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class H Diabetes maternal risks

Lisa Marengo, Noha H Farag, Mark Canfield
Texas ranks 12th nationally in the proportion of adult residents who are obese; approximately 67 % of Texans are overweight or obese. Studies indicate that obesity is related to an increased risk for birth defects; however, small sample sizes have limited the scope of birth defects investigated, and only four levels of body mass index (BMI) are typically explored. Using six BMI levels, we evaluated the association between maternal BMI and birth defects in a population-based registry covering ~1.6 million births...
December 2013: Maternal and Child Health Journal
Matthew B Stenerson, Christopher A Collura, Carl H Rose, Aida N Lteif, William A Carey
Diabetic ketoacidosis (DKA) during pregnancy carries significant risk of intrauterine fetal demise, but little is known about its postnatal sequelae in surviving neonates. We report here the case of an infant who was born to a mother with White's class C diabetes mellitus during an episode of DKA. Throughout pregnancy her glucose control was suboptimal, as evidenced by a predelivery glycosylated hemoglobin level of 8.1%. At 33 weeks' gestation, the mother presented with nausea and vomiting, a serum glucose concentration of 575 mg/dL, and other metabolic derangements consistent with DKA...
September 2011: Pediatrics
J G Ouzounian, G D Hernandez, L M Korst, M M Montoro, L R Battista, C L Walden, R H Lee
OBJECTIVE: To determine whether women with gestational diabetes mellitus (GDM) whose weight gain exceeded the 2009 Institute of Medicine (IOM) recommendations were more likely to have macrosomia. STUDY DESIGN: Retrospective cohort study of the association of weight gain in women with Class A1 GDM, with term (≥37 weeks) singleton liveborns and macrosomia (birthweight ≥4000 g). Multivariate logistic regression models were used to adjust for covariates and test for interactions...
November 2011: Journal of Perinatology: Official Journal of the California Perinatal Association
Sargoor R Veena, Andrew K Wills, David J Fisher, Claudia E Stein, Kalyanaraman Kumaran, Ghattu V Krishnaveni, Krishnarajasagara N Kiran, Patsy J Coakley, Caroline H D Fall
BACKGROUND: Studies since the early 1990s have shown that birth size can be a predictor of the development of Type 2 diabetes mellitus (T2DM). In the present study, we evaluated changes in the strength of associations between T2DM and birth size and maternal weight with age. METHODS: In 1993-1994 (t₀), 509 men and women (mean age 46 years) who had been born in Holdsworth Memorial Hospital were screened for diabetes, with increased diabetes risk identified in those who were shorter at birth and those born to heavier mothers...
September 2009: Journal of Diabetes
Mark Christopher Alanis, William H Goodnight, Elizabeth G Hill, Christopher J Robinson, Margaret S Villers, Donna D Johnson
OBJECTIVE: To determine if pregnancy complications are increased in super-obese (a body mass index (BMI) of 50 or more) compared to other, less obese parturients. DESIGN: Cross-sectional study. SETTING AND POPULATION: All 19,700 eligible women, including 425 (2.2%) super-obese women with singleton births between 1996 and 2007 delivering at a tertiary referral center, identified using a perinatal research database. METHODS: Bivariate and trend analyses were used to assess the relation between super-obesity and various pregnancy complications compared to other well-established BMI categories...
July 2010: Acta Obstetricia et Gynecologica Scandinavica
Lm Silva, M Coolman, Eap Steegers, Vwv Jaddoe, Ha Moll, A Hofman, Jp Mackenbach, H Raat
We examined whether maternal educational level as an indicator of socioeconomic status is associated with gestational hypertension. We also examined the extent to which the effect of education is mediated by maternal substance use (that is smoking, alcohol consumption and illegal drug use), pre-existing diabetes, anthropometrics (that is height and body mass index (BMI)) and blood pressure at enrollment. This was studied in 3262 Dutch pregnant women participating in the Generation R Study, a population-based cohort study...
July 2008: Journal of Human Hypertension
G L Nielsen, C Dethlefsen, M Møller, H T Sørensen
AIMS: To examine the association between maternal glycated haemoglobin in the second half of diabetic pregnancies and the relative risk of delivering large-for-gestational-age (LGA) babies, controlling for maternal body mass index (BMI) before pregnancy, weight gain, age, White class and smoking habits. METHODS: We identified all pregnant diabetic women in North Jutland County, Denmark from 1985 to 2003. Data on HbA(1c) values from the 20th gestational week to term were collected from medical records and the babies were classified as large, normal or small for gestational age...
April 2007: Diabetic Medicine: a Journal of the British Diabetic Association
H Phung, A Bauman, M Tran, L Young, J McDonald, L Michell, K Hillman
OBJECTIVES: To explore the socio-demographic factors and maternal characteristics that influence special care nursery (SCN) admission for infants of more than 34 weeks' gestation. Particularly, this paper aims (i) to estimate the incidence of SCN admission by various mothers' socio-demographic factors; and (ii) to investigate the relationship between SCN admission and mothers' socio-demographic and obstetric and gynaecological factors. METHODS: This was a cohort study of 10,148 pregnant women who accessed the birthing unit within a public district hospital in south-western Sydney in New South Wales, between 1998 and 2001...
March 2005: Journal of Paediatrics and Child Health
E Wender-Ozegowska, K Wróblewska, A Zawiejska, M Pietryga, J Szczapa, R Biczysko
BACKGROUND: The prevention of congenital malformations in the newborns of diabetic mothers still constitutes one of the main problems in this group of patients. AIM: The aim of this study was to analyze the prevalence of fetal malformations in diabetic pregnancies, as well as detection of the cut-off points for the first-trimester glycemia levels, relating to diabetes-induced fetal malformations. METHODS: The data for analysis were collected retrospectively from the case histories of diabetic pregnant women and their newborns, treated in our departments...
January 2005: Acta Obstetricia et Gynecologica Scandinavica
Ute M Schaefer-Graf, Thomas A Buchanan, Anny H Xiang, Ruth K Peters, Siri L Kjos
OBJECTIVE: The purpose of this study was to identify which maternal, antepartum, or neonatal clinical parameters were predictive for a high risk of diabetes mellitus in the puerperium in women with recent gestational diabetes mellitus and to calculate the associated diabetes mellitus rates and odds ratios. STUDY DESIGN: One thousand six hundred thirty-six women underwent an oral glucose tolerance test within 1 to 4 months of delivery. Demographic, historic, and antenatal glycemic parameters and neonatal outcome parameters were tested by univariate and multivariate logistic regression for risk of postpartum diabetes mellitus...
April 2002: American Journal of Obstetrics and Gynecology
K Sadeharju, M Lönnrot, T Kimpimäki, K Savola, S Erkkilä, T Kalliokoski, P Savolainen, P Koskela, J Ilonen, O Simell, M Knip, H Hyöty
AIMS/HYPOTHESIS: We evaluated the role of enterovirus infections in the pathogenesis of Type I (insulin-dependent) diabetes mellitus by monitoring enterovirus antibody levels in prediabetic children who turned positive for diabetes-associated autoantibodies in a prospective birth cohort study. METHODS: Serial serum samples taken during prospective observation starting at birth were analysed for IgG and IgA class antibodies against enterovirus antigens including purified coxsackievirus B4, echovirus 11, poliovirus 1 and a synthetic enterovirus peptide antigen using enzyme immunoassay...
July 2001: Diabetologia
A M Hämäläinen, M S Ronkainen, H K Akerblom, M Knip
The elimination of maternally acquired, diabetes-associated antibodies from the peripheral circulation of infants was studied in a population of 47 mothers and their newborn infants from families in which at least 1 first degree relative had type 1 diabetes. Blood samples were taken from the placental cord; from the infant at follow-up visits at the ages of 3, 6, 9, 12, 18, and 24 months; and from the mother at the time of delivery. The samples were analyzed for cytoplasmic islet cell antibodies (ICA), insulin antibodies (IA), autoantibodies to the 65-kDa isoform of glutamic acid decarboxylase (GADA), and autoantibodies to the protein tyrosine phosphatase-related IA-2 antigen (IA-2A)...
November 2000: Journal of Clinical Endocrinology and Metabolism
S C Blackwell, S S Hassan, H W Wolfe, J Michaelson, S M Berry, Y Sorokin
AIMS: The purpose of this study was to examine factors relevant to mode of delivery in term pregnancies complicated by gestational and pre-gestational diabetes. METHODS: A retrospective chart review of term (> or = 37 weeks) singleton pregnancies complicated by Class A2 through Class R pregnancies which delivered from 1991-1997 was performed. Exclusion criteria were prior cesarean delivery, non-vertex presentation, fetal structural defects, or any contraindications to vaginal delivery...
2000: Journal of Perinatal Medicine
L Cordero, S H Treuer, M B Landon, S G Gabbe
OBJECTIVE: To describe the clinical outcome of infants born to mothers with gestational diabetes mellitus (GDM) and preexisting insulin-dependent diabetes mellitus (IDDM). SETTING: A tertiary care regional perinatal center with a specialized diabetes-in-pregnancy program. DESIGN: Case series. RESULTS: Five hundred thirty infants were born to 332 women with GDM and 177 women with IDDM. Thirty-six percent of these 530 newborns were large for gestational age, 62% were appropriate for gestational age, and only 2% were small for gestational age...
March 1998: Archives of Pediatrics & Adolescent Medicine
T D Dye, K L Knox, R Artal, R H Aubry, M A Wojtowycz
Gestational diabetes mellitus (GDM) is the most common medical complication of pregnancy. Women with GDM are at elevated for numerous maternal health complications, and their infants are at elevated risk for death and morbidity. Management of GDM has traditionally been through diet and close monitoring of glucose levels, with initiation of insulin therapy when diet alone fails to maintain euglycemia. Recently, however, it has been suggested that alternative treatment modalities, such as exercise, may overcome a peripheral resistance to insulin, thus preventing GDM or controlling hyperglycemia in women with GDM...
December 1, 1997: American Journal of Epidemiology
A Aberg, H Rydhström, B Källén, K Källén
OBJECTIVES: To analyze whether women with a diagnosis of gestational diabetes in the current pregnancy had an increased rate of stillbirths or of large for gestational age infants in previous pregnancies without an overtly present/diagnosed gestational diabetes. DESIGN: A case-control analysis with two controls for each case, matched for year of delivery, maternal age (5 year class), and parity. MATERIAL AND METHODS: All women with a diagnosis of gestational diabetes and delivered between 1987 and 1992 were identified from the Swedish Medical Birth Registry...
March 1997: Acta Obstetricia et Gynecologica Scandinavica
J A Noble, A M Valdes, M Cook, W Klitz, G Thomson, H A Erlich
We report here our analysis of HLA class II alleles in 180 Caucasian nuclear families with at least two children with insulin-dependent diabetes mellitus (IDDM). DRB1, DQA1, DQB1, and DPB1 genotypes were determined with PCR/sequence-specific oligonucleotide probe typing methods. The data allowed unambiguous determination of four-locus haplotypes in all but three of the families. Consistent with other studies, our data indicate an increase in DR3/DR4, DR3/DR3, and DR4/DR4 genotypes in patients compared to controls...
November 1996: American Journal of Human Genetics
M C Gordon, M B Landon, J Boyle, K S Stewart, S G Gabbe
Coronary heart disease and myocardial infarction are uncommon complications during pregnancy. Women with insulin-dependent diabetes mellitus (IDDM) have a much greater risk of serious coronary heart disease, but few cases of myocardial infarctions occurring during pregnancy have been reported. Significant maternal morbidity has been reported in half of these cases. This is a case of a myocardial infarction occurring at 21 weeks of gestation in a patient with class R/F IDDM and the subsequent pregnancy management as well as a review of the literature concerning Class H IDDM in pregnancy...
July 1996: Obstetrical & Gynecological Survey
S L Kjos, O A Henry, M Montoro, T A Buchanan, J H Mestman
OBJECTIVE: Our purpose was to assess whether a program of expectant management of uncomplicated pregnancies in mothers with insulin-requiring gestational or pregestational class B reduces the incidence of cesarean birth. STUDY DESIGN: Two hundred women with uncomplicated, insulin-requiring diabetes at 38 weeks' gestation who were compliant with care and whose infants were judged appropriate for gestational age were randomly assigned to (1) active induction of labor within 5 days or (2) expectant management...
September 1993: American Journal of Obstetrics and Gynecology
J L Peacock, J M Bland, H R Anderson
OBJECTIVE: To examine the relation between preterm birth and socioeconomic and psychological factors, smoking, and alcohol, and caffeine consumption. DESIGN: Prospective study of outcome of pregnancy. SETTING: District general hospital in inner London. PARTICIPANTS: 1860 consecutive white women booking for delivery; 1513 women studied after exclusion because of multiple pregnancy and diabetes, refusals, and loss to follow up...
August 26, 1995: BMJ: British Medical Journal
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