scholarly journals Glycemia after Betamethasone in Pregnant Women without Diabetes—Impact of Marginal Values in the 75-g OGTT

Healthcare ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 40
Author(s):  
Ioannis Kakoulidis ◽  
Ioannis Ilias ◽  
Anastasia Linardi ◽  
Aikaterini Michou ◽  
Charalampos Milionis ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Tolerance Test ◽  
Insulin Dosage ◽  
Oral Glucose ◽  
Glycemic Profile ◽  
Normal Glucose ◽  
Marginal Values ◽  
The Mean ◽  
Monitoring Treatment ◽  
In Pregnancy

Betamethasone (BM) administration in pregnancy has been shown to reduce the incidence and severity of neonatal respiratory distress syndrome. Its known diabetogenic impact, combined with placental insulin resistance, leads to a transient increase in glycemia. However, its effect on glucose homeostasis in pregnancy has not been adequately investigated. We closely monitored and assessed the glycemic profile of 83 pregnant women, with normal glucose metabolism, who were given BM during their hospitalization due to threatened premature labor. A significant change in the glycemic profile in most patients was noted, lasting 1.34 ± 1.05 days. Sixty-six of eighty-three women were eventually treated with insulin to maintain glycemia within acceptable limits. The mean ± SD insulin dosage was 12.25 ± 11.28 units/day. The need for insulin therapy was associated with higher BM doses and the presence of marginal values in the 75-g oral glucose tolerance test (OGTT) at 60 min. Our study demonstrates, following BM administration, the need for increased awareness and individualized monitoring/treatment of pregnant women with normal—yet marginal—values in the 75-g OGTT.

scholarly journals Interpretation of Modified Glucose Tolerance Test among Pregnant Malaysian Women

2020 ◽  
Vol 5 (08) ◽  
pp. 309-313
Author(s):  
Muna Kh. Al-kubaisi ◽  
Saad M. Al-Shibli ◽  
Nilar Win
Keyword(s):  
Glucose Tolerance ◽  
Pregnant Women ◽  
Blood Sample ◽  
Blood Sugar ◽  
Glucose Tolerance Test ◽  
Venous Blood ◽  
Tolerance Test ◽  
Oral Glucose ◽  
The Mean ◽  
Local Protocol

Aim: Is to find the mean and two standard deviation of the serum blood sugar among pregnant women while running the modified oral glucose tolerance test (MOGTT) as screening for gestational diabetes mellitus (GDM) & to compare the readings with other protocols adopted in diagnosing GDM. Method: A cross sectional study among pregnant women running routine MOGTT at 24-28 weeks’ gestation. A total of 149 women participated in 4 months period. The test included 5 ml of venous blood sample taken after fasting for 8 hours and a second blood sample 2 hours after having 200 ml of 75 g glucose solution within 10 minutes. Results: The mean for the fasting blood sugar is 4.32 mmol/L±0.52 making value of 2SD of 5.36 mmol/l. The mean of the 2 hours glucose level was 6.11mmol/l±1.38 making the 2SD value of 8.87 mmol/l. Conclusion: Our results for the 1st reading in MOGTT is near to the value of the local protocol in diagnosing GDM. The 2 hours postprandial reading in the local protocol is fairly low when compared with our findings & with guidelines of nearby communities.

scholarly journals Modification of WHO diagnostic criteria for gestational diabetes: implications for classification of hyperglycemia in pregnancy

2017 ◽  
Vol 6 (7) ◽  
pp. 2716 ◽  
Author(s):  
Lucius C. Imoh ◽  
Solomon A. Asorose ◽  
Alfred I. Odo ◽  
Daniel O. Aina ◽  
Alexander O. Abu ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Diagnostic Criteria ◽  
Tolerance Test ◽  
Sub Saharan Africa ◽  
University Teaching ◽  
Oral Glucose ◽  
Exact Test ◽  
Iadpsg Criteria ◽  
In Pregnancy

Background: Low and medium income countries (LMICs) especially in sub-Saharan Africa face unique challenges in screening and diagnosing hyperglycaemia in pregnancy. The implications of applying the 2013 WHO modifications for assessing hyperglycaemia in pregnancy in low resource settings are not known. We evaluated the significance of these recent changes in classification of hyperglycaemia among pregnant Nigerian women.Methods: We reviewed the records of Oral glucose tolerance test conducted on 600 pregnant women at the Jos University Teaching Hospital (JUTH) between July 2012 and June 2016. The collected data were analyzed using Statistical Package for Social Sciences version 18 (SPSS Inc., Chicago, IL, USA). Test for association was done using Fisher’s exact test. P < 0.05 was set as the level of significance.Results: The results show that 15.9%, 20.2% and 15.7% of the women had GDM according to WHO (1999), IADPSG and WHO (2013) diagnostic criteria respectively while 4.8% of the women had DM in pregnancy by WHO 2013 criteria. Overall, 30.2% and 23.9% of women who were classified as GDM by WHO 1999 criteria and IADPSG criteria respectively were qualified to be classified as DM in pregnancy according to the WHO 2013 criteria.Conclusions: The recent Modifications by the WHO 2013 guideline for classifying hyperglycemia in pregnancy may create non-uniform interpretation of OGTT. The confusion in classifying hyperglycemia among pregnant women referred between health centres may become more pronounced. There is an urgent need for a streamlined globally acceptable approach to assessing and classifying hyperglycemia in pregnant women.

scholarly journals Factors influencing stress, anxiety, and depression among Iranian pregnant women: the role of sexual distress and genital self-image

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Afsaneh Keramat ◽  
Mina Malary ◽  
Mahmood Moosazadeh ◽  
Nastaran Bagherian ◽  
Mohammad-Reza Rajabi-Shakib
Keyword(s):  
Pregnant Women ◽  
Multivariate Linear Regression Analysis ◽  
Depression And Anxiety ◽  
Sexual Distress ◽  
Self Image ◽  
Factors Influencing ◽  
Severity Of Depression ◽  
The Mean ◽  
Distress Scale ◽  
In Pregnancy

Abstract Background Pregnancy is a unique period with the increased likelihood of psychological changes and emotional disturbances such as depression, anxiety, and stress. In this study, we investigated the factors influencing depression, anxiety, and stress in pregnancy and identify their associations with Sexual Distress (SD) and Genital Self-Image (GSI). Methods This was a descriptive, correlational, cross-sectional study performed using the two-stage cluster sampling method between September 2019 and January 2020. Overall, 295 pregnant women completed a demographics and obstetric information checklist, Depression Anxiety and Stress Scale-21 (DASS-21), Female Genital Self-Image Scale (FGSI), and Female Sexual Distress Scale-Revised (FSDS-R). Results Analysis of Variance (ANOVA) showed significant differences in the mean scores of SD between the groups with varying degrees of depression, anxiety, and stress (P <  0.001) and in the mean score of GSI between the groups with varying degrees of depression (P = 0.01) and anxiety (P <  0.001). In multivariate linear regression analysis, higher (worse) depression, anxiety, and stress scores were found in women with more advanced age and higher SD scores; however, these scores were lower (better) in those with increased gestational age. Lower depression and anxiety scores were associated with moderate satisfaction with income, moderate satisfaction with BI in pregnancy, and lower stress and depression scores were linked to planned pregnancy. Higher (better) GSI score was a predictor of lower depression score, complication in a previous pregnancy was a predictor of higher stress score, and finally, fear of fetal abortion and being a housewife were predictors of a higher anxiety score. Conclusion Various factors contribute to the development of antenatal depression, anxiety, and stress. A positive correlation was found between SD and the severity of depression, anxiety, and stress, while a negative correlation was noted between GSI and the severity of depression and anxiety. Therefore, raising awareness regarding SD and GSI through screening and counseling sessions can have beneficial effects for mothers and their fetuses.

scholarly journals Interactions between Vitamin D Status, Calcium Intake and Parathyroid Hormone Concentrations in Healthy White-Skinned Pregnant Women at Northern Latitude

Nutrients ◽  
2018 ◽  
Vol 10 (7) ◽  
pp. 916 ◽  
Author(s):  
Andrea Hemmingway ◽  
Karen O’Callaghan ◽  
Áine Hennessy ◽  
George Hull ◽  
Kevin Cashman ◽  
...  
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
Pregnant Women ◽  
Calcium Intake ◽  
Geometric Mean ◽  
Vitamin D Status ◽  
Metabolic System ◽  
Cross Sectional ◽  
The Mean ◽  
In Pregnancy

Adverse effects of low vitamin D status and calcium intakes in pregnancy may be mediated through functional effects on the calcium metabolic system. Little explored in pregnancy, we aimed to examine the relative importance of serum 25-hydroxyvitamin D (25(OH)D) and calcium intake on parathyroid hormone (PTH) concentrations in healthy white-skinned pregnant women. This cross-sectional analysis included 142 participants (14 ± 2 weeks’ gestation) at baseline of a vitamin D intervention trial at 51.9 °N. Serum 25(OH)D, PTH, and albumin-corrected calcium were quantified biochemically. Total vitamin D and calcium intakes (diet and supplements) were estimated using a validated food frequency questionnaire. The mean ± SD vitamin D intake was 10.7 ± 5.2 μg/day. With a mean ± SD serum 25(OH)D of 54.9 ± 22.6 nmol/L, 44% of women were <50 nmol/L and 13% <30 nmol/L. Calcium intakes (mean ± SD) were 1182 ± 488 mg/day and 23% of participants consumed <800 mg/day. The mean ± SD serum albumin-adjusted calcium was 2.2 ± 0.1 mmol/L and geometric mean (95% CI) PTH was 9.2 (8.4, 10.2) pg/mL. PTH was inversely correlated with serum 25(OH)D (r = −0.311, p < 0.001), but not with calcium intake or serum calcium (r = −0.087 and 0.057, respectively, both p > 0.05). Analysis of variance showed that while serum 25(OH)D (dichotomised at 50 nmol/L) had a significant effect on PTH (p = 0.025), calcium intake (<800, 800–1000, ≥1000 mg/day) had no effect (p = 0.822). There was no 25(OH)D-calcium intake interaction effect on PTH (p = 0.941). In this group of white-skinned women with largely sufficient calcium intakes, serum 25(OH)D was important for maintaining normal PTH concentration.

scholarly journals Significant seasonal variations in the rate of women diagnosed with gestational diabetes: A observational single centre study of 28,128 women

2021 ◽  
Author(s):  
Matthew Cauldwell ◽  
Yolande VanDerI'isle ◽  
Ingrid Watt-Coote ◽  
Philip Steer
Keyword(s):  
Gestational Diabetes ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Test Design ◽  
Single Centre ◽  
June July August ◽  
Single Centre Study ◽  
The Mean ◽  
June July

Objective To test the hypothesis that there is seasonal variation in the rates of gestational diabetes (GDM) diagnosed using a 2 hour oral glucose tolerance test. Design Monthly assessment of the percentage of women screened from 1st April 2016 to the 31st December 2020 who were diagnosed as having gestational diabetes Setting London Teaching Hospital Population 28,128 women receiving antenatal care between April 1st 2016 and 31 December 2020. Methods Retrospective study of prospectively collected data. Main Outcome Measures Proportion of women screened diagnosed as having gestational diabetes. Results The mean (SD) percentage of women diagnosed with GDM was 14.78 (2.24) in summer (June, July, August) compared with 11.23 (1.62) in winter (p < 0.001), 12.13 (1.94) in spring (p = 0.002), and 11.88 (2.67) in autumn (p = 0.003). There was a highly significant positive correlation of the percentage testing positive for GDM with the mean maximum monthly temperature (R2 = 0.248, p < 0.001). There was a statistically significant 33.8% increase in the proportion of GDM diagnoses from June 2020 onwards, possibly related to a reduction in exercise secondary to the Covid-19 pandemic. Conclusions There is a 23.3% higher rate of GDM diagnoses in the warmer summer months. There has been a 33.8% rise in GDM diagnoses associated with the Covid-19 pandemic.

scholarly journals Hyperglycemia at 1h-OGTT in Pregnancy: A Reliable Predictor of Metabolic Outcomes?

2021 ◽  
Vol 12 ◽  
Author(s):  
Elena Succurro ◽  
Federica Fraticelli ◽  
Marica Franzago ◽  
Teresa Vanessa Fiorentino ◽  
Francesco Andreozzi ◽  
...  
Keyword(s):  
High Risk ◽  
Independent Predictor ◽  
Perinatal Outcomes ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Cell Dysfunction ◽  
Metabolic Outcomes ◽  
Impaired Insulin ◽  
In Pregnancy

Gestational diabetes mellitus (GDM) is associated with a high risk of developing type 2 diabetes (T2DM) and cardiovascular disease (CVD). Identifying among GDM women those who are at high risk may help prevent T2DM and, possibly CVD. Several studies have shown that in women with GDM, hyperglycemia at 1 h during an oral glucose tolerance test (OGTT) (1-h PG) is not only associated with an increase in adverse maternal and perinatal outcomes but is also an independent predictor of T2DM. Interestingly, also in pregnant women who did not meet the criteria for a GDM diagnosis, 1-h PG was an independent predictor of postpartum impaired insulin sensitivity and beta-cell dysfunction. Moreover, maternal 1- and 2-h PG levels have been found to be independently associated with insulin resistance and impaired insulin secretion also during childhood. There is evidence that hyperglycemia at 1h PG during pregnancy may identify women at high risk of future CVD, due to its association with an unfavorable CV risk profile, inflammation, arterial stiffness and endothelial dysfunction. Overall, hyperglycemia at 1h during an OGTT in pregnancy may be a valuable prediction tool for identifying women at a high risk of future T2DM, who may then benefit from therapeutic strategies aimed at preventing cardiovascular outcomes.

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