Outcome of diabetic pregnancy and glucose intolerance in pregnancy: an audit of fetal loss in Newcastle General Hospital 1977–1990

Hawthorne, Gillian; Snodgrass, Averil; Tunbridge, Michael

doi:10.1016/0168-8227(94)90007-8

Cited by 18 publications

(15 citation statements)

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“…The review of existing data on the determinants of perinatal outcome in diabetic pregnancies concluded that metabolic control during gestation is more important than duration of diabetes [25]. Maternal mortality of diabetic pregnancies followed the same pattern as perinatal mortality [20,21,24,26].…”

Section: Discussionmentioning

confidence: 93%

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Incidence trends in childhood onset IDDM in four countries around the Baltic sea during 1983-1992

Padaiga

Tuomilehto²,

Karvonen³

et al. 1997

Diabetologia

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Incidence of childhood insulin-dependent diabetes mellitus (IDDM) is rising in many areas of the world [1,2]. Despite the role of HLA genetics in the aetiology of IDDM being well known [3,4] the role of putative environmental factors is not yet understood [5][6][7]. Epidemiologically based standardized surveillance systems provide information on the pattern of IDDM incidence which make comparison of IDDM incidence between countries within close geographical areas possible, thus offering an "indirect" way to trace potential environmental factors in the aetiology of IDDM. A collaborative study on the childhood IDDM incidence in countries around the Baltic Sea was started in 1989 named "DIABALT". Short-term data have demonstrated a wide variation in the incidence of IDDM between countries around the Baltic Sea [8,9], from the highest incidence in the world in Finland to one of the lowest within Europe in Poland. In order to obtain more standardized rates for comparison of secular trends in incidence of IDDM in Finland, Estonia, Latvia and Lithuania the analyses of the data were carried out for the period 1983 to 1992. Subjects and methodsGeographically the Baltic States of Estonia, Latvia and Lithuania are located on the south-east coast, while Finland is on the northern coast of the Baltic Sea. Genetically and culturally, the population of Finland is homogeneous [10], while Estonia Diabetologia (1997) 40: 187-192 Incidence trends in childhood onset IDDM in four countries around the Baltic sea during 1983-1992 Summary We present secular trends of childhood onset insulin-dependent diabetes mellitus (IDDM) in Finland, Estonia, Latvia and Lithuania during the period of [1983][1984][1985][1986][1987][1988][1989][1990][1991][1992]. Incidence data were obtained from the national IDDM registries. The average agestandardized incidence per 100 000/year was 35.0 in Finland, followed by 10.2 in Estonia, 7.1 in Lithuania and 6.5 in Latvia. A male excess in incidence was recorded in Finland (1.15) and Latvia (1.01). In all countries, the highest age-specific risk of IDDM was observed in the 11-13 year age range. The large difference in incidence between Finland and other Baltic countries was seen even in 1-2-year-old children. During the 10-year study period overall changes in incidence of IDDM were relatively small in these four countries. The incidence increased in Finland and Lithuania on average by 1 % and 1.4 % per year, respectively. A statistically significant increase was recorded only in 0-4 year old children in Finland, at 5.6 % per year. In Estonia, an 8.3 % increase in this age group, however, was not statistically significant. The different trends in the age-group specific incidence rates were confirmed in Finland. In conclusion, from 1983 to 1992 the incidence of childhood onset IDDM was increasing in Finland and Lithuania, while in Latvia and Estonia it was stable. There are still great differences in IDDM incidence between the countries around the

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Section: Discussionmentioning

confidence: 93%

“…In Finland and in many other industrialized countries, perinatal mortality rates for diabetic pregnancies have decreased since the 1970 s and now they are approaching those of the general population [20,21]. Results from the Joslin Diabetes Center, Boston, Mass., USA show that perinatal mortality of diabetic pregnancies was 23 % before 1961.…”

Section: Discussionmentioning

confidence: 99%

Incidence trends in childhood onset IDDM in four countries around the Baltic sea during 1983-1992

Padaiga

Tuomilehto²,

Karvonen³

et al. 1997

Diabetologia

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“…Gupta et al 1996 Twenty percent of babies born through meconium-stained amniotic fluid (MSAF) suffered severe birth anoxia (lack of oxygen) compared to 5.6% in the non-MSAF group (India). Hawthorne et al 1994 The perinatal mortality (PNM) in women with gestational glucose intolerance was 49.2 of 1,000 compared to a PNM in the background population of 11.6 of 1,000. The fetal malformation rate was 17.3% for established diabetes, 9.8% in gestational glucose intolerance, and 2.2% in the background population (Britain).…”

Section: Costs Of the Puerperiummentioning

confidence: 99%

The Functions of Postpartum Depression

Hagen

1999

Evolution and Human Behavior

217

137

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Evolutionary approaches to parental care suggest that parents will not automatically invest in all offspring, and they should reduce or eliminate investment in their children if the costs outweigh the benefits. Lack of paternal or social support will increase the costs born by mothers, whereas infant health problems will reduce the evolutionary benefits to be gained. Numerous studies support the correlation between postpartum depression (PPD) and lack of social support or indicators of possible infant health and development problems. PPD may be an adaptation that informs mothers that they are suffering or have suffered a fitness cost, which motivates them to reduce or eliminate investment in offspring under certain circumstances, and that may help them negotiate greater levels of investment from others. PPD also appears to be a good model for depression in general.

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“…Diabetic pregnancy is associated with increased risk of growth disturbances and congenital malformations (Mills 1982, Becerra et al 1990, Hawthorne et al 1994, Penney et al 2003. Despite intensified insulin therapy, the risk of embryopathy in infants of diabetic mothers is higher than in offspring of non-diabetic pregnancy (Mills 1982, Becerra et al 1990, Hawthorne et al 1994, Penney et al 2003).…”

Section: Introductionmentioning

confidence: 99%

“…Despite intensified insulin therapy, the risk of embryopathy in infants of diabetic mothers is higher than in offspring of non-diabetic pregnancy (Mills 1982, Becerra et al 1990, Hawthorne et al 1994, Penney et al 2003). …”

Section: Introductionmentioning

confidence: 99%

N-Acetylcysteine and α-cyano-4-hydroxycinnamic acid alter protein kinase C (PKC)-δ and PKC-ζ and diminish dysmorphogenesis in rat embryos cultured with high glucose in vitro

Gäreskog

Wentzel

2007

Journal of Endocrinology

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Malformations and growth disturbances are two-to threefold more common in infants of diabetic mothers than in offspring of non-diabetic pregnancy. Several suggestions have emerged to explain the reasons for diabetic embryopathy, including enhanced mitochondrial production of reactive oxygen species leading to altered activation of protein kinase C. This study aimed to evaluate the effect of a-cyano-4-hydroxycinnamic acid (CHC) and N-acetylcysteine (NAC) addition on morphology and activity of protein kinase C-d and protein kinase C-z in rat embryos exposed to a high glucose concentration in vitro. Day 9 embryos from normal rats were cultured in 10 or 30 mM glucose concentrations with or without supplementation of CHC, NAC, or protein kinase C inhibitors specific for protein kinase C-d and protein kinase C-z. Embryos were evaluated for malformations, crown rump length, and somite number. Protein kinase C-d and protein kinase C-z activities were estimated by western blot by separating membranous and cytosolic fractions of the embryo. We found increased malformations and growth retardation in embryos cultured in high versus low glucose concentrations. These abnormalities were diminished when CHC and NAC or specific protein kinase C-inhibitors were added to the culture medium. The activities of embryonic protein kinase C-d and protein kinase C-z were increased in the high glucose environment after 24-h culture, but were normalized by the addition of CHC and NAC as well as respective inhibitor to the culture medium. These findings suggest that mitochondrial overproduction of reactive oxygen species is involved in diabetic embryopathy. Furthermore, such overproduction may affect embryonic development, at least partly, by enhancing the activities of protein kinase C-d and protein kinase C-z.

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Outcome of diabetic pregnancy and glucose intolerance in pregnancy: an audit of fetal loss in Newcastle General Hospital 1977–1990

Cited by 18 publications

References 18 publications

Incidence trends in childhood onset IDDM in four countries around the Baltic sea during 1983-1992

Incidence trends in childhood onset IDDM in four countries around the Baltic sea during 1983-1992

The Functions of Postpartum Depression

N-Acetylcysteine and α-cyano-4-hydroxycinnamic acid alter protein kinase C (PKC)-δ and PKC-ζ and diminish dysmorphogenesis in rat embryos cultured with high glucose in vitro

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