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Diabetes, hypertension, pregnancy

Cathy Liu, Jade Lodge, Christopher Flatley, Alexander Gooi, Cameron Ward, Karen Eagleson, Sailesh Kumar
OBJECTIVE: To determine obstetric, intrapartum and perinatal outcomes for pregnancies with isolated fetal congenital heart defects (CHD). METHODS: This was a retrospective cohort study of women that delivered an infant with an isolated major CHD between January 2010 and April 2017 at a major Australian perinatal centre. The study cohort was compared with a cohort of women with infants without CHD. Cardiac abnormalities were broadly subdivided into the following five categories using the International Classification of Diseases Tenth Revision (ICD-10) as a guide - transposition of the great arteries (TGA), septal defects, right heart lesions (RHL), left heart lesions (LHL) and "other"...
March 16, 2018: Journal of Maternal-fetal & Neonatal Medicine
Gabriella Bröms, Ann Haerskjold, Fredrik Granath, Helle Kieler, Lars Pedersen, Ingegärd A Berglind
Studies on pregnancy and birth outcomes in women with psoriasis are scarce and the findings inconsistent. The effect of maternal psoriasis and its severity on the risk of adverse pregnancy and birth outcomes was examined. A cross-national population-based cohort study was performed using prospectively collected data from Denmark and Sweden. Singleton births in women with psoriasis were identified in the national health registers between April 2007 and December 2012 and classified according to disease severity...
March 15, 2018: Acta Dermato-venereologica
Tatjana Barišić, Vjekoslav Mandić, Anja Vasilj, Dejan Tiric
OBJECTIVE: To determine the frequency of subclinical hypothyroidism in women with pathological pregnancies and the association between elevated thyroid-stimulating hormone (TSH) and pregnancy outcome. SUBJECTS AND METHODS: A cross-sectional prospective study investigated value of TSH and free thyroxine (FT4) in: 1. pregnant women with hypertension (HTA) (N = 62) or preeclampsia (PE) (N = 50), 2.women with gestational diabetes mellitus (GDM) (N = 92) in pregnancy and 3...
March 14, 2018: Journal of Maternal-fetal & Neonatal Medicine
Carolina Fux-Otta, Manuel Maliqueo, Bárbara Echiburú, Otilio Rosato, Nicolás Crisosto, Gabriel S Iraci, Marta Fiol de Cuneo, Paula Szafryk de Mereshian, Teresa Sir-Petermann
Pregnancy complications and obstetric outcomes were compared in 80 Chilean (PPCOSCh ) and 70 Argentinian (PPCOSAr ) pregnant women. Reference groups of Chilean and Argentinian normal pregnant women from the same antenatal care units were also compared. PPCOSCh showed a higher prevalence of gestational diabetes mellitus (GDM) (OR, 2.28, 95% CI: 1.08-4.77, p = .030) and a lower prevalence of pregnancy-induced hypertension (PIH) (OR, 0.20, 95% CI: 0.07-0.54, p = .001) compared to PPCOSAr . In the normal pregnant groups, the prevalence of PIH was lower in Chilean women compared to Argentinian women (OR, 0...
March 14, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Rajesh Kumari, Venus Dalal, Garima Kachhawa, Ipshita Sahoo, Rajesh Khadgawat, Reeta Mahey, Vidushi Kulshrestha, Perumal Vanamail, J B Sharma, Neerja Bhatla, Alka Kriplani
Background: Gestational diabetes mellitus (GDM) is defined as a carbohydrate intolerance first diagnosed in pregnancy and may be associated with adverse maternal and perinatal outcome. Aim: The aim of the study was to determine the maternal and perinatal outcome in GDM during pregnancy. Materials and Methods: It is a retrospective analysis of women diagnosed with GDM who got antenatal care and delivered in our hospital in previous 5 years...
January 2018: Indian Journal of Endocrinology and Metabolism
Meghan McGee, Shannon Bainbridge, Bénédicte Fontaine-Bisson
The fetal origins of health and disease framework has identified extremes in fetal growth and birth weight as factors associated with the lifelong generation of chronic diseases such as obesity, diabetes, cardiovascular disease, and hypertension. Maternal nutrition plays a critical role in fetal and placental development, in part by providing the methyl groups required to establish the fetus's genome structure and function, notably through DNA methylation. The goal of this narrative review is to describe the role of maternal dietary methyl donor (methionine, folate, and choline) and cofactor (zinc and vitamins B2, B6, and B12) intake in one-carbon metabolism and DNA methylation in the fetus and placenta, as well as their impacts on fetal growth and lifelong health outcomes, with specific examples in animals and humans...
February 26, 2018: Nutrition Reviews
Yanglu Li, Xiangyan Ruan, Husheng Wang, Xue Li, Guiju Cai, Juan Du, Lijuan Wang, Yue Zhao, Alfred O Mueck
OBJECTIVE: To evaluate the prevalence of adverse pregnancy outcomes in healthy Chinese women and to investigate whether these outcomes could be decreased in patients with polycystic ovary syndrome (PCOS) by ethinylestradiol/cyproterone acetate (EE/CPA) pretreatment. DESIGN: Retrospective study. SETTING: Medical university. PATIENT(S): Six thousand healthy women (group A) were selected from 24,566 pregnant women by randomized sampling...
March 7, 2018: Fertility and Sterility
Thierry Brue, Vincent Amodru, Frédéric Castinetti
With fewer than 200 reported cases, Cushing's syndrome (CS) in pregnancy remains a diagnostic and therapeutic challenge. In normal pregnancies, misleading signs may be observed such as striae or hypokalemia, while plasma cortisol and urinary free cortisol may rise up to 2-3-fold. While the dexamethasone suppression test is difficult to use, reference values for salivary cortisol appear valid. The predominant cause is adrenal adenoma (sometimes without decreased ACTH), rather than Cushing's disease. There are considerable imaging pitfalls in Cushing's disease...
March 9, 2018: European Journal of Endocrinology
Laura Schummers, Jennifer A Hutcheon, Michele R Hacker, Tyler J VanderWeele, Paige L Williams, Thomas A McElrath, Sonia Hernandez-Diaz
BACKGROUND: First deliveries in women older than 35, 40, or 45 are at increased risk for adverse pregnancy outcomes compared with those in younger women. However, specific relationships between each additional year of maternal age and pregnancy risks remain unclear, and absolute risks at each maternal age are not known. METHODS: Using a population-based cohort of nulliparous women in British Columbia, Canada, from 2004-2014 (n=203,414), We examined relationships between maternal age (modeled flexibly to allow curvilinear shapes) and pregnancy outcomes using logistic regression...
March 6, 2018: Epidemiology
Louise Mary Webster, Carolyn Gill, Paul T Seed, Kate Bramham, Cornelia Wiesender, Catherine Nelson-Piercy, Jenny E Myers, Lucy C Chappell
Black ethnicity is associated with worse pregnancy outcomes in women with chronic hypertension. Pre-existing endothelial and renal dysfunction, and poor placentation may contribute but pathophysiological mechanisms underpinning increased risk are poorly understood. This cohort study aimed to investigate the relationship between ethnicity, superimposed pre-eclampsia and longitudinal changes in markers of endothelial, renal and placental dysfunction in women with chronic hypertension. Plasma concentrations of placental growth factor (PlGF), syndecan-1, renin, aldosterone, and urinary angiotensinogen:creatinine ratio (AGTCR), protein:creatinine ratio (PCR) and albumin:creatinine ratio (ACR) were quantified during pregnancy and postpartum in women with chronic hypertension...
March 7, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
Mayte E van Alebeek, Myrthe de Vrijer, Renate M Arntz, Noortje A M M Maaijwee, Nathalie E Synhaeve, Hennie Schoonderwaldt, Maureen J van der Vlugt, Ewoud J van Dijk, Roel de Heus, Loes C A Rutten-Jacobs, Frank-Erik de Leeuw
BACKGROUND AND PURPOSE: The study goal was to investigate the prevalence of pregnancy complications and pregnancy loss in women before, during, and after young ischemic stroke/transient ischemic attack. METHODS: In the FUTURE study (Follow-Up of Transient Ischemic Attack and Stroke Patients and Unelucidated Risk Factor Evaluation), a prospective young stroke study, we assessed the occurrence of pregnancy, miscarriages, and pregnancy complications in 223 women aged 18 to 50 years with a first-ever ischemic stroke/transient ischemic attack...
March 6, 2018: Stroke; a Journal of Cerebral Circulation
Beatriz Barquiel, Lucrecia Herranz, Diego Meneses, Óscar Moreno, Natalia Hillman, Mª Ángeles Burgos, José Luis Bartha
OBJECTIVES: Our aim was to investigate the greatest gestational weight gain (GWG) without adverse pregnancy complications in women with gestational diabetes mellitus (GDM) and morbid obesity. METHODS: An observational retrospective study including 3284 patients with single pregnancies and GDM was completed. Of the patients, 131 (4.0%) were classified as having pre-pregnancy morbid obesity (BMI ≥ 35 kg/m2 ). Perinatal complications were compared among BMI groups...
March 1, 2018: Maternal and Child Health Journal
Barbara Torlinska, Sarah C Bath, Aisha Janjua, Kristien Boelaert, Shiao-Yng Chan
Severe iodine deficiency during pregnancy has been associated with pregnancy/neonatal loss, and adverse pregnancy outcomes; however, the impact of mild-to-moderate iodine insufficiency, though prevalent in pregnancy, is not well-documented. We assessed whether mild iodine deficiency during pregnancy was associated with pregnancy/infant loss, or with other adverse pregnancy outcomes. We used samples and data from the Avon Longitudinal Study of Parents and Children (ALSPAC), from 3140 singleton pregnancies and from a further 42 women with pregnancy/infant loss...
March 1, 2018: Nutrients
Alana C Ju, Melvin B Heyman, Andrea K Garber, Janet M Wojcicki
Objective Maternal obesity is a risk factor for preterm birth, a leading cause of infant morbidity and mortality. Native Hawaiian and other Pacific Islanders (NHOPI) have high rates of poor birth outcomes. Despite the high rates of obesity in NHOPI in Hawaii, the association with preterm birth has not been examined in this population. Methods We performed a retrospective cohort study of 20,061 women using data collected by Hawaii's Pregnancy Risk Assessment Monitoring System (PRAMS) from 2000 to 2011. We investigated the contribution of maternal age, pre-pregnancy BMI, gestational diabetes, hypertension, race, socioeconomic status, and smoking to our primary outcomes of preterm birth and low birthweight using multivariable logistic regression, stratified by NHOPI versus non-NHOPI race...
March 1, 2018: Maternal and Child Health Journal
Olina Dagher, Nassiba Alami Laroussi, Michel Carrier, Renzo Cecere, Eric Charbonneau, Simon de Denus, Nadia Giannetti, Line Leduc, Bernard Cantin, Asmaa Mansour, Nancy Poirier, Marie-Josée Raboisson, Michel White, Anique Ducharme
BACKGROUND: Despite reports of successful pregnancies in heart transplant (HTx) recipients, many centers recommend their patients against maternity. METHODS: We reviewed our provincial experience of pregnancy in HTx recipient by performing charts review of all known gestations following HTx in the province of Quebec (Canada), stratified between planned and unplanned pregnancies. Long-term survival was compared to HTx recipient women of childbearing age who didn't become pregnant...
February 26, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
Matthias David, Katrin Alexandra Scherer, Wolfgang Henrich, Jürgen Breckenkamp
Objectives: Does the incidence and/or indication(s) for emergency cesarean section differ if the pregnant woman has an immigrant background (IB)? Does a lack of language proficiency (communication problems) and a low acculturation level result in a longer decision-to-delivery interval (D-D interval)? Are neonates born to women with IB by emergency cesarean section in a poorer condition post delivery? Patient cohorts and method: Standardized interviews were carried out before or immediately after delivery in three Berlin obstetric hospitals...
February 2018: Geburtshilfe und Frauenheilkunde
Sine Knorr, Svend Juul, Birgitte Bytoft, Zuzana Lohse, Tine D Clausen, Rikke B Jensen, Peter Damm, Henning Beck-Nielsen, Elisabeth R Mathiesen, Dorte M Jensen, Claus H Gravholt
AIMS/HYPOTHESIS: The aims of this study were to examine long-term mortality and morbidity rates in mothers with type 1 diabetes, both overall and according to the level of albuminuria prior to pregnancy, the presence of hypertension, pre-eclampsia and periconceptional HbA1c . METHODS: This study was a part of the EPICOM (Environmental Versus Genetic and Epigenetic Influences on Growth, Metabolism and Cognitive Function in Offspring of Mothers with Type 1 Diabetes) study, which is a prospective follow-up study focusing on pregnancies complicated by maternal type 1 diabetes...
February 24, 2018: Diabetologia
Sidse Kjærhus Nørgaard, Marianne Jenlev Vestgaard, Isabella Lindegaard Jørgensen, Björg Ásbjörnsdóttir, Lene Ringholm, Harold David McIntyre, Peter Damm, Elisabeth Reinhardt Mathiesen
AIMS: To identify early clinical, modifiable risk factors for preeclampsia present at first antenatal visit and assess the prevalence of pregnancy-related hypertensive disorders in women with pre-existing diabetes treated with tight glycemic and blood pressure (BP) control. METHODS: A population-based cohort study of 494 women with pre-existing diabetes (307 and 187 women with type 1 and type 2 diabetes, respectively), included at their first antenatal visit from 2012-16...
February 20, 2018: Diabetes Research and Clinical Practice
James H O'Keefe, James J DiNicolantonio, Carl J Lavie
Coffee, a complex brew containing hundreds of biologically active compounds, exerts potent effects on long-term human health. Recently, a plethora of studies have been published focusing on health outcomes associated with coffee intake. An inverse association between coffee consumption and all-cause mortality has been seen consistently in large prospective studies. Habitual coffee consumption is also associated with lower risks for cardiovascular (CV) death and a variety of adverse CV outcomes, including coronary heart disease (CHD), congestive heart failure (HF), and stroke; coffee's effects on arrhythmias and hypertension are neutral...
February 20, 2018: Progress in Cardiovascular Diseases
P J Steer
The study by Lane-Cordova et al reports that "women with preterm birth (PTB)/small for gestational age (SGA) babies had lower fitness" but then conclude that "Neither fitness nor hemodynamic responses to exercise, a median of 5 years preceding pregnancy, were associated with PTB/SGA". This apparent contradiction came about because they adjusted for 'a number of demographic variables independently associated with PTB/SGA - age, race, education, study center, BMI, current and former smoking, diabetes, and hypertension'...
February 23, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
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