Hyperglycemia in Pregnancy and Women’s Health in the 21st Century

McIntyre, H. David; Fuglsang, Jens; Kampmann, Ulla; Knorr, Sine; Ovesen, Per

doi:10.3390/ijerph192416827

Cited by 10 publications

(6 citation statements)

References 128 publications

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“…Besides, higher OGTT 0 hour and OGTT 2 hours were found to be significant predictors of SGA when the glucose values were analysed as continuous variables. This may contribute to within the mild elevation range of blood glucose levels; blood glucose passes through the placental circulation to the fetus and extra glucose in the fetus is stored as body fat 43. There may be a protective mechanism ensuring that the fetus receives adequate nutrients within the normal range.…”

Section: Discussionmentioning

confidence: 99%

“…This may contribute to within the mild elevation range of blood glucose levels; blood glucose passes through the placental circulation to the fetus and extra glucose in the fetus is stored as body fat. 43 There may be a protective mechanism ensuring that the fetus receives adequate nutrients within the normal range. However, this does not imply that higher blood glucose levels are better.…”

Section: Discussionmentioning

confidence: 99%

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Risk factors and glycaemic control in small-for-gestational-age infants born to mothers with gestational diabetes mellitus: a case–control study using propensity score matching based on a large population

Li,

Pan,

Zheng

et al. 2024

BMJ Open

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BackgroundSmall for gestational age (SGA) poses a significant concern for newborns, being linked to neonatal complications and potential metabolic disorders in adulthood, especially when born to mothers with gestational diabetes mellitus (GDM), elevating their risk of complications and mortality. However, the pregnancy risk factors and glycaemic control associated with SGA infants born to mothers with GDM remain unclear.AimTo identify the pregnancy risk factors and glycaemic control associated with SGA infants born to mothers with GDM.MethodThis case–control study was conducted among 1910 women with GDM in China. Data were collected by the integrated electronic medical record system. Using 1:4 propensity score matching analysis, we adjusted for gestational age as confounder. Univariate and multivariate analyses were performed to identify risk factors.ResultsRisk factors for SGA born to mothers with GDM included a history of low birth weight, gestational hypertension, oligohydramnios, short maternal height, underweight pre-pregnancy body mass index and inadequate weight growth. While SGA was protected by weakly positive ketonuria levels in the first trimester, multiparous, anaemia and previous uterine scar were protective factors for SGA. Moreover, 2-hour postprandial glucose and haemoglobin A1c in the second trimester, as well as the 0-hour and 2-hour 75 g oral glucose tolerance test (OGTT) were linked to risk of SGA.ConclusionsSGA infants are the result of multifactorial interactions among GDM pregnant women. Notably, glycaemic control levels were associated with SGA. There is a need for enhanced perinatal monitoring and antenatal care to reduce SGA.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk factors and glycaemic control in small-for-gestational-age infants born to mothers with gestational diabetes mellitus: a case–control study using propensity score matching based on a large population

Li,

Pan,

Zheng

et al. 2024

BMJ Open

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“…This necessitates intensive medical therapy and often requires adjusted insulin administration to prevent threatening hyperglycemia for the fetus. In reaction to the stress of coexisting illnesses or drugs taken for the treatment of obstetrical issues, the elevated insulin resistance may also cause ketoacidosis [70].…”

Section: Evaluation During Preconceptionmentioning

confidence: 99%

Current Trends in Diagnosis and Treatment Approach of Diabetic Retinopathy during Pregnancy: A Narrative Review

Rosu,

Prodan-Bărbulescu,

Maghiari

et al. 2024

Diagnostics

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Diabetes mellitus during pregnancy and gestational diabetes are major concerns worldwide. These conditions may lead to the development of severe diabetic retinopathy during pregnancy or worsen pre-existing cases. Gestational diabetes also increases the risk of diabetes for both the mother and the fetus in the future. Understanding the prevalence, evaluating risk factors contributing to pathogenesis, and identifying treatment challenges related to diabetic retinopathy in expectant mothers are all of utmost importance. Pregnancy-related physiological changes, including those in metabolism, blood flow, immunity, and hormones, can contribute to the development or worsening of diabetic retinopathy. If left untreated, this condition may eventually result in irreversible vision loss. Treatment options such as laser therapy, intravitreal anti-vascular endothelial growth factor drugs, and intravitreal steroids pose challenges in managing these patients without endangering the developing baby and mother. This narrative review describes the management of diabetic retinopathy during pregnancy, highlights its risk factors, pathophysiology, and diagnostic methods, and offers recommendations based on findings from previous literature.

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“…2 HIP is associated with a significantly increased risk of adverse perinatal outcomes, including preeclampsia, birth injuries, increased caesarean section rates, and an increased incidence of type 2 diabetes mellitus in offspring. [3][4][5] The International Society for the Study of Hypertension in Pregnancy (ISSHP) defines PE as new onset hypertension and proteinuria after 20 weeks of gestation or with other end-organ damage, that affects 2-8% of pregnancies worldwide, and can lead to preterm delivery, fetal growth restriction, maternal convulsions, damage to vital organs such as the heart, liver and kidneys and in severe cases, maternal and fetal death. [6][7][8] It has been shown that HIP is associated with an increased risk of PE.…”

Section: Introductionmentioning

confidence: 99%

A Prediction Model of Preeclampsia in Hyperglycemia Pregnancy

Fang,

Liu,

et al. 2024

DMSO

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To investigate the risk factors associated with preeclampsia in hyperglycemic pregnancies and develop a predictive model based on routine pregnancy care. Patients and Methods:The retrospective collection of clinical data was performed on 951 pregnant women with hyperglycemia, including those diagnosed with diabetes in pregnancy (DIP) and gestational diabetes mellitus (GDM), who delivered after 34 weeks of gestation at the Maternal and Child Health Hospital Affiliated to Anhui Medical University between January 2017 and December 2019. Observation indicators included liver and kidney function factors testing at 24-29 +6 weeks gestation, maternal age, and basal blood pressure. The indicators were screened univariately, and the "rms" package in R language was applied to explore the factors associated with PE in HIP pregnancy by stepwise regression. Multivariable logistic regression analysis was used to develop the prediction model. Based on the above results, a nomogram was constructed to predict the risk of PE occurrence in pregnant women with HIP. Then, the model was evaluated from three aspects: discrimination, calibration, and clinical utility. The internal validation was performed using the bootstrap procedure. Results: Multivariate logistic regression analysis showed that cystatin C, uric acid, glutamyl aminotransferase, blood urea nitrogen, and basal systolic blood pressure as predictors of PE in pregnancy with HIP. The predictive model yielded an area under curve (AUC) value of 0.8031 (95% CI: 0.7383-0.8679), with an optimal threshold of 0.0805, at which point the sensitivity was 0.8307 and specificity of 0.6604. Hosmer-Lemeshow test values were P = 0.3736, Brier score value was 0.0461. After 1000 Bootstrap resamplings for internal validation, the AUC was 0.7886, the Brier score was 0.0478 and the predicted probability of the calibration curve was similar to the actual probability. A nomogram was constructed based on the above to visualize the model. Conclusion:This study developed a model for predicting PE in pregnant women with HIP, achieving high predictive performance of PE risk through the information of routine pregnancy care.

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Hyperglycemia in Pregnancy and Women’s Health in the 21st Century

Cited by 10 publications

References 128 publications

Risk factors and glycaemic control in small-for-gestational-age infants born to mothers with gestational diabetes mellitus: a case–control study using propensity score matching based on a large population

Risk factors and glycaemic control in small-for-gestational-age infants born to mothers with gestational diabetes mellitus: a case–control study using propensity score matching based on a large population

Current Trends in Diagnosis and Treatment Approach of Diabetic Retinopathy during Pregnancy: A Narrative Review

A Prediction Model of Preeclampsia in Hyperglycemia Pregnancy

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