scholarly journals Spontaneous Abortions and Gestational Diabetes Mellitus- A Study from Pakistan

2021 ◽  
Vol 2 (2) ◽  
pp. 58-63
Author(s):  
Aasia Kanwal ◽  
Asma Salam ◽  
Aisha Bashir

Background: Gestational diabetes mellitus leads to adverse pregnancy outcomes. Objectives: The objective of the study was to explore the relationship of spontaneous abortions with gestational diabetes mellitus in pregnant women from rural and urban Lahore. Methods: This cross-sectional study was conducted at University of Health Sciences, Lahore in 2019. Among 60 pregnant women sampled, 30 had gestational diabetes mellitus (GDM) and 30 were normal pregnant controls. Pregnant women were sampled from different hospitals of rural and urban areas of Lahore. Independent sample t-test was applied for analyzing the data. Chi- square test was used to analyze the categorical variables. Association of fasting blood glucose (FBG) and abortions was checked. Odd ratio and relative risk were calculated. Results: Mean fasting blood sugar levels were significantly higher in GDM group (105 mg/dL) as compared to non-GDM group (80.50 mg/dL) at p<0.001. The proportions of the women with increased number of abortions had significantly higher blood glucose levels (OR 5.091, 95% CI, RR 1.27). Conclusions: Gestational diabetes mellitus is associated with an increased risk of spontaneous abortions.

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Lei Liu ◽  
Jiajin Hu ◽  
Liu Yang ◽  
Ningning Wang ◽  
Yang Liu ◽  
...  

Background. Obese women with gestational diabetes mellitus (GDM) have a higher risk of adverse outcomes than women with obesity or GDM alone. Our study is aimed at investigating the discriminatory power of circulatory Wnt1-inducible signaling pathway protein-1 (WISP1), a novel adipocytokine, on the copresence of prepregnancy overweight/obesity and GDM and at clarifying the relationship between the WISP1 level and clinical cardiometabolic parameters. Methods. A total of 313 participants were screened from a multicenter prospective prebirth cohort: Born in Shenyang Cohort Study (BISCS). Subjects were examined with a 2×2 factorial design for body mass index BMI≥24 and GDM. Between 24 and 28 weeks of pregnancy, follow-up individuals underwent an OGTT and blood sampling for cardiometabolic characterization. Results. We observed that the WISP1 levels were elevated in prepregnancy overweight/obesity patients with GDM, compared with nonoverweight subjects with normal blood glucose (3.45±0.89 vs. 2.91±0.75 ng/mL). Multilogistic regression analyses after adjustments for potential confounding factors revealed that WISP1 was a strong and independent risk factor for prepregnancy overweight/obesity with GDM (all ORs>1). In addition, the results of the ROC analysis indicated that WISP1 exhibited the capability to identify individuals with prepregnancy overweight/obesity and GDM (all AUC>0.5). Finally, univariate and multivariate linear regression showed that WISP1 level was positively and independently correlated with fasting blood glucose, systolic blood pressure, and aspartate aminotransferase and was negatively correlated with HDL-C and complement C1q. Conclusions. WISP1 may be critical for the prediction, diagnosis, and therapeutic strategies against obesity and GDM in pregnant women.


2020 ◽  
Vol 27 (05) ◽  
pp. 1004-1010
Author(s):  
Saher Fatima ◽  
Sadia Saeed ◽  
Syeda Fariha Hasnny ◽  
Nathumal Maheshwari ◽  
Urooj Tabassum ◽  
...  

Objectives: Determining serum cobalamin levels in Pregnant Women suffering from Gestational Diabetes mellitus (GDM) presenting at our tertiary care hospital. Study Design: Case control study. Setting: Department of Gynecology and Medicine, SMBB Medical College Layari General Hospital Karachi. Period: January 2016 to April 2017. Material & Methods: Sample of 100 pregnant women in 2nd and 3rd trimester was selected into; 50 controls and 50 GDM cases through convenient sampling. GDM was defined as pregnant women with fasting blood sugar ≥100 mg/dL. 5 ml blood was collected; 3 ml put into EDTA tubes for complete blood counts and 2 ml for sera. Blood glucose was estimated by hexokinase method, HbA1c by colorimetric method and cobalamin by ECLIA assay method. SPSS software 21.0 (IBM, Inc USA) was used for data analysis using Student t-test and Chi-square test (P ≤ 0.05). Results: Age of control was 30.43±1.49 years and 29.95±1.27 years in cases. Gestational age was 33.67±2.69 weeks in controls and 34.75±2.53 weeks in cases. Control and cases shows serum cobalamin levels of 316.34± 113.77 pg/ml and 253.5±121.32 pg/ml respectively (P=0.009). Serum cobalamin deficiency was noted in 68% of cases and 40% of controls (P<0.05). Glycemic control was bad in majority of cases. Serum cobalamin shows inverse correlation with random blood glucose, fasting blood glucose and Glycated HbA1. Conclusion: We found low serum cobalamin levels in pregnant women suffering from gestational diabetes mellitus that showed inverse correlation with random and fasting blood glucose and glycemic control.


PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243192
Author(s):  
Michael d’Emden ◽  
Donald McLeod ◽  
Jacobus Ungerer ◽  
Charles Appleton ◽  
David Kanowski

Objective To evaluate the role of fasting blood glucose (FBG) to minimise the use of the oral glucose tolerance test in pregnancy (POGTT) for the diagnosis of gestational diabetes mellitus (GDM). Research design and methods We analysed the POGTTs of 26,242 pregnant women in Queensland, Australia, performed between 1 January 2015 and 30 June 2015. A receiver operator characteristics (ROC) assessment was undertaken to indicate the FBG level that most effectively identified women at low risk of an abnormal result. Results There were 3,946 (15.0%) patients having GDM with 2,262 (8.6%) having FBG ≥ 5.1mmol/l. The ROC identified FBG levels >4.6mmol/l having the best specificity (77%) and sensitivity (54%) for elevated 1 and/or 2hr BGLs. There were 19,321 (73.7%) women having FBG < 4.7mmol/l with a prevalence of GDM of 4.0%, less than 1/3rd the overall rate. Only 4,638 (17.7%) women having FBGs from 4.7–5.0mmol/l would require further evaluation to confirm or exclude the diagnosis. Conclusion This contemporary study of women across the state of Queensland, Australia suggests the FBG can be used effectively to define glucose tolerance in pregnancy, minimising their contact with pathology laboratories and potential exposure to the corona virus. This analysis, used in conjunction with outcome data from the HAPO study, provides reassurance to women and their health professionals that FBG < 4.7mmol/l has both a low rate of abnormal glucose tolerance and minimal adverse pregnancy-associated complications.


2017 ◽  
Vol 10 (3) ◽  
pp. 120-124 ◽  
Author(s):  
Margaret Bublitz ◽  
Suzanne De La Monte ◽  
Susan Martin ◽  
Lucia Larson ◽  
Ghada Bourjeily

Background Women with childhood maltreatment histories are at increased risk for adverse birth outcomes. Mechanisms explaining this link are poorly understood. Past research is limited by sampling pregnant women at low risk for adverse maternal and neonatal outcomes. Methods This pilot study was a secondary data analysis of 24 women with gestational diabetes mellitus; 17% of the sample also reported a maltreatment history. Women provided a blood sample to measure inflammatory cytokines and insulin resistance, and saliva samples to measure diurnal cortisol. Birth outcomes for past and current pregnancies were recorded. Results Histories of maltreatment were associated with elevated interleukin-15 and a marginally greater incidence of preterm delivery in current and past pregnancies. Conclusions This pilot study was the first to demonstrate an association between childhood maltreatment history and inflammatory cytokine levels in pregnant women diagnosed with gestational diabetes mellitus.


2012 ◽  
Vol 19 (04) ◽  
pp. 462-468
Author(s):  
M. IKRAM ◽  
SYED HAIDER HASAN ALAM ◽  
SHAFQAT MUKHTAR ◽  
M. Saeed

Introduction: Gestational diabetes mellitus is common disorder in pregnancy. It is associated with adverse pregnancy outcome. There is no consensus regarding the optimal approach to screening of gestational diabetes mellitus. The present study has tried toobserve the value of fasting blood glucose in screening of gestational diabetes. Objective: To determine the frequency of patients in whomfasting blood glucose and 100gm glucose tolerance show agreement for screening of gestational diabetes mellitus at 24 -28 wks. Studydesign: Comparative cross sectional study. Settings: The study was conducted at Gynecology and Obstetrics department Shaikh ZayedFederal Post Graduate Institute Lahore. Duration of study with dates: 6 months from 12Nov 2010 to 11 May 2011. Material and method: Thestudy included 135 booked patients with positive family history of diabetes mellitus. All patients underwent fasting blood glucose at 24-28 weeksof gestation, regardless of results of fasting blood glucose on next visit they underwent 100g oral glucose tolerance test (OGTT). The agreementbetween fasting blood glucose and 100g oral glucose tolerance test was calculated in frequency and percentages. Results: The mean age ofwomen in studied population was 27.15±3.70.Out of 135 patients 86.7 %( 117) showed agreement between results of fasting blood glucose and100g OGTT while 13.31 %( 18) showed no agreement between both of the tests. Conclusions: Fasting blood glucose is a good screeningoption for gestational diabetes mellitus along with positive history. It provides a simple, cheap and more practical test for screening of gestationaldiabetes mellitus. However diagnostic confirmation with 100g OGTT should be done.


2021 ◽  
Vol 8 ◽  
Author(s):  
Wendy N. Phoswa

Purpose of the Review: The main objective of this study is to investigate mechanisms associated with gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) in HIV infected pregnant women by looking how placental hormones such as (progesterone and prolactin) and basic haemostatic parameters are regulated in HIV infected pregnancies.Recent Findings: HIV/AIDS are a major global obstetric health burden that lead to increased rate of morbidity and mortality. HIV/AIDS has been associated with the pathophysiology of GDM and HDP. Increased risk of GDM due to highly active antiretroviral therapy (HAART) usage has been reported in HIV infected pregnancies, which causes insulin resistance in both pregnant and non-pregnant individuals. HAART is a medication used for lowering maternal antepartum viral load and pre-exposure and post-exposure prophylaxis of the infant. In pregnant women, HAART induces diabetogenic effect by causing dysregulation of placental hormones such as (progesterone and prolactin) and predispose HIV infected women to GDM. In addition to HIV/AIDS and GDM, Studies have indicated that HIV infection causes haemostatic abnormalities such as hematological disorder, deregulated haematopoiesis process and the coagulation process which results in HDP.Summary: This study will help on improving therapeutic management and understanding of the pathophysiology of GDM and HDP in the absence as well as in the presence of HIV infection by reviewing studies reporting on these mechanism.


2020 ◽  
Author(s):  
Adnette Fagninou ◽  
Magloire Pandoua Nekoua ◽  
Salomon Ezéchiel Mahougnon Fiogbe ◽  
Kabirou Moutairou ◽  
Akadiri YESSOUFOU

Abstract Background : Immunological and biochemical parameters are gaining more and more importance in the prognosis of diabetes and its complications. Here we assessed the predictive power of immunological parameters correlated with biochemical ones in gestational diabetes mellitus (GDM). Material and Methods : 217 pregnant women were screened for GDM between the 2 nd and the 3 rd trimester of gestation, based on IAGDP methods in this cross-sectional descriptive study. Immunological and biochemical parameters were determined using appropriate methods. Receiver operating characteristics (ROC) curve analyses were conducted to assess the optimal cutoff and value of immunological to biochemical parameter ratios for predicting GDM. Results : 11.90% of pregnant women were diagnosed GDM positive. Serum glucose levels, total cholesterol, LDL-cholesterol, triglycerides and total proteins were significantly increased while HDL-cholesterol decreased in women with GDM compared to controls. The levels of glycosylated hemoglobin and creatinine, as well as transaminase (AST and ALT) activities did not significantly differ between GDM and pregnant controls. Total leucocytes (white blood cell), lymphocyte and platelet numbers were significantly higher in women with GDM than in pregnant controls. We also found that the lymphocyte:HDL-C, monocyte:HDL-C and granulocyte:HDL-C ratios were significantly higher in women with GDM than in pregnant controls ( p = 0.001; p = 0.009 and p = 0.004 respectively). Women with a lymphocyte:HDL-C ratio greater than 3.66 had a 4-fold increased risk of developing GDM than those with lower ratios (odds ratio 4.00; 95% CI: 1.094 – 14.630; p =0.041). Conclusion : The lymphocyte:HDL-C, monocyte:HDL-C and granulocyte:HDL-C ratios may represent valuable makers, and the lymphocyte:HDL-C ratio in particular may have strong predictive power for GDM. This ratio can be easily assessed in patients.


2021 ◽  
pp. 787-792
Author(s):  
Zainab k. Hussain ◽  
Jabbar H. Yenzeel ◽  
Hayfa H. Hassani

To study the genetic effect of gestational diabetes mellitus by study IRS1gene expression in female with Gestational diabetes mellitus. It is characterized high level of blood glucose, especially during first trimester then increased during the 2nd and 3rd trimester of the pregnancy period. The blood samples taken from one hundred twenty healthy women and female with gestational diabetes mellitus in 3rd trimester period of pregnancy, level of fasting blood glucose (FBG) also HbA1c% measured to diagnose GDM, in addition to lipid profile (cholesterol, triglyceride, HDL, LDL, and VLDL), molecular study consist of RNA extraction and qRT- PCR for IRS1gene expression determination. The fasting blood glucose mg/dl and HbA1c% level was increased highly significantly (P<0.01) between patients and control (healthy women) in 3rd trimester stage in addition lipid profile included )serum cholesterol, serum triglyceride, LDL and VLDL( (mg/dl) but level of HDL (mg/dl) was decreased highly significantly (P<0.01) between patients and control. The result showed high significant of IRS1 expression gene in control (1.00 ± 0.00) while in patients (0.147 ± 0.02). The low expression of IRS1 gene was connected with gestational diabetes mellitus comparison in control (healthy women) in Iraqi female in third trimester of pregnancy


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