Altered maternal metabolism during mild gestational hyperglycemia as a predictor of adverse perinatal outcomes: A comprehensive analysis

Rudge, Marilza Vieira Cunha; Barbosa, Angélica Mércia Pascon; Sobrevía, Luis; Gelaleti, Rafael Bottaro; Hallur, Raghavendra Lakshmana Shetty; Marcondes, João Paulo de Castro; Salvadori, Daisy Maria Fávero; Prudêncio, Caroline Baldini; Magalhães, Cláudia Garcia; Costa, Roberto Antônio de Araújo; Abbade, Joélcio Francisco; Corrente, José Eduardo; Calderon, Iracema de Mattos Paranhos

doi:10.1016/j.bbadis.2019.05.014

Cited by 14 publications

(19 citation statements)

References 49 publications

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“…The GP test was performed over a one-day hospital stay with the women on a 2840 kcal diet, fractionated in five meals. Plasma glucose measurement was taken every two hours, from 8 AM to 6 PM [ 14 ]. Immediately after the diagnosis, both MGH and GDM, as well as T2DM pregnant women previously identified, were cared for by a multiprofessional team and underwent maternal glucose control, according to the ADA's recommendation.…”

Section: Methodsmentioning

confidence: 99%

“…Oral hypoglycemic drugs are not recommended by the Brazilian Health Surveillance Agency (ANVISA) to be used in pregnancy, so they are not prescribed in our center. The maternal glucose control was monitored every 1 or 2 weeks by GP test, performed with an individual-specific diet [ 14 , 15 ].…”

Section: Methodsmentioning

confidence: 99%

“…GM, a marker of maternal glycemic control, was defined as the arithmetic mean of glucose level measurements taken on the day before SFH assessment in six samples obtained from subjects treated with insulin and in 10 samples from subjects not receiving insulin. Glycemic control was classified as adequate (GM < 120 mg/dL) or inadequate (GM ≥ 120 mg/dL) [ 14 ].…”

Section: Methodsmentioning

confidence: 99%

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Symphysis-Fundal Height Curve in Pregnancies Complicated by Maternal Hyperglycemia: Comparison with Curves of Nondiabetic Pregnant Women

Basso

Costa

Dias

et al. 2020

BioMed Research International

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Background. Reference symphysis-fundal height (SFH) curves for pregnancies complicated by maternal hyperglycemia are not available. Objective. To build an SFH curve according to gestational age for pregnant women with hyperglycemia-type 2 diabetes (T2DM), gestational diabetes mellitus (GDM), or mild gestational hyperglycemia (MGH) and compare it with three other curves in use in Brazil. Methods. Prospective cohort study of 422 pregnant women with hyperglycemia attending the Perinatal Diabetes Research Center (PDRC) of Botucatu Medical School, São Paulo State University/UNESP. Between 13 and 41 weeks of pregnancy, 2470 SFH measurements were obtained (mean 5.85 per woman). For the assessment of glycemic control, 2074 glucose level measurements were taken and the glycemic mean (GM) at each gestational week was estimated. Results. GM was adequate (<120 mg/dL) in 94.9% and inadequate (≥120 mg/dL) in 5.1% of the cases. The equation applied for SFH prediction was expressed as SFH=1.082+0.966∗week (r2=84.6%). At visual analysis, P10 and P90 SFH measurements were higher in the study curve than in the three other curves. Statistical analysis confirmed that SFH median values in this study were higher than those in the reference curve of habitual risk pregnancies, especially after 19 weeks of pregnancy. Conclusion. Taking into account that the maternal hyperglycemia was at strict control, our unedited results suggest that the current SFH curve can be a useful tool in prenatal care of T2DM, GDM, and MGH pregnant women.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Symphysis-Fundal Height Curve in Pregnancies Complicated by Maternal Hyperglycemia: Comparison with Curves of Nondiabetic Pregnant Women

Basso

Costa

Dias

et al. 2020

BioMed Research International

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“…The diagnostic protocol for GDM is a 75-g oral glucose tolerance test (OGTT) ( Table 1) combined with the glycemic profile in use at PDRC-UNESP-Brazil since 1984 [46] for pregnant women without confirmed GDM or overt diabetes in their first trimester of pregnancy. All hyperglycemic pregnant women will be classified as GDM.…”

Section: Gdm Diagnosismentioning

confidence: 99%

“…All hyperglycemic pregnant women will undergo the same treatment, including adequate nutritional advice from nutritionists, encouragement to exercise regularly, and insulin associated with dietary advice if necessary [46].…”

Section: Prenatal Management Of Patients With Gdmmentioning

confidence: 99%

Study protocol to investigate biomolecular muscle profile as predictors of long-term urinary incontinence in women with gestational diabetes mellitus

Rudge¹,

Abbade²,

Hallur³

et al. 2020

BMC Pregnancy Childbirth

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Background: Pelvic floor muscles (PFM) and rectus abdominis muscles (RAM) of pregnant diabetic rats exhibit atrophy, co-localization of fast and slow fibers and an increased collagen type I/III ratio. However, the role of similar PFM or RAM hyperglycemic-related myopathy in women with gestational diabetes mellitus (GDM) remains poorly investigated. This study aims to assess the frequency of pelvic floor muscle disorders and pregnancy-specific urinary incontinence (PS-UI) 12 months after the Cesarean (C) section in women with GDM. Specifically, differences in PFM/ RAM hyperglycemic myopathy will be evaluated. Methods: The Diamater is an ongoing cohort study of four groups of 59 pregnant women each from the Perinatal Diabetes Research Centre (PDRC), Botucatu Medical School (FMB)-UNESP (São Paulo State University), Brazil. Diagnosis of GDM and PS-UI will be made at 24-26 weeks, with a follow-up at 34-38 weeks of gestation. Inclusion in the study will occur at the time of C-section, and patients will be followed at 24-48 h, 6 weeks and 6 and 12 months postpartum. Study groups will be classified as (1) GDM plus PS-UI; (2) GDM without PS-UI; (3) Non-GDM plus PS-UI; and (4) Non-GDM without PS-UI. We will analyze relationships between GDM, PS-UI and hyperglycemic myopathy at 12 months after C-section. The mediator variables to be evaluated include digital palpation, vaginal squeeze pressure, 3D pelvic floor ultrasound, and 3D RAM ultrasound. RAM samples obtained during C-section will be analyzed for ex-vivo contractility, morphological, molecular and OMICS profiles to further characterize the hyperglycemic myopathy. Additional variables to be evaluated include maternal age, socioeconomic status, educational level, ethnicity, body mass index, weight gain during pregnancy, quality of glycemic control and insulin therapy. Discussion: To our knowledge, this will be the first study to provide data on the prevalence of PS-UI and RAM and PFM physical and biomolecular muscle profiles after C-section in mothers with GDM. The longitudinal design allows for the assessment of cause-effect relationships between GDM, PS-UI, and PFMs and RAMs myopathy. The findings may reveal previously undetermined consequences of GDM.

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Integration of nutrigenomics, melatonin, serotonin and inflammatory cytokines in the pathophysiology of pregnancy-specific urinary incontinence in women with gestational diabetes mellitus

França

Sobrevía

et al. 2023

Biochimica et Biophysica Acta (BBA) - Molecular Basis of Diseas

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Altered maternal metabolism during mild gestational hyperglycemia as a predictor of adverse perinatal outcomes: A comprehensive analysis

Cited by 14 publications

References 49 publications

Symphysis-Fundal Height Curve in Pregnancies Complicated by Maternal Hyperglycemia: Comparison with Curves of Nondiabetic Pregnant Women

Symphysis-Fundal Height Curve in Pregnancies Complicated by Maternal Hyperglycemia: Comparison with Curves of Nondiabetic Pregnant Women

Study protocol to investigate biomolecular muscle profile as predictors of long-term urinary incontinence in women with gestational diabetes mellitus

Integration of nutrigenomics, melatonin, serotonin and inflammatory cytokines in the pathophysiology of pregnancy-specific urinary incontinence in women with gestational diabetes mellitus

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