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Pregestational Diabetes

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https://www.readbyqxmd.com/read/29755036/pregnancy-related-risk-factors-are-associated-with-a-significant-burden-of-treated-hypertension-within-10-years-of-delivery-findings-from-a-population-based-norwegian-cohort
#1
Grace M Egeland, Svetlana Skurtveit, Anne Cathrine Staff, Geir Egil Eide, Anne-Kjersti Daltveit, Kari Klungsøyr, Lill Trogstad, Per M Magnus, Anne Lise Brantsæter, Margaretha Haugen
BACKGROUND: The association between pregnancy complications and women's later cardiovascular disease has, primarily, been evaluated in studies lacking information on important covariates. This report evaluates the prospective associations between pregnancy-related risk factors (preeclampsia/eclampsia, gestational hypertension, pregestational and gestational diabetes mellitus, preterm delivery, and fetal growth restriction) and pharmacologically treated hypertension within 10 years after pregnancy, while adjusting for a wide range of covariates...
May 13, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29752712/maternal-diabetes-alters-the-development-of-ductus-venosus-shunting-in-the-fetus
#2
Agnethe Lund, Cathrine Ebbing, Svein Rasmussen, Torvid W Kiserud, Jörg Kessler
INTRODUCTION: Despite adequate glycemic control, the risks of fetal macrosomia and perinatal complications are increased in diabetic pregnancies. Adjustments of the umbilical venous (UV) distribution, including increased ductus venosus (DV) shunting, can be important fetal compensatory mechanisms, but the impact of pregestational diabetes on UV and DV flow is not known. MATERIAL AND METHODS: In this prospective study, 49 women with pregestational diabetes mellitus underwent monthly ultrasound examinations from gestational week 20 to 36...
May 11, 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29747733/pregestational-diabetes-in-pregnancy
#3
REVIEW
Ronan Sugrue, Chloe Zera
Diabetes is a common chronic condition in women of reproductive age. Preconception care is crucial to reducing the risk of adverse maternal and fetal outcomes, such as hypertensive disorders, abnormal fetal growth, traumatic delivery and stillbirth, associated with poor glycemic control. Insulin is the preferred medication to optimize glucose control in women with pregestational diabetes. Frequent dose adjustments are needed during pregnancy to achieve glycemic goals, and team-based multidisciplinary care may help...
June 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/29744539/community-based-pre-pregnancy-care-programme-improves-pregnancy-preparation-in-women-with-pregestational-diabetes
#4
Jennifer M Yamamoto, Deborah J F Hughes, Mark L Evans, Vithian Karunakaran, John D A Clark, Nicholas J Morrish, Gerry A Rayman, Peter H Winocour, Clare Hambling, Amanda W Harries, Michael J Sampson, Helen R Murphy
AIMS/HYPOTHESIS: Women with diabetes remain at increased risk of adverse pregnancy outcomes associated with poor pregnancy preparation. However, women with type 2 diabetes are less aware of and less likely to access pre-pregnancy care (PPC) compared with women with type 1 diabetes. We developed and evaluated a community-based PPC programme with the aim of improving pregnancy preparation in all women with pregestational diabetes. METHODS: This was a prospective cohort study comparing pregnancy preparation measures before and during/after the PPC intervention in women with pre-existing diabetes from 1 June 2013 to 28 February 2017...
May 9, 2018: Diabetologia
https://www.readbyqxmd.com/read/29740916/real-world-management-of-pregestational-diabetes-not-achieving-glycemic-control-for-many-patients-in-the-uk
#5
Lucia Cea-Soriano, Luis A García-Rodríguez, Kimberly G Brodovicz, Elvira Gonzalez-Masso, Dorothee B Bartels, Sonia Hernández-Díaz
PURPOSE: Our goal was to describe the management of pregestational diabetes in pregnant women in the United Kingdom. METHODS: We used electronic medical records from The Health Improvement Network database between January 1995 and June 2012 to identify the first pregnancy in women 15 to 45 years of age with pregestational diabetes type 1 or type 2. Information on lifestyle factors, demographic characteristics, prescription of specific antidiabetic medications, and glycemic control measures (HbA1c) was obtained from primary care provider records...
May 8, 2018: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29740837/increased-fetal-epicardial-fat-thickness-a-novel-ultrasound-marker-for-altered-fetal-metabolism-in-diabetic-pregnancies
#6
Mehmet O Akkurt, Ozhan M Turan, Sarah Crimmins, Christopher R Harman, Sifa Turan
OBJECTIVE: To evaluate whether fetal epicardial fat thickness (EFT) differs in diabetic and nondiabetic pregnant women. METHODS: Retrospective case-control study of pregnancies between 24 and 36 weeks complicated by preexisting (PDM) or gestational (GDM) diabetes mellitus, matched one to one with controls for body mass index and gestational age (GA). Epicardial fat was identified as the hypoechogenic area between myocardium and visceral pericardium over the right ventricle and its thickness was measured by a single observer blinded to clinical condition and outcomes...
May 8, 2018: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/29727881/association-between-sonographic-estimated-fetal-weight-and-the-risk-of-cesarean-delivery-among-nulliparous-women-with-diabetes-in-pregnancy
#7
Annie M Dude, William A Grobman, Lynn M Yee
OBJECTIVE:  The objective of this study was to examine the association between an ultrasound-estimated fetal weight (US-EFW) and mode of delivery among nulliparous diabetic women. STUDY DESIGN:  This is a retrospective cohort study of nulliparous women with medication-requiring gestational or pregestational diabetes who delivered term, singleton gestations following a trial of labor. We determined whether having had an US-EFW within 35 days of delivery was associated with cesarean delivery...
May 4, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29720745/the-influence-of-maternal-obesity-on-pregnancy-complications-and-neonatal-outcomes-in-diabetic-and-nondiabetic-women
#8
Burcu Budak Timur, Hakan Timur, Aytekin Tokmak, Hatice Isik, Elif Gul Yapar Eyi
Introduction: This study aimed to investigate the influence of obesity on pregnancy complications and neonatal outcomes in diabetic and nondiabetic women. Materials and Methods: This retrospective case control study was conducted on 1193 pregnant women and their neonates at a tertiary level maternity hospital between March 2007 and 2011. The pregnant women were classified into 2 groups according to the presence of diabetes mellitus. Six hundred and seven patients with gestational diabetes or pregestational diabetes formed the diabetic group (study group) and 586 patients were in the nondiabetic group (control group)...
April 2018: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/29699712/foetoplacental-epigenetic-changes-associated-with-maternal-metabolic-dysfunction
#9
Bredford Kerr, Andrea Leiva, Marcelo Farías, Susana Contreras-Duarte, Fernando Toledo, Francisca Stolzenbach, Luis Silva, Luis Sobrevia
Metabolic-related diseases are attributed to a sedentary lifestyle and eating habits, and there is now an increased awareness regarding pregnancy as a preponderant window in the programming of adulthood health and disease. The developing foetus is susceptible to the maternal environment; hence, any unfavourable condition will result in foetal physiological adaptations that could have a permanent impact on its health. Some of these alterations are maintained via epigenetic modifications capable of modifying gene expression in metabolism-related genes...
April 12, 2018: Placenta
https://www.readbyqxmd.com/read/29624902/one-hour-ogtt-plasma-glucose-at-gdm-diagnosis-is-a-common-predictor-of-the-need-for-insulin-therapy-in-pregnancy-and-postpartum-impaired-glucose-tolerance
#10
Takeshi Nishikawa, Keiko Ono, Shoko Hashimoto, Hiroyuki Kinoshita, Takuro Watanabe, Hirotaka Araki, Kae Otsu, Wakana Sakamoto, Masahiro Harada, Tetsushi Toyonaga, Shoichi Kawakami, Jyunichiro Fukuda, Yoshio Haga, Daisuke Kukidome, Takeshi Takahashi, Eiich Araki
AIMS/INTRODUCTION: Because gestational diabetes mellitus (GDM) is a risk for adverse perinatal outcomes, and patients with a history of GDM have an increased risk of impaired glucose tolerance (IGT). Here, we conducted two non-interventional and retrospective studies of GDM patients in Japan. MATERIALS AND METHODS: In the first study, we enrolled 529 GDM patients and assessed predictors of the need for insulin therapy. In the second study, we enrolled 185 patients from the first study, and assessed predictors of postpartum IGT...
April 6, 2018: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/29582816/prevalence-progression-and-outcomes-of-diabetic-retinopathy-during-pregnancy-in-indian-scenario
#11
Tarjani Makwana, Brijesh Takkar, Pradeep Venkatesh, Jai Bhagwan Sharma, Yashdeep Gupta, Rohan Chawla, Rajpal Vohra, Alka Kriplani, Nikhil Tandon
Purpose: The objective of this study is to evaluate pattern of diabetic retinopathy (DR) during pregnancy in females with pregestational diabetes mellitus (DM). Methods: This is an ambispective observational cohort study conducted at an Indian tertiary care centre. A total of 50 pregnant females with pregestational DM were included while those with gestational DM were excluded from the study. Ocular examination (inclusive of fundus photography) was conducted and systemic parameters (inclusive of Glycated hemoglobin) were assessed during each of the 3 trimesters and 3 months postpartum...
April 2018: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/29540896/intra-partum-management-of-women-with-diabetes
#12
Roopa Jewel, Jubbin Jagan Jacob
Management of hyperglycaemia is crucial during labour to improve outcomes both in the newborn and in the mother. This is particularly crucial in mothers with pregestational type 1 diabetes and in all mothers requiring insulin treatment during pregnancy. The use of antenatal steroids in mothers at risk of preterm delivery complicates management of hyperglycaemia in the immediate antepartum period and requires appropriate dosing adjustments of insulin therapy. Mothers are generally asked to be nil per orum during active labour...
March 2018: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/29534258/management-of-diabetes-in-the-intrapartum-and-postpartum-patient
#13
Annie Dude, Charlotte M Niznik, Emily D Szmuilowicz, Alan M Peaceman, Lynn M Yee
Achieving maternal euglycemia in women with pregestational and gestational diabetes mellitus is critical to decreasing the risk of neonatal hypoglycemia, as maternal blood glucose levels around the time of delivery are directly related to the risk of hypoglycemia in the neonate. Many institutions use continuous insulin and glucose infusions during the intrapartum period, although practices are widely variable. At Northwestern Memorial Hospital, the "Management of the Perinatal Patient with Diabetes" policy and protocol was developed to improve consistency of management while also allowing individualization appropriate for the patient's specific diabetic needs...
March 13, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29525688/comparing-the-risk-of-adverse-pregnancy-outcomes-of-chinese-patients-with-polycystic-ovary-syndrome-with-and-without-antiandrogenic-pretreatment
#14
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...
April 2018: Fertility and Sterility
https://www.readbyqxmd.com/read/29506426/which-criteria-should-be-used-for-starting-pharmacologic-therapy-for-management-of-gestational-diabetes-in-pregnancy-evidence-from-randomized-controlled-trials
#15
Claudia Caissutti, Gabriele Saccone, Adeeb Khalifeh, A Dhanya Mackeen, Melisa Lott, Vincenzo Berghella
INTRODUCTION: There is inconclusive evidence to support any specific criteria for starting pharmacologic therapy after diet in women with gestational diabetes mellitus (GDM). We aimed to analyze the most used criteria for starting pharmacologic treatment for patients with GDM. MATERIAL AND METHODS: Electronic databases were searched from their inception to September 2017. We included all the randomized controlled trials (RCTs) of GDM managed initially by diet and exercise reporting criteria for starting pharmacologic therapy...
March 20, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29486854/pregestational-diabetes-increases-fetoplacental-vascular-resistance-in-rats
#16
Olga Vajnerova, Petr Kafka, Tereza Kratzerova, Karel Chalupsky, Vaclav Hampl
INTRODUCTION: Diabetes is a well-known risk factor in pregnancy. Because maternal diabetes involves oxidative stress that is also induced by chronic hypoxia and can alter vascular function, we sought to determine the effects of chronic maternal hyperglycemia on the fetoplacental vasculature in rats and to compare it with the effects of chronic hypoxia. METHODS: Diabetes was induced in female rats by a streptozotocin injection at a neonatal age. When these animals reached adulthood, their hyperglycemia was confirmed and they were inseminated...
March 2018: Placenta
https://www.readbyqxmd.com/read/29478010/insulin-analogues-use-in-pregnancy-among-women-with-pregestational-diabetes-mellitus-and-risk-of-congenital-anomaly-a-retrospective-population-based-cohort-study
#17
Hao Wang, Ewa Wender-Ozegowska, Ester Garne, Margery Morgan, Maria Loane, Joan K Morris, Marian K Bakker, Miriam Gatt, Hermien de Walle, Susan Jordan, Anna Materna-Kiryluk, Vera Nelen, Guy Thys, Awi Wiesel, Helen Dolk, Lolkje T W de Jong-van den Berg
OBJECTIVES: To evaluate the risk of major congenital anomaly associated with first-trimester exposure to insulin analogues compared with human insulin in offspring of women with pregestational diabetes. DESIGN AND SETTING: A population-based cohort of women with pregestational diabetes (n=1661) who delivered between 1996 and 2012 was established retrospectively from seven European regions covered bythe European Surveillance of Congenital Anomalies (EUROCAT) congenital anomaly registries...
February 24, 2018: BMJ Open
https://www.readbyqxmd.com/read/29442404/cesarean-section-and-diabetes-during-pregnancy-an-nsw-population-study-using-the-robson-classification
#18
Reem Zeki, Jeremy J N Oats, Alex Y Wang, Zhuoyang Li, Caroline S E Homer, Elizabeth A Sullivan
AIM: The aim of this study was to identify the main contributors to cesarean section (CS) among women with and without diabetes during pregnancy using the Robson classification and to compare CS rates within Robson groups. METHODS: A population-based cohort study was conducted of all women who gave birth in New South Wales, Australia, between 2002 and 2012. Women with pregestational diabetes (types 1 and 2) and gestational diabetes mellitus (GDM) were grouped using the Robson classification...
February 14, 2018: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29433770/acid-folic-and-pregnancy-a-mandatory-supplementation
#19
Morgane Valentin, Perrine Coste Mazeau, Michel Zerah, Pierre François Ceccaldi, Alexandra Benachi, Dominique Luton
Neural tube defects (NTD) occur in 0.5 to 2 per 1000 pregnancies with various handicaps for the affected child. It is now well established that folic acid deficiency (absolute or relative) is a predisposing factor to this type of malformation. Several randomized controlled trials showed that high-dose folic acid (4mg) is an essential factor for prevention of neural tube defects recurrence and significantly prevents the first occurrence of neural tube defects with a lower dose (0.4mg). Other etiologies can favor the occurrence of NTD such as MTHFR polymorphism, some antiepileptic therapies, obesity and pregestational mellitus diabetes...
April 2018: Annales D'endocrinologie
https://www.readbyqxmd.com/read/29408586/a-prospective-cohort-study-of-fetal-heart-rate-monitoring-deceleration-area-is-predictive-of-fetal-acidemia
#20
Alison G Cahill, Methodius G Tuuli, Molly J Stout, Julia D López, George A Macones
BACKGROUND: Intrapartum electronic fetal monitoring is the most commonly used tool in obstetrics in the United States; however, which electronic fetal monitoring patterns predict acidemia remains unclear. OBJECTIVE: This study was designed to describe the frequency of patterns seen in labor using modern nomenclature, and to test the hypothesis that visually interpreted patterns are associated with acidemia and morbidities in term infants. We further identified patterns prior to delivery, alone or in combination, predictive of acidemia and neonatal morbidity...
May 2018: American Journal of Obstetrics and Gynecology
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