Diabetes During Pregnancy: Surveillance, Preconception Care, and Postpartum Care

Kim, Shin Y.; Robbins, Cheryl L.

doi:10.1089/jwh.2018.7052

Cited by 16 publications

(9 citation statements)

References 51 publications

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“…Chronic hypertensive disorders, diabetes, and asthma are risk factors for both PTB and LBW, independent of age (Azeez et al, 2019;Berry et al, 2018;Plows, Stanley, Baker, Reynolds, & Vickers, 2018). Recent population-based and multistate studies estimate that the rates of comorbidities like pregestational diabetes, gestational diabetes, hypertensive disorders, obesity, and asthma have increased among all age groups in the United States, and more pregnant women are presenting for delivery with one or multiple comorbidities (Azeez et al, 2019;Bardenheier et al, 2015;Bateman et al, 2012;Deputy, Dub, & Sharma, 2018;Fridman et al, 2014;Kim, Deputy, & Robbins, 2018). These trends suggest that the population of pregnant women may be increasingly less healthy, independent of shifts in maternal age structure (Fridman et al, 2014).…”

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confidence: 99%

Adverse Birth Outcomes Among Women of Advanced Maternal Age With and Without Health Conditions in Maryland

Berger

Wolfson

Reid

et al. 2021

Women's Health Issues

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Background: Advanced maternal age (AMA) has been linked to both higher risk of adverse birth outcomes and higher levels of comorbidities. It is unclear if adverse outcomes are higher for older healthy women. This study examined the association between AMA and adverse birth outcomes among women with and without preexisting and pregnancyrelated health conditions. Methods: Analysis of data for 14,933 singleton births between 2004 and 2015 from the population-based Maryland Pregnancy Risk Assessment Monitoring System was conducted, comparing women aged 20-34 years and 35 years and older. Multivariable logistic regression estimated the difference in odds of preterm birth (PTB) and low birthweight (LBW) by age group among women with and without health conditions. The analysis of women without health conditions was stratified by parity. Results: Among women without health conditions, AMA was associated with higher odds of PTB regardless of birthweight, LBW regardless of term, LBW term births, and LBW PTBs; stratified analysis showed higher risk of these outcomes among both older primiparas and multiparas. Compared with younger women with hypertensive disorders, older women with similar health conditions had higher odds of PTB regardless of birthweight. Older women with asthma had higher odds of LBW term births. Conclusions: AMA is associated with adverse birth outcomes among women with and without health conditions compared with younger women with similar health status. Improved screening and management of health conditions during pregnancy is needed for older women, regardless of parity.

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confidence: 99%

Adverse Birth Outcomes Among Women of Advanced Maternal Age With and Without Health Conditions in Maryland

Berger

Wolfson

Reid

et al. 2021

Women's Health Issues

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“…The primary exposure of “impaired MFE” was defined by the presence of ≥1 of the following: gestational hypertension, preeclampsia, gestational diabetes, and/or maternal smoking during pregnancy. 20 , 21 , 22 This composite variable was defined a priori. The components were not analyzed individually because they were not mutually exclusive and to minimize multiple comparisons.…”

Section: Methodsmentioning

confidence: 99%

Impact of Maternal–Fetal Environment on Mortality in Children With Single Ventricle Heart Disease

Savla

Putt

Huang

et al. 2022

JAHA

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BACKGROUND Children with single ventricle heart disease have significant morbidity and mortality. The maternal–fetal environment (MFE) may adversely impact outcomes after neonatal cardiac surgery. We hypothesized that impaired MFE would be associated with an increased risk of death after stage 1 Norwood reconstruction. METHODS AND RESULTS We performed a retrospective cohort study of children with hypoplastic left heart syndrome (and anatomic variants) who underwent stage 1 Norwood reconstruction between 2008 and 2018. Impaired MFE was defined as maternal gestational hypertension, preeclampsia, gestational diabetes, and/or smoking during pregnancy. Cox proportional hazards regression models were used to investigate the association between impaired MFE and death while adjusting for confounders. Hospital length of stay was assessed with the competing risk of in‐hospital death. In 273 children, the median age at stage 1 Norwood reconstruction was 4 days (interquartile range [IQR], 3–6 days). A total of 72 children (26%) were exposed to an impaired MFE; they had more preterm births (18% versus 7%) and a greater percentage with low birth weights <2.5 kg (18% versus 4%) than those without impaired MFE. Impaired MFE was associated with a higher risk of death (hazard ratio [HR], 6.05; 95% CI, 3.59–10.21; P <0.001) after adjusting for age at surgery, Hispanic ethnicity, genetic syndrome, cardiac diagnosis, surgeon, and birth era. Children with impaired MFE had almost double the risk of prolonged hospital stay (HR, 1.95; 95% CI, 1.41–2.70; P <0.001). CONCLUSIONS Children exposed to an impaired MFE had a higher risk of death following stage 1 Norwood reconstruction. Prenatal exposures are potentially modifiable factors that can be targeted to improve outcomes after pediatric cardiac surgery.

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“…Identifying women at high risk for developing GDM is of clinical relevance. The main risk factors for developing GDM are advanced maternal age, obesity, abnormal weight gain in pregnancy, first-degree relative with T2DM, a history of GDM, macrocosmia (newborn > 4 kg), perinatal complications, and polycystic ovary syndrome [ 5 ]. Although screening women with low GDM risk may not be cost-effective, these women represent a small percentage; thus, identifying and excluding them from screening may add unnecessary complexity to the screening process [ 6 ].…”

Section: Glucose Metabolism Disordersmentioning

confidence: 99%

Screening and management of major endocrinopathies during pregnancy: an update

et al. 2022

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Endocrinopathies during pregnancy constitute a challenging issue, being prevalent and requiring appropriate management to avoid maternal and fetal complications. This review aims to summarize and present major endocrine problems during pregnancy, the appropriate screening, maternal monitoring and management, fetal monitoring, and follow-up. Glucose metabolism, thyroid function, as well as calcium and vitamin D metabolism are the main endocrine domains that should be screened and monitored during pregnancy. Gestational diabetes mellitus (GDM) is the most prevalent endocrine disease during pregnancy, followed by thyroid disorders. Specific recommendations are provided for the optimal clinical care of pregnant women and their offspring for GDM, thyroid disorders, and calcium and vitamin D disorders.

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Diabetes During Pregnancy: Surveillance, Preconception Care, and Postpartum Care

Cited by 16 publications

References 51 publications

Adverse Birth Outcomes Among Women of Advanced Maternal Age With and Without Health Conditions in Maryland

Adverse Birth Outcomes Among Women of Advanced Maternal Age With and Without Health Conditions in Maryland

Impact of Maternal–Fetal Environment on Mortality in Children With Single Ventricle Heart Disease

Screening and management of major endocrinopathies during pregnancy: an update

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