Pregnancy outcomes and maternal characteristics in women with pregestational and gestational diabetes: a retrospective study on 206,917 singleton live births

Gualdani, Elisa; Cianni, Graziano Di; Seghieri, Marta; Francesconi, Paolo; Seghieri, Giuseppe

doi:10.1007/s00592-021-01710-0

Cited by 18 publications

(23 citation statements)

References 31 publications

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“… 11–13 It is also responsible for prolonging labor, increasing the risk of obstructed labor and cesarean delivery, 14 and has notable effects on the fetus. 12 , 15 , 16 Recent animal experiments have shown that lean and obese animals are typically less fertile, but not necessarily in humans. 17 Few high-quality studies have explored the nonlinear relationship between body mass index and infertility.…”

Section: Introductionmentioning

confidence: 99%

Association Between Body Mass Index and Female Infertility in the United States: Data from National Health and Nutrition Examination Survey 2013–2018

Zhu¹,

Zhou²,

Zhu³

et al. 2022

IJGM

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Purpose This study aimed to investigate the effects of body mass index (BMI) on infertility in women of childbearing age. Patients and Methods We performed a cross-sectional study using data from 3624 participants from the National Health and Nutrition Examination Survey (NHANES). We used BMI and fertility status in the survey as independent and dependent variables, respectively. We evaluated their relationship and used smoothed curve fitting and multivariate logistic regression analysis as well as a generalized additive model (GAM) to determine the effect of BMI. Results Logistic regression model analysis linked BMI and infertility after adjusting for potential confounders OR 1.03, 95%Cl: 1.02–1.05). There was a non-linear relationship between BMI and infertility, with each unit increase in BMI reducing the risk of infertility by 33% when BMI was <19.5 kg/m 2 . In contrast, when BMI ≥19.5 kg/m 2 , each unit increase in BMI predicted a 3% increase in the risk of infertility. Conclusion The relationship between infertility and BMI presented a U-shaped curve. Therefore, a BMI that lay at the extremes of the spectrum tended to predict infertility. We believe that this study will support the maintenance of suitable BMI levels in women preparing for pregnancy.

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Section: Introductionmentioning

confidence: 99%

Association Between Body Mass Index and Female Infertility in the United States: Data from National Health and Nutrition Examination Survey 2013–2018

Zhu¹,

Zhou²,

Zhu³

et al. 2022

IJGM

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“…Epidemiological studies have reported that GDM affects ~15.5-19.9% of all pregnant women in China ( 2 , 3 ). GDM is associated with several adverse events, including stillbirth, fetal macrosomia and development of type 2 DM later in life ( 4-6 ). The activation of inflammation in placenta and adipose tissue plays key roles in IR during the pathogenesis of GDM ( 7 , 8 ).…”

Section: Introductionmentioning

confidence: 99%

NLRP3 inflammasome activation in gestational diabetes mellitus placentas is associated with hydrogen sulfide synthetase deficiency

Tan

et al. 2021

Exp Ther Med

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The placenta may play a key role in the activation of inflammation and initiation of insulin resistance (IR) during gestational diabetes mellitus (GDM) pathogenesis. Interleukin (IL)-1β and IL-18, regulated by NLR family pyrin domain containing-3 (NLRP3) inflammasome, are important inflammatory cytokines in the initiation of maternal IR during GDM. However, the mechanism responsible for the regulatory of NLRP3 inflammasome in placenta remains unknown. Hydrogen sulfide (H 2 S) exerts anti-inflammatory function partially via suppressing the activation of the NLPR3 inflammasome. The present study aimed to investigate the role of NLRP3 inflammasome, H 2 S synthetase cystathionine-γ-lyase (CSE) and cystathionine-β-synthetase (CBS) in placenta in the pathogenesis of GDM. Clinical placenta samples were collected from pregnant women with GDM (n=16) and healthy pregnant women at term (n=16). Western blot analysis was performed to detect the protein expression levels of NLRP3, cleaved caspase-1, CBS and CSE in the placenta samples. Pearson's correlation analysis was performed to assess the correlation between NLRP3 inflammasome and H 2 S synthetase. Human placental cells were cultured and treated with different concentrations of NaHS (0, 10, 25 and 50 nmol/l) or L-cysteine (0, 0.25, 0.50 and 1.00 mmol/l). In addition, western blot analysis was performed to detect the protein expression levels of NLRP3 and cleaved caspase-1, while ELISA was performed to measure the production of IL-1β and IL-18 in the culture media. The results demonstrated that the expression levels of NLRP3 and cleaved caspase-1 increased, while the expression levels of CBS and CSE decreased in the placenta samples. In addition, the expression levels of NLRP3 and cleaved caspase-1 were inversely correlated with the expression levels of CBS and CSE. Notably, NaHS and L-cysteine significantly suppressed the expression levels of NLRP3 and cleaved caspase-1, and the production of IL-1 and IL-18 in human placental cells. Taken together, the results of the present study suggest that H 2 S synthetase deficiency in placenta may contribute to excessive activation of NLRP3 inflammasome in GDM.

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“…The study in Dublin showed aprevalence of pre-gestational diabetes of 20% and 18% in two time periods (1999–2003 and 2004–2008, respectively) among pregnant women with diabetes [ 34 ], almost identical to our results. Another regional study from Tuscany, Italy, showed arelatively high attribution of GDM to DM in pregnancy of 95.7% [ 35 ]. The study that included the data on more than 1.5 million live births in Sweden between 1998 and 2012 showed that the percentage of GDM among diabetes in pregnancy was just under 75% and that the prevalence of T2DM was 16.6% [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Maternal and Fetal Outcomes among Pregnant Women with Diabetes

Gojnić

Todorović

Stanisavljević

et al. 2022

IJERPH

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The aim of this study was to examine the differences in pregnancy complications, delivery characteristics, and neonatal outcomes between women with type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), and gestational diabetes mellitus (GDM). This study included all pregnant women with diabetes in pregnancy in Belgrade, Serbia, between 2010 and 2020. The total sample consisted of 6737 patients. In total, 1318 (19.6%) patients had T1DM, 138 (2.0%) had T2DM, and 5281 patients (78.4%) had GDM. Multivariate logistic regression with the type of diabetes as an outcome variable showed that patients with T1DM had a lower likelihood of vaginal delivery (OR: 0.73, 95% CI: 0.64–0.83), gestational hypertension (OR: 0.47, 95% CI: 0.36–0.62), higher likelihood of chronic hypertension (OR: 1.88, 95% CI: 1.55–2.29),and a higher likelihood ofgestational age at delivery before 37 weeks (OR: 1.38, 95% CI: 1.18–1.63) compared to women with GDM. Multivariate logistic regression showed that patients with T2DM had a lower likelihood ofgestational hypertension compared to women with GDM (OR: 0.37, 95% CI: 0.15–0.92).Our results indicate that the highest percentage of diabetes in pregnancy is GDM, and the existence of differences in pregnancy complications, childbirth characteristics, and neonatal outcomes are predominantly between women with GDM and women with T1DM.

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Pregnancy outcomes and maternal characteristics in women with pregestational and gestational diabetes: a retrospective study on 206,917 singleton live births

Cited by 18 publications

References 31 publications

Association Between Body Mass Index and Female Infertility in the United States: Data from National Health and Nutrition Examination Survey 2013–2018

Association Between Body Mass Index and Female Infertility in the United States: Data from National Health and Nutrition Examination Survey 2013–2018

NLRP3 inflammasome activation in gestational diabetes mellitus placentas is associated with hydrogen sulfide synthetase deficiency

Maternal and Fetal Outcomes among Pregnant Women with Diabetes

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