Metabolic disorder of pregnancy (understanding pathophysiology of diabetes and preeclampsia)

Salzer, Liat; Tenenbaum-Gavish, Kinneret; Hod, Moshe

doi:10.1016/j.bpobgyn.2014.09.008

Cited by 55 publications

(46 citation statements)

References 95 publications

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“…To maintain stable blood glucose levels, β cells in the pancreas subsequently increase the production of insulin, which results in hyperinsulinemia [69]. Evidence suggests that insulin resistance contribute to sodium retention and vasoconstriction in the pathogenesis of hypertensive disorders during pregnancy [70][71][72][73]. A better understanding of the association between these conditions may lead to implement more effective strategies on mutual risk factors during prenatal care.…”

Section: Discussionmentioning

confidence: 99%

Effects of gestational diabetes mellitus on risk of adverse maternal outcomes: a prospective cohort study in Northwest Ethiopia

Muche

Olayemi

Gete

2020

BMC Pregnancy Childbirth

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Background: Gestational diabetes mellitus is a leading medical condition woman encounter during pregnancy with serious short-and long-term consequences for maternal morbidity. However, limited evidence was available on potential impacts of gestational diabetes mellitus using updated international diagnostic criteria on adverse maternal outcomes. Therefore, this study aimed to assess the effects of gestational diabetes mellitus on the risk of adverse maternal outcomes in Northwest Ethiopia. Methods: A prospective cohort study was conducted among pregnant women followed from pregnancy to delivery. Gestational diabetes mellitus status was determined by using a two-hour 75 g oral glucose tolerance test and based on updated international diagnostic criteria. Multivariable log-binomial model was used to examine the effects of gestational diabetes mellitus on the risk of adverse maternal outcomes. Results: A total of 694 women completed the follow-up and included in the analysis. Women with gestational diabetes mellitus had a higher risk of composite adverse maternal outcome (ARR=1.58, 95% CI: 1.22, 2.04), caesarean delivery (ARR=1.67; 95%: 1.15, 2.44), pregnancy induced hypertension (ARR= 3.32; 95%: 1.55, 7.11), premature rupture of membranes (ARR= 1.83; 95%: 1.02, 3.27), antepartum hemorrhage (ARR= 2.10; 95%: 1.11, 3.98) and postpartum hemorrhage (ARR= 4.85; 95%:2.28, 10.30) compared to women without gestational diabetes mellitus. Conclusions: Gestational diabetes mellitus increased the risk of adverse maternal outcomes. This implies that maternal care and intervention strategies relating to women with gestational diabetes mellitus should be strengthened.

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Section: Discussionmentioning

confidence: 99%

Effects of gestational diabetes mellitus on risk of adverse maternal outcomes: a prospective cohort study in Northwest Ethiopia

Muche

Olayemi

Gete

2020

BMC Pregnancy Childbirth

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“…Besides the finding that women having their first baby with a family history of pre-eclampsia increases two-to five-fold the risk of developing PE, the genetic predisposition to pre-eclampsia has been studied to various degrees, with genetic factors possibly playing a role in increased sFlt-1 production and placental size, imprinted genes possibly involved in the maternal contribution to develop preeclampsia and a number of genetic disorders being associated with pre-eclampsia (trisomy 13, angiotensinogen gene variant T235, eNOS, genes causing thrombophilia, and a number of SNPs) despite little significance [105]. pre-eclampsia is an extremely complex spectrum disorder with gene clusters falling into four categories, those involved in (i) hormone secretion, response to hypoxia, and response to nutrient levels; (ii) immune and inflammatory responses (including cytokine/interferon signalling); (iii) metabolism, cell proliferation and cell cycle as well as stress response and DNA damage; (iv) hormone secretion and ion channel activity, and nervous system development or neurological system processes [106].…”

Section: Genetic and Epigenetic Influences 61 Geneticsmentioning

confidence: 99%

Biochemical Dysregulation of Pre-Eclampsia and Gestational Diabetes Mellitus

Portelli¹,

Baron²

2019

Prediction of Maternal and Fetal Syndrome of Preeclampsia

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Emerging evidence indicates that among the various pregnancy complications, pre-eclampsia and gestational diabetes mellitus (GDM) seem to have, at least in part, shared underlying ethiologies. Apart from sharing numerous risk factors, it has been shown that the rate of pre-eclampsia is influenced by the presence and severity of GDM, with hyperglycemia due to insulin resistance and the biochemical changes this brings about (angiogenic imbalance, oxidative stress and inflammation), playing some role in the pathogenesis of endothelial dysfunction leading to the development of pre-eclampsia. However, so far the biochemical mechanisms underlying and linking these two conditions is still not properly understood. The altered physiological parameters, dysregulation of potential protein biomarkers and DNA-related changes (mutations, methylations, miRNAs) will be combined in this review to explore possible underlying mechanisms.

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“…La resistencia a la insulina está implicada en la patogénesis de la enfermedad cardiaca isquémica, diabetes mellitus ti po 2 e hipertensión esencial, las que si concurren con obesidad, se les denomina síndrome metabólico. El embarazo normalmente se relaciona con resistencia a la insulina progresiva desde el segundo trimestre, pareciéndose en el tercer trimestre a la resistencia a la insulina de la diabetes mellitus ti po 2 (DM2) (24) . En el Perú, la diabetes mellitus afecta a 7% de la población y el ti po 2 es responsable de 96,8% de las visitas de pacientes ambulatorios con DM.…”

Section: Relación De La Obesidad Con Otras Enfermedadesunclassified

Gestación en la mujer obesa: consideraciones especiales

Romero

2017

An Fac med

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Resumen La obesidad sería el problema de salud más común en las mujeres en edad reproductiva. Los embarazos complicados con obesidad se relacionan con diabetes gestacional, preeclampsia, parto pretérmino, partos instrumentados y cesáreas, así como infecciones y hemorragia en el posparto. Y el bebe tiene mayor riesgo de malformaciones congénitas, ser grande/macrosómico, complicarse con distocia de hombros y muerte fetal. Las implicancias relacionadas al manejo de la obesidad en el embarazo no son muy conocidas por la falta de opciones de manejo basadas en la evidencia. El manejo de la obesidad debería empezar desde antes del embarazo, siguiendo el precepto de que una mujer debe estar en las mejores condiciones físicas y mentales si desea gestar. El profesional de la salud encargado del control prenatal necesita del apoyo de un nutricionista y/o endocrinólogo. Se debe tener en cuenta que las mujeres obesas pueden tener más dificultades en el parto, por lo que requieren de infraestructura y manejo especiales, por médicos especializados. En esta revisión se considera los problemas de salud relacionados en la madre y el hijo. Palabras clave. Obesidad; Gestación; Morbilidad Materna; Morbilidad Perinatal. Abstract Obesity would be the most common health problem for women of reproductive age. Pregnancies complicated with obesity are associated with gestational diabetes, preeclampsia, preterm birth, instrumental delivery and cesarean section, infections and postpartum hemorrhage. And the baby is at higher risk of congenital malformations, macrosomia, shoulder dystocia, and fetal death. The implications related to the management of obesity in pregnancy are not well understood due to lack of evidence-based management options. The management of obesity should start before the woman gets pregnant, following the rule that a woman should be in the best physical and mental conditions if she wants to have a baby. The health provider in charge of the prenatal care needs the support of a dietitian or an endocrinologist. Obese women are more likely to have difficulties during labor and delivery and require both special infrastructure and care by specialized physicians. Future health problems of mother and baby are considered in this review.

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Metabolic disorder of pregnancy (understanding pathophysiology of diabetes and preeclampsia)

Cited by 55 publications

References 95 publications

Effects of gestational diabetes mellitus on risk of adverse maternal outcomes: a prospective cohort study in Northwest Ethiopia

Effects of gestational diabetes mellitus on risk of adverse maternal outcomes: a prospective cohort study in Northwest Ethiopia

Biochemical Dysregulation of Pre-Eclampsia and Gestational Diabetes Mellitus

Gestación en la mujer obesa: consideraciones especiales

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