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Neonate and hypoglycemia

Basilio Pintaudi, Raffaella Fresa, Mariagrazia Dalfrà, Alessandro Roberto Dodesini, Ester Vitacolonna, Andrea Tumminia, Laura Sciacca, Cristina Lencioni, Teresa Marcone, Giuseppe Lucisano, Antonio Nicolucci, Matteo Bonomo, Angela Napoli
AIMS: To assess the risk of adverse neonatal outcomes in women with gestational diabetes (GDM) by identifying subgroups of women at higher risk to recognize the characteristics most associated with an excess of risk. METHODS: Observational, retrospective, multicenter study involving consecutive women with GDM. To identify distinct and homogeneous subgroups of women at a higher risk, the RECursive Partitioning and AMalgamation (RECPAM) method was used. Overall, 2736 pregnancies complicated by GDM were analyzed...
September 17, 2018: Acta Diabetologica
Tiffany L Harriman, Brigit Carter, Robin B Dail, Katherine E Stowell
BACKGROUND: Preterm infants are a vulnerable patient population, especially during the first hours of life. Hypothermia, hypoglycemia, and early-onset sepsis are common problems related to prematurity. Implementation of a Golden Hour protocol has been shown to improve outcomes for preterm infants. PURPOSE: To evaluate the effectiveness of a Golden Hour protocol for infants born at less than 32 weeks' gestation on improving the admission process in a military care facility...
September 12, 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Nayereh Ghomian, Seyede Houra Mousavi Vahed, Samaneh Firouz, Mohammad Ali Yaghoubi, Masoud Mohebbi, Amirhossein Sahebkar
BACKGROUND: Insulin has been a conventional medication in the treatment of female patients suffering from gestational diabetes mellitus (GDM). However, the need for a large number of insulin injections in these patients causes them a lot of discomforts. Recently, an alternative medication, metformin, has received considerable attention in the treatment of GDM. The aim of this study was to compare the efficacy of metformin and insulin in regulating blood glucose levels and fetal outcomes in GDM...
September 7, 2018: Journal of Cellular Physiology
Ana Filipa Ferreira, Catarina Miranda Silva, Dora Antunes, Filipa Sousa, António Carlos Lobo, Paulo Moura
INTRODUCTION: There is no international consensus regarding gestational diabetes mellitus diagnostic criteria. In Portugal, the Carpenter and Coustan criteria were replaced by an adaptation of the International Association of Diabetes and Pregnancy Study Groups criteria. Our aim was to compare the incidence and outcomes of pregnancies complicated by gestational diabetes mellitus according to the current and previous criteria. MATERIAL AND METHODS: Retrospective analysis of 1218 singleton pregnancies complicated with gestational diabetes mellitus, with surveillance/delivery between 2008-2015...
August 31, 2018: Acta Médica Portuguesa
Gabriele Saccone, Adeeb Khalifeh, Huda B Al-Kouatly, Kerri Sendek, Vincenzo Berghella
OBJECTIVE: Worldwide controversy exists regarding the best approach and criteria for gestational diabetes mellitus (GDM) screening and diagnosis. The aim of this systematic review and meta-analysis of randomized trials was to assess the incidence of maternal and neonatal outcomes comparing the one step with the two step approach for the diagnosis of GDM. METHODS: Electronic databases were searched from their inception until June 2018. We included all randomized trials comparing the one step versus the two step method for screening and diagnosis of GDM...
September 3, 2018: Journal of Maternal-fetal & Neonatal Medicine
Xinhong Zhang, Qinping Liao, Fengying Wang, Dan Li
Gestational diabetes mellitus (GDM) is associated with adverse perinatal outcomes. This study aimed to examine the association between GDM and abnormal vaginal flora, and the association between abnormal vaginal flora and adverse pregnancy outcomes.This was a prospective study of pregnant women who visited Xuanwu Hospital of the Capital Medical University (Beijing, China) between February and October 2015. All women were screened for GDM according to the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) recommendations...
August 2018: Medicine (Baltimore)
Alessandro Perri, Lucia Giordano, Mirta Corsello, Francesca Priolo, Giovanni Vento, Enrico Zecca, Eloisa Tiberi
BACKGROUND: Continuous glucose monitoring using subcutaneous sensors is useful in the management of glucose control in neonatal intensive care. We evaluated feasibility and reliability of a continuous glucose monitoring system in a population of very low birth weight neonates needing parenteral nutrition. Moreover, we presented percentiles of glycemia of the studied population. METHODS: Very low birth weight neonates were enrolled within 24 h from birth. An ENLITE sensor connected to a continuous glucose monitoring system was inserted and maintained for at least 72 h...
August 22, 2018: Italian Journal of Pediatrics
Gaia Pocobelli, Onchee Yu, Sharon Fuller, James R Fraser, Paige D Wartko, Lu Chen, Katherine M Newton, Jane Dimer, David K McCulloch, Susan Warwick, Sascha Dublin
OBJECTIVE: To compare perinatal outcomes before and after a clinical guideline change from a two-step to a one-step approach to screening for gestational diabetes mellitus (GDM). METHODS: We conducted a before-after cohort study of women with singleton live birth deliveries within Kaiser Permanente Washington, a mixed-model health plan in Washington state. We used Kaiser Permanente Washington electronic health data and linked birth certificates. We compared outcomes before (January 2009-March 2011) and after (April 2012-December 2014) the guideline change among women who received prenatal care from health care providers internal to Kaiser Permanente Washington (n=4,977 before, n=6,337 after)...
August 17, 2018: Obstetrics and Gynecology
Tal Weissbach, Ishai Heusler, Michal Ovadia, Liron David, Yair Daykan, Faye Schreiber, Tal Biron-Shental
OBJECTIVE: To correlate the duration of Category II cardiotocograms (CTG) with adverse neonatal outcomes associated with perinatal asphyxia and determine the duration before fetal compromise. STUDY DESIGN: This retrospective, observational study used electronic medical record data from a cohort of 271 patients, delivered by C-section due to non-reassuring fetal heart rate, at a tertiary medical center, from 2015 through 2017. Duration of Category II CTG, variability, tachycardia and deceleration frequency were analyzed and correlated to immediate postnatal outcomes...
July 30, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Giuseppa Patti, Chiara Guzzeti, Natascia Di Iorgi, Anna Elsa Maria Allegri, Flavia Napoli, Sandro Loche, Mohamad Maghnie
Central adrenal insufficiency (CAI) is a life-threatening condition caused by either pituitary disease (secondary adrenal insufficiency) or impaired hypothalamic function with inadequate CRH production (tertiary adrenal insufficiency). ACTH deficiency may be isolated or, more frequently, occur in conjunction with other pituitary hormone deficiencies and midline defects. Genetic mutations of the TBX19 causing isolated CAI are rare but a number of genes encoding transcription factors involved in hypothalamic-pituitary gland development, as well as other genes including POMC and PC1, are associated with ACTH deficiency...
August 2018: Best Practice & Research. Clinical Endocrinology & Metabolism
Karina L Arce-López, Juan Vicencio-Rivas, José Iglesias-Leboreiro, Isabel Bernárdez-Zapata, Mario E Rendón-Macías, Ariela Braverman-Bronstein
Introducción: El bajo peso neonatal (< 2.5 kg o < percentil 10) se atribuye a causas constitucionales (pequeño para la edad gestacional [PEG]) o a la restricción en el crecimiento intrauterino (RCIU), con riesgos posnatales diferentes. En ausencia de una valoración fetal-placentaria prenatal adecuada, resulta difícil establecerlo. El conocer los antecedentes maternos de enfermedades gestacionales (AMEG): hipertensión arterial (HTA), hipotiroidismo, Diabetes Mellitus (DM) gestacional y otra; pudiera orientar a la diferenciación y el manejo...
2018: Boletín Médico del Hospital Infantil de México
Ashraf Soliman, Husam Salama, Hilal Al Rifai, Vincenzo De Sanctis, Sawsan Al-Obaidly, Mai Al Qubasi, Tawa Olukade
AIMS OF THE STUDY: We describe the impact of different forms of dysglycemia on maternal and neonatal health. This research is a part of the PEARL-Peristat Maternal and newborn registry, funded by Qatar National Research Fund (QNRF) Doha, Qatar. METHODS: A population-based retrospective data analysis of 12,255 women with singleton pregnancies screened during the year 2016-2017, of which 3,027 women were identified with gestation diabetes mellitus (GDM) during pregnancy and 233 were diabetic before pregnancy...
May 23, 2018: Acta Bio-medica: Atenei Parmensis
Ronny Wickström, Beatrice Skiöld, Gunnar Petersson, Olof Stephansson, Maria Altman
To determine whether moderate neonatal hypoglycemia in otherwise healthy infants is associated with adverse neurodevelopmental outcome in pre-school children. Population-based cohort study with prospectively collected register data from Sweden. All singletons born July 1st 2008 through December 31st 2012 (n = 101,060) in the region were included. Infants with congenital malformations, infants treated in neonatal intensive care unit, infants with inborn errors of metabolism and infants to mothers with diabetes were excluded...
October 2018: European Journal of Epidemiology
Rachel T McGrath, Sarah J Glastras, Samantha L Hocking, Gregory R Fulcher
Despite significant reductions in serious adverse perinatal outcomes for women with type 1 diabetes in pregnancy, the opposite effect has been observed for fetal overgrowth and associated complications, such as neonatal hypoglycemia, shoulder dystocia, and admission to the neonatal intensive care unit. In addition, infants born large for gestational age (LGA) have an increased lifetime risk of obesity, diabetes, and chronic disease. Although exposure to hyperglycemia plays an important role, women who seemingly achieve adequate glycemic control in pregnancy continue to experience a greater risk of excess fetal growth, leading to LGA neonates and macrosomia...
August 2018: Diabetes Care
Hamid Nemati, Parvaneh Karimzadeh, Minoo Fallahi
Objective: Neonatal seizures are common, difficult to diagnose and treat, and associated with a great mortality rate and long-term risk of neurodevelopmental impairments. We aimed to determine the etiology, clinical presentation, and neurodevelopmental outcome of neonatal seizures. Materials and Methods: In this cross-sectional study, 88 neonates, aged < 28 days, admitted to Mofid Children's Hospital, Tehran, Iran, from September 2011 to 2013 with the initial diagnosis of seizure were enrolled by convenient sampling method...
2018: Iranian Journal of Child Neurology
Lina Huerta-Saenz, Carol Saunders, Yun Yan
Background: Congenital hyperinsulinism (CHI) is the leading cause of persistent hypoglycemia in infants. The infants of diabetic mothers (IDMs) very frequently present with neonatal hypoglycemia associated to transient hyperinsulinism however the incidence of CHI in IDMs is unknown. Case presentation: Here we report 2 cases of CHI where the diagnoses were challenged and delayed because both patients were infants of diabetic mothers (IDMs) and had concomitant complicated medical conditions...
2018: International Journal of Pediatric Endocrinology
Ashley N Battarbee, Mark A Clapp, Kim A Boggess, Anjali Kaimal, Carrie Snead, Jay Schulkin, Sofia Aliaga
OBJECTIVE:  The objective of this study was to measure knowledge and practice variation in late preterm steroid use. STUDY DESIGN:  Electronic survey of American College of Obstetricians and Gynecologists (ACOG) members about data supporting the ACOG/Society for Maternal-Fetal Medicine (SMFM) recommendations and practice when caring for women with anticipated late preterm birth (PTB), 340/7 to 366/7 weeks. RESULTS:  Of 352 administered surveys, we obtained 193 completed responses (55%); 82...
July 17, 2018: American Journal of Perinatology
Dotun Ogunyemi, Andrew Jovanovski, James Liu, Perry Friedman, Nathaniel Sugiyama, James Creps, Ichchha Madan
Objective  To determine independent perinatal associations of anxiety and depression in women who were and were not treated with psychotropic drugs in comparison to unaffected pregnancies. Study Design  From 2013 to 2014, 978 (6.3%) cases of anxiety/depression, of which 35% used psychotropic drugs, were compared with 14,514 (93.7%) unaffected pregnancies using logistic regression. Results  Subjects were more likely to be Non-Hispanic Whites, use tobacco and illegal substances, be unmarried, use public insurance, and have medical complications of pregnancy...
July 2018: American Journal of Perinatology Reports
Andrew J Spiro, Katherine N Vu, Alicia Lynn Warnock
Objective: To present the case of an atypical Hepatocyte Nuclear Factor 4 Alpha (HNF4A) mutation that is not consistent with the classically published presentation of HNF4A -Mature Onset Diabetes of the Young (MODY). Methods: Clinical presentation and literature review. Results: A 43-year-old nonobese man was referred to the endocrinology clinic for evaluation of elevated fasting blood glucose (FBG) measurements. Laboratory review revealed prediabetes and hypertriglyceridemia for the previous decade...
2018: Case Reports in Endocrinology
Lee Dresang, Christopher Hooper-Lane
Giving betamethasone to women at risk for delivery between 34 weeks 0 days and 36 weeks 6 days can lower by almost 40% the incidence of transient tachypnea of the newborn, severe respiratory distress syndrome, and the use of surfactant (strength of recommendation [SOR]: A, systematic review of randomized controlled trials [RCTs]). Betamethasone may increase neonatal hypoglycemia, but the hypoglycemia isn't associated with a prolonged hospital stay or other negative outcomes.
July 2018: Journal of Family Practice
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