scholarly journals Mutations in transcription factor as rare causes of diabetes in pregnancy

2019 ◽  
Vol 22 (3) ◽  
pp. 274-280 ◽  
Author(s):  
Natalia A. Zubkova ◽  
Fatima F. Burumkulova ◽  
Vasily A. Petrukhin ◽  
Margarita A. Plechanova ◽  
Anton E. Panov ◽  
...  
Keyword(s):  
Transcription Factor ◽  
Glycemic Control ◽  
Pregnant Women ◽  
Clinical Characteristics ◽  
Diabetes In Pregnancy ◽  
Perinatal Complications ◽  
Nuclear Factors ◽  
Hepatocyte Nuclear Factors ◽  
Hnf1a Gene ◽  
In Pregnancy

MODY1 and MODY3 represent rare causes of diabetes in pregnancy. Establishing a molecular diagnosis of MODY1 or MODY3 during pregnancy may be important for minimizing risk of perinatal complications and for improving glycemic control after pregnancy. The objective of the study was to evaluate the contribution of mutations in HNF4A and HNF1A genes in development of diabetes in pregnancy and to describe clinical characteristics of diabetes in pregnancy associated with these mutations. 230 pregnant women (20-43 years) with different type of glucose intolerance complicated during their current pregnancy were included in the study. A custom NGS panel targeting 28 diabetes causative genes was used for sequencing. Heterozygous mutations in HNF4A and HNF1A genes were detected in 3% of cases. Mutations p.I271T in HNF4A gene and p.L148F, p.Y265C, p.G288W in HNF1A gene were novel. This study includes a description of patients with pregnancy diabetes due to mutations in hepatocyte nuclear factors.

scholarly journals Knowledge and Practices of Pregnant Women regarding Oral Health in A Tertiary Care Hospital in Nepal

2019 ◽  
Vol 57 (217) ◽  
Author(s):  
Neha Gupta ◽  
Manisha Chhetry
Keyword(s):  
Oral Health ◽  
Pregnant Women ◽  
Dental Care ◽  
Dental Health ◽  
Care Center ◽  
Tertiary Care ◽  
Care Hospital ◽  
Perinatal Complications ◽  
Institutional Review ◽  
In Pregnancy

Introduction: Poor dental hygiene has been associated with various perinatal complications in studiesdone worldwide but few studies in Nepal have explored the knowledge of pregnant ladies regardingdental hygiene. The aim of the study was to know the knowledge and practices of pregnant womenregarding oral health in a tertiary care center in Nepal. Methods: A qualitative study was carried out in Nobel Medical College and Teaching Hospital fromJanuary 15, 2018 to June 15, 2018 after approval from the Institutional Review Committee of NobelMedical College. Convenience sampling was done. Fifty pregnant women admitted in antenatalward were interviewed regarding their knowledge of dental care in pregnancy, the common dentalproblems they faced and the treatment taken. A predesigned proforma was used and results wereanalyzed using SPSS version 17. Results: Twenty two (44%) patients reported dental problems during pregnancy. Bleeding gumswas seen in 7 (14%) and toothache in 7 (14%) were commonly reported dental problems. Forty seven(94%) patients acknowledged that routine dental care was needed for health, only 6 (12%) wereaware that poor dental health could affect baby weight. Oral health not seen as priority in 24 (48%)was the main barrier to seeking dental care in pregnancy followed by costs of treatment in 18 (36%)and safety concerns in pregnancy in 8 (16%) cases. Conclusions: Though dental problems were a common occurrence in pregnancy, utilization ofservices was low for the same. The participants reported significant barriers to obtaining dental careincluding lack of knowledge about the importance of maternal oral health and the treatment costs.

scholarly journals Screening of Diabetes in Pregnancy

2021 ◽  
Author(s):  
Barış Sever ◽  
Halil Gürsoy Pala
Keyword(s):  
Pregnant Women ◽  
Diagnostic Criteria ◽  
International Association ◽  
Threshold Value ◽  
Study Groups ◽  
The United States ◽  
Population Characteristics ◽  
Diabetes In Pregnancy ◽  
Screening Programs ◽  
In Pregnancy

The prevalence of gestational diabetes mellitus (GDM) is approximately 6% of pregnant women in the United States. The prevalence ranges is about from 2% to 38% worldwide and varies among racial-ethnic groups, often paralleling the prevalence of type 2 diabetes. The prevalence also varies due to differences in screening practices, population characteristics (eg, mean age and body mass index [BMI] of pregnant women), testing method, and diagnostic criteria. The prevalence is increasing over time, possibly due to increases in mean maternal age and weight, particularly with increasing obesity. In 2010, the International Association of Diabetes and Pregnancy Study Groups proposed new screening and diagnostic criteria for diabetes in pregnancy. Using these criteria, the global prevalence of hyperglycemia in pregnancy is estimated at 17%, with regional estimates ranging from 10% in North America to 25% in Southeast Asia. Different screening programs are carried out in different clinics, and all these differences lead to different results in the frequency of GDM. The criteria of the method and threshold value acceptance depends on the health policies of the countries, the experience of the clinicians and the characteristics of the patient population. In this review, we analyzed the methods recommended for GDM screening in pregnancy.

CLINICAL CHARACTERISTICS AND FETO-MATERNAL OUTCOMES IN PREGNANT WOMEN WITH COVID -19 INFECTIONS

2021 ◽  
pp. 30-32
Author(s):  
Gulshan Bano ◽  
Anubha Prashad ◽  
Rakhee Soni ◽  
Mohammed Mishal
Keyword(s):  
Pregnant Women ◽  
Cesarean Delivery ◽  
Clinical Features ◽  
Clinical Characteristics ◽  
Maternal Outcomes ◽  
Hypertensive Disorder ◽  
Co Morbidity ◽  
Hypertensive Disorder Of Pregnancy ◽  
The Mean ◽  
In Pregnancy

Background and objectives:-COVID-19 is ongoing pandemic, caused by novel Corona Virus. There is very scarce information is available about clinical features and feto-maternal outcomes of COVID-19 in pregnancy. Therefore, this study was aimed to determine clinical characteristics and feto-maternal outcomes of pregnant women with COVID-19. Methods- In this retrospective study, we included all pregnant women admitted with COVID-19 over three months. Clinical features, laboratory ndings and feto-maternal outcomes were assessed.Results:-The mean age of the patients was 24 years. Hypertensive disorder of pregnancy was most common associated co-morbidity. Majority of patients (81%) were asymptomatic. Lymphocytopenia was seen in 58% of the patients and 47% had elevated levels of CRP. All patients who presented in rst trimester had spontaneous abortion. There is relatively higher rate of preterm birth (21%) and cesarean delivery(43%). All the neonates were tested negative for COVID-19. Conclusion;- There is relatively higher rate of cesarean delivery. Overall feto-maternal outcome was good and there was no evidence of vertical transmission.

scholarly journals Clinical Effectiveness of Different Technologies for Diabetes in Pregnancy: Systematic Literature Review (Preprint)

2020 ◽  
Author(s):  
Claudia Eberle ◽  
Maxine Loehnert ◽  
Stefanie Stichling
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Clinical Effectiveness ◽  
Neonatal Outcomes ◽  
Diabetes In Pregnancy ◽  
Pregnancy And Birth ◽  
In Pregnancy

BACKGROUND Hyperglycemia in pregnancy occurs worldwide and is closely associated with health issues in women and their offspring, such as pregnancy and birth complications, respectively, as well as comorbidities, such as metabolic and cardiovascular diseases. To optimize the management of diabetic pregnancies, sustainable strategies are urgently needed. Investigation of constantly evolving technologies for diabetes that help to manage pregnancy and health is required. OBJECTIVE We aimed to conduct a systematic review to assess the clinical effectiveness of technologies for diabetes in pregnancy. METHODS Relevant databases including MEDLINE (PubMed), Cochrane Library, Embase, CINAHL, and Web of Science Core Collection were searched in September 2020 for clinical studies (2008-2020). Findings were organized by type of diabetes, type of technology, and outcomes (glycemic control, pregnancy- and birth-related outcomes, and neonatal outcomes). Study quality was assessed using Effective Public Health Practice Project criteria. RESULTS We identified 15 randomized controlled trials, 3 randomized crossover trials, 2 cohort studies, and 2 controlled clinical trials. Overall, 9 studies focused on type 1 diabetes, 0 studies focused on gestational diabetes, and 3 studies focused on both type 1 diabetes and type 2 diabetes. We found that 9 studies were strong quality, 11 were moderate quality, and 2 were weak quality. Technologies for diabetes seemed to have particularly positive effects on glycemic control in all types of diabetes, shown by some strong and moderate quality studies. Positive trends in pregnancy-related, birth-related, and neonatal outcomes were observed. CONCLUSIONS Technologies have the potential to effectively improve the management of diabetes during pregnancy. Further research on the clinical effectiveness of these technologies is needed, especially in pregnant women with type 2 diabetes.

scholarly journals Diabetes in Pregnancy and Risk of Antepartum Depression: A Systematic Review and Meta-Analysis of Cohort Studies

2020 ◽  
Vol 17 (11) ◽  
pp. 3767 ◽  
Author(s):  
Kai Wei Lee ◽  
Siew Mooi Ching ◽  
Navin Kumar Devaraj ◽  
Seng Choi Chong ◽  
Sook Yee Lim ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Cohort Studies ◽  
Pregnant Women ◽  
Meta Analysis ◽  
Diabetes In Pregnancy ◽  
Antepartum Depression ◽  
Increased Risk ◽  
In Pregnancy

Previous literature has reported that patients with diabetes in pregnancy (DIP) are at risk of developing antepartum depression but the results have been inconsistent in cohort studies. We conducted a systematic review and performed a meta-analysis to quantify the association between DIP and risk of antepartum depression in cohort studies. Medline, Cinahl, and PubMed databases were searched for studies investigating DIP involving pregnant women with pre-existing diabetes and gestational diabetes mellitus and their risk of antepartum depression that were published in journals from inception to 27 December 2019. We derived the summary estimates using a random-effects model and reported the findings as pooled relative risks (RR) and confidence interval (CI). Publication bias was assessed using a funnel plot and was quantified by Egger and Begg’s tests. Ten studies, involving 71,036 pregnant women were included in this meta-analysis. The pooled RR to develop antepartum depression was (RR = 1.430, 95% CI: 1.251–1.636) among women with gestational diabetes mellitus. Combining pregnant women with pre-existing diabetes mellitus and gestational diabetes mellitus, they had a significant increased risk of developing antepartum depression (RR = 1.431, 95% CI: 1.205–1.699) compared with those without it. In comparison, we found no association between pre-existing diabetes mellitus in pregnancy (RR = 1.300, 95% CI: 0.736–2.297) and the risk of developing antepartum depression. This study has a few limitations: first, different questionnaire and cut-off points were used in evaluation of depression across the studies. Second, there was a lack of data on history of depression prior to pregnancy, which lead to confounding bias that could not be solved by this meta-analysis. Third, data were dominated by studies in Western countries; this is due to the studies from Eastern countries failing to meet our inclusion criteria for statistical analysis. Women with gestational diabetes mellitus have an increased risk of developing antepartum depression compared to those without the disease. Therefore, more attention on the mental health status should be given on pregnant women diagnosed with pre-existing diabetes mellitus and gestational diabetes mellitus.

scholarly journals PO-0637 Diabetes In Pregnancy And The Risk Of Severe Perinatal Complications: Data From The French Population In 2011

2014 ◽  
Vol 99 (Suppl 2) ◽  
pp. A462.1-A462
Author(s):  
C Billionnet ◽  
A Weill ◽  
U Simeoni ◽  
P Ricordeau ◽  
F Alla ◽  
...  
Keyword(s):  
French Population ◽  
Diabetes In Pregnancy ◽  
Perinatal Complications ◽  
In Pregnancy

scholarly journals Perinatal risks at the repeated caesarean section and vaginal delivery in women with a uterine scar

2014 ◽  
Vol 18 (2 (70)) ◽  
Author(s):  
O. V. Kravchenko ◽  
V. A. Varvus
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Genital Tract ◽  
Vaginal Birth ◽  
Perinatal Complications ◽  
Lower Segment ◽  
Perinatal Pathology ◽  
Uterine Scar ◽  
Perinatal Risks ◽  
In Pregnancy

251 pregnant women were under observation with a uterine scar after previously performed cesarean section. 225 women were operated one more time. 26 women had delivery through natural genital tract (10 % of the pregnant women with a uterine scare). It was established that the delivery occurred physiologically due to the correct assessment of risk factors for vaginal birth in women with a uterine scar. The presence of uterine scar in the lower segment does not significantly affect the nature and duration of labor. An increased fetal weight at vaginal birth in women with a uterine scar to 300g does not increase obstetric and perinatal complications. Thus, the study has shown that an increase of complications such as placentation in the scar and scar failure is high risk of maternal and perinatal pathology in pregnancy with a uterine scar.

scholarly journals Nutritional support in pregnancy: possibilities for the prevention of obstetric complications

2021 ◽  
pp. 67-74
Author(s):  
O. I. Mikhailova ◽  
D. D. Mirzabekova ◽  
N. E. Kan ◽  
V. L. Tyutyunnik
Keyword(s):  
Folic Acid ◽  
Pregnant Women ◽  
Nutritional Support ◽  
Pantothenic Acid ◽  
Nutritional Deficiencies ◽  
Perinatal Complications ◽  
Beneficial Effects ◽  
Iron And Folic Acid ◽  
Guidelines And Recommendations ◽  
In Pregnancy

This review focuses on the causes and consequences of nutritional deficiencies in the pregnant woman’s diet, as well as on the possibilities of its supplementation. It has been shown that inadequate intake of vitamins and minerals during pregnancy is accompanied by a lack of nutrient supply to the fetus, which can cause growth retardation, low birth weight and other obstetric and perinatal complications.According to the analysed guidelines and recommendations, the body’s need for vitamins and minerals increases at least twice as much during pregnancy. Adverse effects of the environment, a number of gastrointestinal and liver diseases, chronic diseases, antibiotic therapy, etc. increase this need.However, adequate nutritional support of the fetus is the result of several steps. These include the frequency of maternal food intake, the availability of nutrients in the food and the ability of the placenta to transport substrates effectively to the fetus.The most recommended vitamin for consumption in pregnancy is folic acid, alone or in combination with other B vitamins, as its deficiency leads to birth defects in the child.The authors of this review have reviewed a number of large studies conducted over the past decade that recommend iron and folic acid for pregnant women, regardless of dietary intake, as they have proven beneficial effects on the course and outcome of pregnancy. Folic acid, according to current recommendations, must be prescribed to every pregnant woman in the form of 400 mcg tablets daily regardless of her diet. Other most important and necessary vitamins for pregnant women are: vitamins A, C, D, E, K, B1, B2, B6, B12, PP, pantothenic acid, biotin.

scholarly journals Clinical characteristics, management, maternal and neonatal outcome among seven severe and critically ill pregnant women with COVID-19 pneumonia

2020 ◽  
Vol 3 (2) ◽  
pp. 158-166
Author(s):  
Hazari Komal Sundeep ◽  
Paulose Litty ◽  
Kurien Nimmi ◽  
Mohammad Hozaifah ◽  
A Elgergawi Taghrid Faek ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Clinical Characteristics ◽  
Case Series ◽  
Fetal Outcome ◽  
World Health ◽  
Investigational Therapies ◽  
Serious Disease ◽  
Novel Coronavirus ◽  
Health Organization ◽  
In Pregnancy

Pneumonia caused by the Novel coronavirus disease 2019 (COVID-19) is a highly infectious disease and the ongoing outbreak has been declared as a Pandemic by the World health organization. Pneumonia is a serious disease in pregnancy and requires prompt attention. Viral pneumonia has higher morbidity and mortality compared to bacterial pneumonia in pregnancy. All efforts are well exerted to understand the newly emerged disease features but still some areas are gray. The treatment is primarily supportive with antivirals, steroids, anticoagulation and antibiotics for secondary bacterial infection. Severe cases require intensive care monitoring with oxygen support, mechanical ventilation. Investigational therapies include convalescent plasma, cytokine release inhibitors and other immunomodulatory agents like interferons. The mortality appears driven by the presence of severe Adult Respiratory Syndrome (ARDS) and organs failure. COVID pandemic is a challenging and stressful socio-economic situation with widespread fear of infection, disease and death. In the specialty of obstetrics and gynecology, studies are being conducted to ascertain the manifestation of disease in pregnant women and the fetal outcome. The aim of our case series is to describe the demographics, clinical characteristics, laboratory and radiological findings, feto- maternal outcome of severe and critical COVID pneumonia in pregnant women in Latifa Hospital.

scholarly journals The Interplay Between Diet Quality and Pre-pregnancy Body Mass Index on Glycemic Parameters in Pregnancy: A Comparison of Various Diet Quality Scores (OR35-02-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Karen Lindsay ◽  
Claudia Buss ◽  
Sonja Entringer ◽  
Pathik Wadhwa
Keyword(s):  
Body Mass Index ◽  
Glycemic Control ◽  
Pregnant Women ◽  
Body Mass ◽  
Diet Quality ◽  
Healthy Eating Index ◽  
Quality Score ◽  
Obese Women ◽  
Interaction Term ◽  
In Pregnancy

Abstract Objectives Nutrition in pregnancy plays an important role in maintaining glycemic control but there is no consensus on how to characterize maternal diet quality with respect to glycemic outcomes. The objective of this study is to compare the associations between 4 indices of diet quality with biomarkers of glycemic control (insulin, homeostasis model of insulin resistance (HOMA-IR)) in pregnancy, and to determine whether associations vary as a function of pre-pregnancy body mass index (pBMI). Methods In a prospective longitudinal study of N = 220 pregnant women, dietary intakes were assessed at 3 time points across gestation by 3 × 24h-diet recalls per assessment, from which 4 validated diet quality scores were derived: Dietary Approaches to Stop Hypertension (DASH), Alternative Healthy Eating Index for Pregnancy (AHEI-P), Mediterranean Diet Score (MDS), Dietary Inflammatory Index (DII). Fasting blood samples collected at each assessment were assayed for insulin and glucose and HOMA-IR was computed. pBMI was computed from self-reported pre-pregnancy weight and measured height. Linear regression models predicting mean pregnancy values of insulin and HOMA-IR by diet quality score and pBMI and the diet quality*pBMI interaction term were computed. Results pBMI is strongly predictive of insulin and HOMA-IR and each diet quality score exerts similar significant main effects on glycemic parameters (Table 1). Only the DII*pBMI interaction term was significantly associated with insulin and HOMA-IR (Table 2). Figures 1A and 1B depict that the effect of DII on glycemic control is most pronounced for women with a pBMI < 25.0 Kg/m2, while levels among overweight and obese women remain relatively stable regardless of the inflammatory profile of the diet. Neither DASH, MDS or AHEI-P showed a significant effect on glycemic markers when analyzed as a function of pBMI. Conclusions Although each of the examined diet quality scores may serve as crude predictors of glycemic control in pregnancy, only the DII detected significant differential effects as a function of pBMI. A more pro-inflammatory diet in normal weight pregnant women may exert a stronger influence on glycemic control compared to overweight and obese women, likely attributed to the overriding effects of excess adiposity on dysglycemia. Funding Sources National Institutes of Health: NICHD, NIMHD, NIMH. Supporting Tables, Images and/or Graphs

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