scholarly journals Associations between plasma protein, IgG and IgA N-glycosylation and metabolic health markers in pregnancy and gestational diabetes

2021 ◽  
Author(s):  
Tamara Štambuk ◽  
Domagoj Kifer ◽  
Lea Duvnjak ◽  
Marijana Vučić Lovrenčić ◽  
Olga Gornik
Keyword(s):  
Gestational Diabetes ◽  
Pregnant Women ◽  
Plasma Protein ◽  
Positive Association ◽  
Protein Glycosylation ◽  
Valuable Insight ◽  
Fasting Insulin ◽  
Significant Difference ◽  
The Impact ◽  
In Pregnancy

Abstract Background. Monitoring of the human circulating N-glycome could provide valuable insight into an individual’s metabolic status. Therefore, we examined if aberrant carbohydrate metabolism in gestational diabetes mellitus (GDM) associates with alterations in plasma protein, immunoglobulin G (IgG) and immunoglobulin A (IgA) N-glycosylation.Methods. Plasma protein, IgG and IgA N-glycans were enzymatically released, purified and chromatographically profiled in 48 pregnant women with normal glucose tolerance and 41 pregnant women with GDM, all sampled at 24-28 weeks of gestation.Results. Fasting insulin exhibited significant associations to numerous glycan traits, including several plasma protein N-glycans bearing bisecting GlcNAc, afucosylated fully sialylated IgG glycan and fully sialylated triantennary IgA glycan (padj range: 7.66x10-05–1.15x10-02). Insulin resistance markers HOMA2-IR and HOMA2-%B were mostly associated to the same glycan structures as fasting insulin. Both markers also showed positive association with high-branched plasma glycans (padj=1.15x10-02 and 2.26x10-03) and negative association with low-branched plasma glycans (padj=1.25x10-02 and 2.27x10-03). Additionally, HOMA2-%B index was significantly related to the glycosylation features describing IgG sialylation. Multiple glycans showed significant associations with total cholesterol and triglyceride levels. None of the tested glycan traits showed a significant difference between GDM and normoglycemic pregnancies.Conclusion. Markers of glucose homeostasis and lipid metabolism in pregnancy show extensive associations to various N-glycosylation features. However, plasma protein, IgG and IgA N-glycans were not able to differentiate pregnant women with and without GDM, possibly due to numerous physiological changes accompanying pregnancy, which confound the impact of GDM on protein glycosylation.

scholarly journals Perspectives on mHealth Interventions During and After Gestational Diabetes

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 768-768
Author(s):  
Niamh Kelly-Whyte ◽  
Ciara McNulty ◽  
Sharleen O'Reilly
Keyword(s):  
Gestational Diabetes ◽  
Pregnant Women ◽  
Intervention Development ◽  
Intervention Design ◽  
Cochrane Central Register ◽  
Lifestyle Interventions ◽  
Pregnancy And Postpartum ◽  
Meta Analyses ◽  
The Impact ◽  
In Pregnancy

Abstract Objectives To systematically review the perspectives of women with gestational diabetes (GDM) or a recent history of GDM on mHealth lifestyle interventions during pregnancy and postpartum to inform future intervention development. Methods This systematic review was published according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The research was conducted in PubMed, MEDLINE, EMBASE, CINAHL, PsycInfo, and Cochrane Central Register of Controlled Trials for qualitative studies up until 28 April 2020. Study quality was evaluated using Joanna Briggs Institute critical appraisal checklist for qualitative research and a reflexive thematic synthesis was performed. The COM-B model was used to apply findings to improve future intervention development. Results 14 studies met the inclusion criteria representing the views of 327 women. Differences emerged within the themes identified in pregnancy and postpartum. In pregnancy 3 overarching themes emerged relating to mHealth interventions- support, connectedness and trust. Pregnant women valued the support of healthcare professionals (HCPs) when participating in mHealth interventions, along with information from sources they can trust. The use of self-monitoring was useful in pregnancy as they could see their progress and feel connected to their pregnancy. Using mHealth alongside usual care in pregnancy was seen as beneficial. Postpartum 2 overarching themes emerged- support and connectedness. Postpartum women did not value the input of HCPs as much as pregnant women. They valued connections made with their peers. They indicated more limitations with mHealth interventions than women during pregnancy. They discussed the use of rewards to remain motivated, while in pregnancy the health of the baby appeared to be the main motivator. 7 key recommendations have been made for future intervention design using the COM-B model, most with high or moderate confidence. Conclusions Women's views on mHealth lifestyle interventions differ between pregnancy and the postpartum period, and these needs should be reflected in intervention design. The results also reflect the impact a GDM diagnosis has on women highlighting the need for ongoing support continuing into postpartum. Funding Sources No funding was received for this research.

scholarly journals Prevalence and perinatal outcomes in GDM and non-GDM in a rural pregnancy cohort of Bangladesh

2014 ◽  
Vol 7 (2) ◽  
pp. 21-27
Author(s):  
M Abu Sayeed ◽  
Samsad Jahan ◽  
Mir Masudur Rhaman ◽  
M Mainul Hasan Chowdhury ◽  
Parvin Akter Khanam ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Cesarean Delivery ◽  
Perinatal Outcomes ◽  
Married Women ◽  
Pregnancy Cohort ◽  
Significant Difference ◽  
In Pregnancy

Gestational diabetes mellitus (GDM) or hyperglycemia in pregnancy is associated with adverse perinatal outcomes such as large for gestational age (LGA), excess fetal adiposity and cesarean delivery. This study addressed the prevalence of diabetes in pregnancy and to compare the perinatal outcomes between GDM and non-GDM in a rural pregnancy cohort of Bangladesh. Ten villages were purposively selected in a rural area about 100 km off Dhaka City. A population census was conducted. A randomized sample of married women of age 15-45y was drawn from the census data. These women having either regular menstruation (non-regnant) or cessation of menstruation for ?24weeks (pregnant) were considered eligible. Both the pregnant and non-pregnant women were invited to volunteer the study. Weight, height, waist- and hip-girth and blood pressure were taken. Fasting blood sample was collected for the estimation of plasma glucose (FPG), triglycerides (TG), cholesterol (chol), high-density lipoprotein (HDL). FPG >5.1 mmol/L was taken as cut-off for hyperglycemia in non-pregnant and gestational diabetes mellitus (GDM) for the pregnant women. The biophysical characteristics were compared between pregnant and non-pregnant; and then GDM and non-GDM. Only the pregnant women were taken as a pregnancy cohort. The cohort had followup from 24wks of pregnancy through 28 post-natal days. Results The census yielded 23545 (m / f=11896 / 11649) people of all ages. The married women of age 15-45y were 4526. Of them, 2100 were randomly selected for investigation and 1585 (75.5%) volunteered. The overall prevalence (95% CI) of hyperglycemia (FPG >5.1 mmol/L) was 18.5% (16.7 – 20.3). The prevalence of GDM was 8.9% (7.0 – 10.8) and non-GDM was 19.8% (18.8 – 20.8). The BMI and WHR were significantly higher in the pregnant than non-pregnant women; whereas, there was no significant difference between GDM and non-GDM group. The prevalence rates of abortions, stillbirths, hospital delivery, cesarean delivery, hospital stay ?7days, puerperal sepsis and neonatal death did not differ between GDM and non-GDM subjects significantly. The prevalence of GDM in rural Bangladesh is comparable with any other population with higher prevalence of GDM. The prevalence of hyperglycemia was found significantly higher in the non-pregnant than the pregnant women. The anthropometric measures did not differ significantly between GDM and non-GDM though FPG was found significantly higher in the former. Compared with the non-GDM the GDM subjects had no significantly higher fetomaternal morbidity and mortality possibly due to non-sedentary habit, non-obesity, non-dyslipidemia or may be due to inherent genetic makeup. A well designed study in a larger sample may explain our findings. DOI: http://dx.doi.org/10.3329/imcj.v7i2.20101 Ibrahim Med. Coll. J. 2013; 7(2): 21-27

scholarly journals Impact of the COVID-19 pandemic on mental health in pregnancy women: results from two cohort studies in China

2020 ◽  
Author(s):  
Hong Mei ◽  
Na Li ◽  
Junwei Li ◽  
Dan Zhang ◽  
Zhongqiang Cao ◽  
...  
Keyword(s):  
Mental Health ◽  
Cohort Study ◽  
Pregnant Women ◽  
Anxiety And Depression ◽  
Significant Difference ◽  
Stress Levels ◽  
Set Up ◽  
Anxiety Depression ◽  
The Impact ◽  
In Pregnancy

Abstract Background The COVID-19 pandemic led to a global atmosphere of anxiety and depression. However, the impact of this disaster on mental health in pregnancy women was not clear. Methods Based on two cohort study, the Novel Coronavirus Disease Influenced Pregnant Cohort Study (NCP) set up during the COVID-19 epidemic and the Healthy Baby Cohort Study (HBC) set up in 2012, we compared the anxiety, depression and stress levels of pregnant women who did not or did go through the COVID-19 pandemic and analyzed the risk factors for mental health in pregnancy women. Results There were 784 and 2448 participants in the CNP and HBC studies involved in the analysis, respectively. We found that there were 23.09% and 4.72% pregnant women suffering for mild and moderate-to-several anxieties for those in the NCP study, and 21.53% and 3.06% in the HBC study. The mild and moderate-to-several depression rate was 25.89% and 11.35% for those in the NCP study, and 19.81% and 0.51% for those in the HBC study, respectively. No significant difference was found for anxiety, depression and stress levels was found at each gestational trimester (p > 0.05). The pandemic of COVID-19 was significantly associated with maternal depression and stress (p < 0.05), with the co-efficient and 95%CI as 0.37 (0.18, 0.55) and − 0.12 (-0.09, -0.32), respectively. Pregnant women with pre-pregnancy obesity, higher educational level or good sleep quality might have lower risks for anxiety, depression and stress compared with the referenced groups. conclusions The pandemic had a huge impact on depression, especially moderate-to-sever level, in pregnant women at whatever gestational week; and that pre-pregnancy obesity, highly educated and sleep well ones had less anxiety and depression risks. The society, especially the family members, should pay more attention to pregnant ones and give more social support to them.

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 Impact of Diagnostic Criteria for Gestational Diabetes Mellitus on Adverse Maternal Outcomes: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (4) ◽  
pp. 666
Author(s):  
Fahimeh Ramezani Tehrani ◽  
Marzieh Saei Ghare Naz ◽  
Razieh Bidhendi Yarandi ◽  
Samira Behboudi-Gandevani
Keyword(s):  
Systematic Review ◽  
Gestational Diabetes ◽  
Pregnant Women ◽  
Diagnostic Criteria ◽  
Meta Analysis ◽  
Population Based ◽  
Maternal Outcomes ◽  
Care Providers ◽  
Iadpsg Criteria ◽  
The Impact

This systematic review and meta-analysis aimed to examine the impact of different gestational-diabetes (GDM) diagnostic-criteria on the risk of adverse-maternal-outcomes. The search process encompassed PubMed (Medline), Scopus, and Web of Science databases to retrieve original, population-based studies with the universal GDM screening approach, published in English language and with a focus on adverse-maternal-outcomes up to January 2020. According to GDM diagnostic criteria, the studies were classified into seven groups. A total of 49 population-based studies consisting of 1409018 pregnant women with GDM and 7,667,546 non-GDM counterparts were selected for data analysis and knowledge synthesis. Accordingly, the risk of adverse-maternal-outcomes including primary-cesarean, induction of labor, maternal-hemorrhage, and pregnancy-related-hypertension, overall, regardless of GDM diagnostic-criteria and in all diagnostic-criteria subgroups were significantly higher than non-GDM counterparts. However, in meta-regression, the increased risk was not influenced by the GDM diagnostic-classification and the magnitude of the risks among patients, using the IADPSG criteria-classification as the most strict-criteria, was similar to other criteria. In conclusion, a reduction in the diagnostic-threshold increased the prevalence of GDM, but the risk of adverse-maternal-outcome was not different among those women who were diagnosed through more or less intensive strategies. Our review findings can empower health-care-providers to select the most cost-effective approach for the screening of GDM among pregnant women.

The role of the platelet profile in the prediction of gestational diabetes

2021 ◽  
pp. 50-54
Keyword(s):  
Body Mass Index ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Pregnant Women ◽  
Body Mass ◽  
First Trimester ◽  
Oral Glucose ◽  
Mean Corpuscular Hemoglobin ◽  
Lymphocyte Ratio ◽  
Significant Difference

Objective: In our study, the results of oral glucose tolerance test (OGTT) and other hemogram parameters of pregnant women with and without gestational diabetes mellitus (GDM) were compared. The aim of our study is to investigate the benefit of these parameters in predicting GDM risk. Material and Method: The study was planned as a descriptive, retrospective and cross-sectional study. It was included 218 pregnant women who applied to the Gynecology and Obstetrics Clinic of Amasya Sabuncuoğlu Şerefeddin Training and Research Hospital between January 01, 2019 and January 31, 2020. It was examined complete blood count parameters, ultrasound findings, complete urinalysis, first trimester blood glucose, body mass index, age, and gravide parameters the patients we included in the study. The results were analyzed retrospectively and was evaluated the statistical significance relationship with gestational diabetes. Results: There was no statistically significant difference in age, body mass index (BMI), obesity status and number of gravida between the pregnant women who were examined and those without GDM (p> 0.05). The hemoglobin, platelet count, mean platelet volume (MPV), mean corpuscular volume (MCV), mean corpuscular hemoglobine (MCH), and mean corpuscular hemoglobin concentration (MCHC) values, and neutrophil, lymphocyte, monocyte and basophil counts, urine density and femur length were statistically significant. There was no difference (p> 0.05). No statistically significant difference was found in terms of neutrophile lymphocyte ratio (NLR), neutrophile monocyte ratio (NMR), platelet lymphocyte ratio (PLR), monocyte eosinophil ratio (MER), platelet MPV ratio (PMPVR), and platelet neutrophile ratio (PNR) values (p> 0.05) Conclusion: HbA1c, hematocrit and blood glucose in the first trimester may be predictors of GDM. In addition, we think that further studies are needed in a prospective design in more patients in terms of others parameters.

Peripheral Immunological Cells in Pregnant Women and their Change during Diabetes

2017 ◽  
Vol 125 (10) ◽  
pp. 677-683 ◽  
Author(s):  
Ulrike Friebe-Hoffmann ◽  
Linda Antony ◽  
Jan-Steffen Kruessel ◽  
Brigitte Pawlowski ◽  
Thomas Hoffmann
Keyword(s):  
T Cells ◽  
Gestational Diabetes ◽  
Pregnant Women ◽  
Immune Cell ◽  
Γδ T Cells ◽  
Complication Rates ◽  
And Shifts ◽  
The Impact ◽  
Pregnant Diabetic

AbstractDuring the last decades the incidence of diabetes has dramatically increased as well as the number of pregnant diabetic women. There is still missing data regarding patterns and shifts of immune cell populations due to pregnancy with or without diabetes. The study aimed to investigate the impact of pregnancy, type 1 diabetes (T1D) and gestational diabetes mellitus (GDM) on different immune cells in female. The number and proportion of CD3-, CD4-, CD8- and γδ T-cells as well as B-, NK-, NKT- and dendritic cells (DC) incl. rate of apoptosis was analyzed in peripheral blood samples from 24 non-pregnant women, 24 pregnant controls, 25 non-pregnant T1D, 18 women with GDM and 15 pregnant T1D (PT1D) women. Compared to healthy controls, healthy pregnant women had reduced numbers of lymphoid DC and γδ T-cells, while women with gestational diabetes presented with increased numbers of γδ T-cells. Pregnant women with T1D showed increased NKT cells and a decrease of NK cells compared to healthy pregnant or non-pregnant T1D women. Apoptosis of γδ T-cells in healthy pregnant women was found to be decreased in comparison to their non-pregnant controls while apoptosis of myeloid and lymphoid DC was increased in pregnant T1D in comparison to non-pregnant T1D. Those results may indicate that increased complication rates during diabetic pregnancies might be due to an impaired adaptation of the immune system.

scholarly journals The consequences of obesity and excess weight gain in pregnancy

2011 ◽  
Vol 70 (4) ◽  
pp. 450-456 ◽  
Author(s):  
Jane E. Norman ◽  
Rebecca Reynolds
Keyword(s):  
Insulin Resistance ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Pregnant Women ◽  
Postpartum Haemorrhage ◽  
Maternal Obesity ◽  
Adverse Pregnancy Outcome ◽  
Operative Delivery ◽  
Adverse Pregnancy ◽  
In Pregnancy

The prevalence of obesity in pregnancy is rising exponentially; about 15–20% of pregnant women now enter pregnancy with a BMI which would define them as obese. This paper provides a review of the strong links between obesity and adverse pregnancy outcome which operate across a range of pregnancy complications. For example, obesity is associated with an increased risk of maternal mortality, gestational diabetes mellitus, thromboembolism, pre-eclampsia and postpartum haemorrhage. Obesity also complicates operative delivery; it makes operative delivery more difficult, increases complications and paradoxically increases the need for operative delivery. The risk of the majority of these complications is amplified by excess weight gain in pregnancy and increases in proportion to the degree of obesity, for example, women with extreme obesity have OR of 7·89 for gestational diabetes and 3·84 for postpartum haemorrhage compared to their lean counterparts. The consequences of maternal obesity do not stop once the baby is born. Maternal obesity programmes a variety of long-term adverse outcomes, including obesity in the offspring at adulthood. Such an effect is mediated at least in part via high birthweight; a recent study has suggested that the odds of adult obesity are two-fold greater in babies weighing more than 4 kg at birth. The mechanism by which obesity causes adverse pregnancy outcome is uncertain. This paper reviews the emerging evidence that hyperglycaemia and insulin resistance may both play a role: the links between hyperglycaemia in pregnancy and both increased birthweight and insulin resistance have been demonstrated in two large studies. Lastly, we discuss the nature and rationale for possible intervention strategies in obese pregnant women.

scholarly journals Effect of Diabetes Education Program on Gestational Diabetes Mellitus Knowledge Among Diabetic Pregnant Women: An Experimental Study

2020 ◽  
Author(s):  
Uchenna Cosmas Ugwu ◽  
Osmond Chukwuemeka Ene
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Education Program ◽  
Diabetes Education ◽  
Control Groups ◽  
Significant Difference ◽  
And Control ◽  
Experimental Group

Abstract Background: Gestational diabetes mellitus (GDM) is a disease condition present during pregnancy and if not properly managed would have severe effect on the maternal and neonatal health. This research determined the effect of diabetes education program (DEP) on gestational diabetes mellitus knowledge (GDMK) among diabetic pregnant women (DPW) and significant differences within groups.Methods: This study was based on a pretest – posttest measures of experimental research design involving experimental (n=110) and control (n=110) groups. A total of 220 DPW were purposively recruited from public hospitals in Nigeria between October and December 2019. The DEP was delivered to DPW in experimental group. The Gestational Diabetes Mellitus Knowledge Questionnaire (GDMKQ) of 0.774 was used for data collection. The statistical analysis was completed using IBM SPSS version 22. Results: The results revealed that no statistically significant difference existed on GDM history (P=0.801>0.05), smoking habit (P=0.0615>0.05), parity status (P=0.503>0.05), and level of education (P=0.720>0.05), while difference was observed on alcohol status (P=0.011<0.05), and age by birth (P=0.009<0.05). Also, while no significant difference existed between the DPW in the treatment and control groups on GDMK pretest measures (P=0.901>0.05), difference existed between the DPW in the intervention and control groups on GDMK posttest scores (P=0.026<0.05). Also, the higher percentage score (78%) of DPW in the experimental group in the posttest GDMK measures which is higher than the score in the pretest measures (55%) of the same group were indications that DEP has significant effect on GDMK among DPW.Conclusion: This demonstrates that reliable interventions are effective in combating pregnancy-related complications. This requires collaborative efforts by concerned bodies to combat notable complications during pregnancy using reliable intervention.Trial Registration: In retrospect, the Pan African Clinical Trial Registry documented the study with registration trial code (Trial No.: PACTR201903003187005)

scholarly journals The Impact of Social Support and Pregnancy on Subjective Well-Being: A Systematic Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Buyantungalag Battulga ◽  
Marc Reginald Benjamin ◽  
Hong Chen ◽  
Enkhmandakh Bat-Enkh
Keyword(s):  
Social Support ◽  
Systematic Review ◽  
Life Satisfaction ◽  
Pregnant Women ◽  
Positive Association ◽  
Well Being ◽  
Protective Role ◽  
Subjective Well Being ◽  
Health Maintenance ◽  
The Impact

Background: Subjective well-being (SWB) has a protective role in mental health maintenance and is prone to change during short stressful moments, such as pregnancy. Longstanding research suggests that social support (SS) from the partner and family members of pregnant women directly or indirectly acts as a buffer against negative mental outcomes. For happier pregnancies, it is important to understand how SS and pregnancy affect the SWB.Objective: This review aims to examine the extended association of being pregnant and SS on the SWB of pregnant women.Methods: A systematic review was conducted in PubMed, ScienceDirect, and Google Scholar. Articles published in peer-reviewed journals were included regardless of the year and if they had assessed the impact of at least one SWB or SS outcome among healthy pregnant women. The tools of the National Heart, Lung, and Blood Institute were used for quality assessment.Results: Thirty-four studies that assessed the domains of SWB measurements, such as happiness, quality of life (QoL), life satisfaction, positive and negative effects, and well-being, were included and its association with either pregnancy or SS was summarized. Variable results, such as life satisfaction, happiness, and mental component of QoL, were found to be high during pregnancy, but positive emotion and physical components of QoL had decreased. Almost universally, SS during pregnancy was found to have a positive association with all measurements of SWB.Conclusion: This study had found that, despite some arising trends, pregnancy itself does not necessarily have similar impacts on SWB across healthy pregnant women. However, SS had a significant effect on SWB.

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