salivary total antioxidant capacity and malondialdehyde compared to the healthy control group. All of antioxidants markers, the uric acid, total antioxidant, peroxidase and catalase, decreased in GDM group that the difference of peroxidase and catalase was statistically significant. All of oxidative stress markers, the salivary malondyaldehid, total oxidative stress and total thiol, increased in GDM group. GDM group exhibited significantly higher salivary total oxidative stress levels. Conclusion: Catalase level was significantly lower and total oxidative stress was significantly higher. These two markers might have significant importance and might exhibit early changes compared to other factors in GDM. . Some of salivary antioxidants might have diagnostic, prognostic or therapeutic implications in GDM. Other studies with large sample size on salivary and blood samples need to be done to confirm this properties and salivary samples using instead of blood samples in GDM biomarkers changes.

scholarly journals Pregnancy Outcomes and SARS-CoV-2 Infection: The Spanish Obstetric Emergency Group Study

Viruses ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 853
Author(s):  
Sara Cruz Melguizo ◽  
María Luisa de la Cruz Conty ◽  
Paola Carmona Payán ◽  
Alejandra Abascal-Saiz ◽  
Pilar Pintando Recarte ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Perinatal Outcomes ◽  
Preterm Births ◽  
Hypertensive Disorder ◽  
Obstetric Emergency ◽  
Increased Risk ◽  
Emergency Group ◽  
Adverse Perinatal Outcomes ◽  
Maternal Disease ◽  
The Relationship

Pregnant women who are infected with SARS-CoV-2 are at an increased risk of adverse perinatal outcomes. With this study, we aimed to better understand the relationship between maternal infection and perinatal outcomes, especially preterm births, and the underlying medical and interventionist factors. This was a prospective observational study carried out in 78 centers (Spanish Obstetric Emergency Group) with a cohort of 1347 SARS-CoV-2 PCR-positive pregnant women registered consecutively between 26 February and 5 November 2020, and a concurrent sample of PCR-negative mothers. The patients’ information was collected from their medical records, and the association of SARS-CoV-2 and perinatal outcomes was evaluated by univariable and multivariate analyses. The data from 1347 SARS-CoV-2-positive pregnancies were compared with those from 1607 SARS-CoV-2-negative pregnancies. Differences were observed between both groups in premature rupture of membranes (15.5% vs. 11.1%, p < 0.001); venous thrombotic events (1.5% vs. 0.2%, p < 0.001); and severe pre-eclampsia incidence (40.6 vs. 15.6%, p = 0.001), which could have been overestimated in the infected cohort due to the shared analytical signs between this hypertensive disorder and COVID-19. In addition, more preterm deliveries were observed in infected patients (11.1% vs. 5.8%, p < 0.001) mainly due to an increase in iatrogenic preterm births. The prematurity in SARS-CoV-2-affected pregnancies results from a predisposition to end the pregnancy because of maternal disease (pneumonia and pre-eclampsia, with or without COVID-19 symptoms).

scholarly journals Fetal movement counting is associated with the reduction of delayed maternal reaction after perceiving decreased fetal movements: a prospective study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shigeki Koshida ◽  
Shinsuke Tokoro ◽  
Daisuke Katsura ◽  
Shunichiro Tsuji ◽  
Takashi Murakami ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Maternal Behavior ◽  
Multivariable Analysis ◽  
Perinatal Outcomes ◽  
Fetal Movement ◽  
Post Intervention ◽  
Fetal Movements ◽  
Adverse Perinatal Outcomes ◽  
The Impact ◽  
Maternal Reaction

AbstractMaternal perception of decreased fetal movement is associated with adverse perinatal outcomes. Although there have been several studies on interventions related to the fetal movements count, most focused on adverse perinatal outcomes, and little is known about the impact of the fetal movement count on maternal behavior after the perception of decreased fetal movement. We investigated the impact of the daily fetal movement count on maternal behavior after the perception of decreased fetal movement and on the stillbirth rate in this prospective population-based study. Pregnant women in Shiga prefecture of Japan were asked to count the time of 10 fetal movements from 34 weeks of gestation. We analyzed 101 stillbirths after the intervention compared to 121 stillbirths before the intervention. In multivariable analysis, maternal delayed visit to a health care provider after the perception of decreased fetal movement significantly reduced after the intervention (aOR 0.31, 95% CI 0.11–0.83). Our regional stillbirth rates in the pre-intervention and post-intervention periods were 3.06 and 2.70 per 1000 births, respectively. Informing pregnant women about the fetal movement count was associated with a reduction in delayed maternal reaction after the perception of decreased fetal movement, which might reduce stillbirths.

scholarly journals Uric Acid and Xanthine Levels in Pregnancy Complicated by Gestational Diabetes Mellitus—The Effect on Adverse Pregnancy Outcomes

2018 ◽  
Vol 19 (11) ◽  
pp. 3696 ◽  
Author(s):  
Anna Pleskacova ◽  
Vendula Bartakova ◽  
Katarina Chalasova ◽  
Lukas Pacal ◽  
Katerina Kankova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Uric Acid ◽  
High Risk ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Perinatal Outcomes ◽  
Anthropometric Parameters ◽  
Pregnancy And Postpartum ◽  
Adverse Perinatal Outcomes ◽  
Adverse Pregnancy

Uric acid (UA) levels are associated with many diseases including those related to lifestyle. The aim of this study was to evaluate the influence of clinical and anthropometric parameters on UA and xanthine (X) levels during pregnancy and postpartum in women with physiological pregnancy and pregnancy complicated by gestational diabetes mellitus (GDM), and to evaluate their impact on adverse perinatal outcomes. A total of 143 participants were included. Analyte levels were determined by HPLC with ultraviolet detection (HPLC-UV). Several single-nucleotide polymorphisms (SNPs) in UA transporters were genotyped using commercial assays. UA levels were higher within GDM women with pre-gestational obesity, those in high-risk groups, and those who required insulin during pregnancy. X levels were higher in the GDM group during pregnancy and also postpartum. Positive correlations between UA and X levels with body mass index (BMI) and glycemia levels were found. Gestational age at delivery was negatively correlated with UA and X levels postpartum. Postpartum X levels were significantly higher in women who underwent caesarean sections. Our data support a possible link between increased UA levels and a high-risk GDM subtype. UA levels were higher among women whose glucose tolerance was severely disturbed. Mid-gestational UA and X levels were not linked to adverse perinatal outcomes.

scholarly journals Diagnostic utility of protein excretion in 24-hour urine and the protein to creatinine ratio for adverse perinatal outcomes and time of delivery

2021 ◽  
Vol 29 (3) ◽  
pp. 255-265
Author(s):  
İbrahim Ömeroğlu ◽  
Didem Dereli Akdeniz ◽  
Hakan Gölbaşı ◽  
Ceren Gölbaşı ◽  
Atalay Ekin
Keyword(s):  
Pregnant Women ◽  
Latency Period ◽  
Perinatal Outcomes ◽  
Urinary Protein ◽  
Neonatal Outcomes ◽  
Protein Loss ◽  
Spot Urine ◽  
Protein Levels ◽  
Adverse Perinatal Outcomes ◽  
Diagnosis Of Hypertension

Objective Our study aimed to evaluate the perinatal and neonatal outcomes of hypertensive pregnant women with or without proteinuria. We compared the predictivity of spot urinary protein to creatinine (P/C) ratio and 24-hour protein excretions on outcomes. Methods We retrospectively enrolled 230 pregnant women with a new diagnosis of hypertension between 20 and 37 weeks of gestation. We divided the patients into two groups according to the protein level determined by 24-hour urine collection and P/C ratio. The presence and level of proteinuria, its relationship with the P/C ratio, and the relationship between these findings and perinatal outcomes were evaluated. Results Gestational age at delivery weeks and latency period (duration between diagnosis of hypertension and delivery) were significantly earlier in pregnant women with ≥300 mg/24-h and P/C ratio ≥0.3. Adverse neonatal outcomes were significant in patients with proteinuria ≥300 mg/24-hour and P/C ratio ≥0.3. Urinary protein levels in 24-hour urine were significantly higher in pregnant women with P/C ratio ≥0.3 and a significantly positive correlation was found between 24-h proteinuria and P/C (r=0.382, p<0.001). Conclusion Our study demonstrated that a protein loss of ≥300 mg in 24-h and a P/C ratio in spot urine ≥0.3 in hypertensive pregnant women is associated with adverse perinatal outcomes. Furthermore, we have identified that proteinuria ≥300 mg/day and spot urine P/C ratio ≥0.3 in hypertensive pregnant women make them prone to early delivery risk.

Placental elasticity assessment by point shear wave elastography in pregnancies with intrauterine growth restriction

2019 ◽  
Vol 47 (8) ◽  
pp. 841-846 ◽  
Author(s):  
Murat Akbas ◽  
Faik M. Koyuncu ◽  
Burcu Artunç-Ulkumen
Keyword(s):  
Pregnant Women ◽  
Shear Wave ◽  
Intrauterine Growth Restriction ◽  
Perinatal Outcomes ◽  
Shear Wave Elastography ◽  
Growth Restriction ◽  
Intrauterine Growth ◽  
The Mean ◽  
Adverse Perinatal Outcomes ◽  
Doppler Indices

Abstract Background Placental elasticity varies in different diseases. Our objective was to evaluate placental elasticity using point shear wave elastography (pSWE) in pregnancies with intrauterine growth restriction (IUGR). Methods A total of 66 pregnant women with IUGR and 81 healthy pregnant women were enrolled. Placental elasticity was measured using the transabdominal pSWE method. Ten measurements were made, and the mean was accepted as the mean placental elasticity value in each case. The results for IUGR pregnancies and controls were compared. Results The mean pSWE values were significantly higher in pregnancies with IUGR, which means that women with IUGR have stiffer placentas (P < 0.001). Furthermore, the pSWE values were significantly and positively correlated with Doppler indices and adverse perinatal outcomes. Conclusion The pregnancies with IUGR had stiffer placentas than the healthy controls. The utilization of pSWE for placental elasticity may be useful in the diagnosis and management of IUGR as a supplement to the existing ultrasonography methods.

scholarly journals Maternal and perinatal outcomes in diabetic pregnancies at BPKIHS

2017 ◽  
Vol 6 (6) ◽  
pp. 2262
Author(s):  
Anamika Das
Keyword(s):  
Diabetes Mellitus ◽  
Pregnant Women ◽  
Neonatal Outcome ◽  
Post Partum ◽  
Perinatal Outcomes ◽  
Perinatal Complications ◽  
Overt Diabetes ◽  
Global Pandemic ◽  
The Government ◽  
Sedentary Life Style

Background: Diabetes has become a global pandemic because of aging population, sedentary life style, urbanization, and increasing incidence of obesity; this study was aimed to identify the maternal and perinatal outcome in Diabetes complicating pregnancies and to compare the outcome in Gestational Diabetes Mellitus and Overt Diabetes Mellitus.Methods: This was a descriptive study conducted from 1st April 2013-31st March 2014 on total 75 pregnant women. All antenatally diagnosed cases of GDM and overt diabetes, booked or unbooked, whoever came for delivery were studied. Both mothers and neonates were followed up in ante-partum, intra-partum, and post-partum period till their stay in hospital. Management of the patient was done as per the hospital protocol.Results: Out of 75 cases enrolled, 25.33% had GDM and 16% had overt diabetes mellitus.57.33%patients were multigravida, among which 40% had GDM and 17.33% had Overt Diabetes Mellitus.61.33% patients underwent LSCS, of which 41.33% had GDM and 20% had overt diabetes mellitus. Obstetric complication was more common in GDM patients (30.66%) compared to Overt (22.66%). 89.33%babies had good neonatal outcome and 10.66% babies (6.66% of GDM mothers and 4% of overt mothers) had poor neonatal outcome (macrosomia, hypoglycaemia, prematurity, respiratory distress with NICU stay and use of antibiotics, poor APGAR (<7 at 5 min), gross congenital malformation, hyperbilirubinemia, stillbirth and neonatal death).Conclusions: Maternal and perinatal complications was commonly seen in diabetic pregnancy though more common in GDM.The time has come for the Government of Nepal to implement an effective plan to the benefit of pregnant women with diabetes during pregnancy.

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