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Tsokkou S, Konstantinidis I, Georgaki MN, Kavvadas D, Papadopoulou K, Keramas A, Sioga A, Papamitsou T, Karachrysafi S. Gestational Diabetes Mellitus and Its Correlation in the Development of Pancreatic Cancer: A 10-Year Systematic Review. Cancers (Basel) 2024; 16:1840. [PMID: 38791917 PMCID: PMC11119090 DOI: 10.3390/cancers16101840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
PURPOSE Pancreatic cancer (PC) is a fatal malignancy with an aggressive course derived from the cells of pancreatic tissue. Gestational diabetes mellitus (GDM) is a state of spontaneous hyperglycemia occurring during gestation and has been suggested as a risk factor PC. Women with a history of GDM revealed a risk rate of 7.1% for the development of PC. The current systematic review aims to investigate the correlation between GDM and the degree to the prevalence of PC. METHODOLOGY For this systematic review, the PICO model was prepared to construct and outline the exact questions of the study, a PRISMA flow diagram was prepared and quality assessment was conducted using the Newcastle Ottawa Scale (NOS) for Cohort Studies, the NIH Quality Assessment Tool-Criteria for Case Reports and the Cochrane quality assessment tool for Systematic Reviews and Meta-analysis studies. RESULT A total of eight articles were retrieved from the main databases, and a table was created to summarize the information found. Even though the data found were limited, the quality assessment performed revealed that the articles were of high validity. CONCLUSIONS It can be concluded that GDM has an association with the development of PC and can be considered as a risk factor.
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Affiliation(s)
- Sophia Tsokkou
- Research Team “Histologistas”, Interinstitutional Postgraduate Program “Health and Environmental Factors”, Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (S.T.); (I.K.); (M.-N.G.); (D.K.); (K.P.); (A.K.); (A.S.); (T.P.)
- Laboratory of Histology-Embryology, Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Ioannis Konstantinidis
- Research Team “Histologistas”, Interinstitutional Postgraduate Program “Health and Environmental Factors”, Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (S.T.); (I.K.); (M.-N.G.); (D.K.); (K.P.); (A.K.); (A.S.); (T.P.)
| | - Maria-Nefeli Georgaki
- Research Team “Histologistas”, Interinstitutional Postgraduate Program “Health and Environmental Factors”, Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (S.T.); (I.K.); (M.-N.G.); (D.K.); (K.P.); (A.K.); (A.S.); (T.P.)
- Environmental Engineering Laboratory, Department of Chemical Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Dimitrios Kavvadas
- Research Team “Histologistas”, Interinstitutional Postgraduate Program “Health and Environmental Factors”, Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (S.T.); (I.K.); (M.-N.G.); (D.K.); (K.P.); (A.K.); (A.S.); (T.P.)
- Laboratory of Histology-Embryology, Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Kyriaki Papadopoulou
- Research Team “Histologistas”, Interinstitutional Postgraduate Program “Health and Environmental Factors”, Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (S.T.); (I.K.); (M.-N.G.); (D.K.); (K.P.); (A.K.); (A.S.); (T.P.)
- Laboratory of Histology-Embryology, Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Antonios Keramas
- Research Team “Histologistas”, Interinstitutional Postgraduate Program “Health and Environmental Factors”, Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (S.T.); (I.K.); (M.-N.G.); (D.K.); (K.P.); (A.K.); (A.S.); (T.P.)
- Laboratory of Histology-Embryology, Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Antonia Sioga
- Research Team “Histologistas”, Interinstitutional Postgraduate Program “Health and Environmental Factors”, Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (S.T.); (I.K.); (M.-N.G.); (D.K.); (K.P.); (A.K.); (A.S.); (T.P.)
- Laboratory of Histology-Embryology, Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Theodora Papamitsou
- Research Team “Histologistas”, Interinstitutional Postgraduate Program “Health and Environmental Factors”, Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (S.T.); (I.K.); (M.-N.G.); (D.K.); (K.P.); (A.K.); (A.S.); (T.P.)
- Laboratory of Histology-Embryology, Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Sofia Karachrysafi
- Research Team “Histologistas”, Interinstitutional Postgraduate Program “Health and Environmental Factors”, Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (S.T.); (I.K.); (M.-N.G.); (D.K.); (K.P.); (A.K.); (A.S.); (T.P.)
- Laboratory of Histology-Embryology, Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
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Taieb A, Majdoub M, Souissi N, Chelly S, Ben Abdelkrim A. Determination of the Contributing Factors and HbA1c Cutoff Leading to Glucose Tolerance Abnormalities Following Gestational Diabetes. Cureus 2024; 16:e56218. [PMID: 38618305 PMCID: PMC11016321 DOI: 10.7759/cureus.56218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2024] [Indexed: 04/16/2024] Open
Abstract
The prevalence of gestational diabetes mellitus (GDM) has been steadily increasing over the past years. It is a major risk factor for glucose intolerance and type 2 DM (T2DM). The American Diabetes Association recommends that women whose pregnancy was complicated by GDM be screened for persistent glucose abnormalities at six to 12 weeks postpartum with either a fasting plasma glucose test alone or with a fasting 75-g, two-hour oral glucose tolerance test. This study aimed to identify the main predictive factors of glucose tolerance disorders in early postpartum women with a recent history of GDM. In this retrospective descriptive study, we identified 400 women who met the eligibility criteria for the study. The mean age was 34.54 ± 5.51 years. A total of 70% had a family history of DM, 16% had a personal history of GDM, and 23% had fetal macrosomia in previous pregnancies. The overall incidence of postpartum carbohydrate tolerance disorders was 36.4%, including 12% prediabetes and 24.4% DM. The prevalence of prediabetes and T2DM after delivery was higher with older maternal age, multigravidity, a higher BMI, a history of GDM, and fetal macrosomia in previous pregnancies. Furthermore, the persistence of this impaired glucose tolerance in postpartum was associated with a higher term of diagnosis, a higher glycated hemoglobin (HbA1c) percentage (the discriminant cutoff value with the best sensitivity/specificity ratio was 5.25%), the use of insulin therapy, cesarean section delivery, and fetal macrosomia. After adjusting for confounders, only prior GDM, a higher HbA1c level, macrosomia, and gestational term were found to significantly affect postpartum glucose tolerance. Although postpartum screening for T2DM is recommended for all women with GDM, a significant number of patients fail it. A better knowledge of predictive factors for this outcome is therefore needed for a more effective and targeted medical intervention.
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Affiliation(s)
- Ach Taieb
- Endocrinology, Hospital University of Farhat Hached Sousse Tunisia, Sousse, TUN
| | - Marwa Majdoub
- Endocrinology, Hospital University of Farhat Hached Sousse Tunisia, Sousse, TUN
| | - Nesrine Souissi
- Nutrition, Hospital University of Farhat Hached Sousse Tunisia, Sousse, TUN
| | - Souhir Chelly
- Infectious Control and Prevention, Hospital University of Farhat Hached Sousse Tunisia, Sousse, TUN
| | - Asma Ben Abdelkrim
- Endocrinology, Hospital University of Farhat Hached Sousse Tunisia, Sousse, TUN
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Li R, Wang Y, Yang L, Zhong P, Huang G, Liang Q, Yu X. Genetic variants of ERBB4 gene and risk of gestational diabetes mellitus: a susceptibility and diagnostic nomogram study. Front Endocrinol (Lausanne) 2023; 14:1283539. [PMID: 38149095 PMCID: PMC10749950 DOI: 10.3389/fendo.2023.1283539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 11/15/2023] [Indexed: 12/28/2023] Open
Abstract
Introduction Gestational diabetes (GDM) is one of the common complications of female pregnancy, which seriously affects the health of mothers and their offspring. So far, the etiology has not been fully clarified. Methods A case-control study was conducted to clarify the relationship between Erb-b2 receptor tyrosine kinase 4 (ERBB4) functional tag genetic variants (rs1595064, rs1595065, rs1595066 and rs6719645) and the risk of GDM. Associations between variants and GDM risk were evaluated with the odds ratios (ORs) and their corresponding 95% confidence intervals (CIs). Subsequently, the false-positive reporting probability (FPRP), multi-factor dimension reduction (MDR) and bioinformatics analysis were adopted to confirm the significant associations. A nomogram model was constructed to predict the risk of GDM. Results Association analysis demonstrated that rs1595066 TT genotype performed a protective effect on GDM risk among all subjects (TT vs. CC: adjusted OR = 0.60, 95% CI = 0.38 - 0.94, P = 0.026; TT vs. CC/CT: adjusted OR = 0.61, 95% CI = 0.40 - 0.95, P = 0.027). Meanwhile, stratified analysis showed that rs1595066 TT can also reduce the GDM risk in age > 30.09 years old, pre-pregnancy BMI > 22.23 Kg/m2, SBP ≤ 110.08 mmHg, etc subgroups. Interactions between rs1595066 and DBP (P interaction = 0.01), FPG (P interaction < 0.001) and HbA1c (P interaction < 0.001) were detected. The FPRP analysis confirmed that association between rs1595066 and GDM risk in subjects of FPG < 4.79 mmol/L (P = 0.199) is true. The MDR analysis showed that rs1595066 was the best single locus model while the 4-loci model was the best multiple factors model to predict GDM risk. Functional prediction revealed that rs1595066 may disturb the stability of miRNA-mRNA binding. The predictive nomogram model has a well consistence and acceptable discriminative ability with a diagnosed AUC of 0.813. Discussion ERBB4 variants can change an individual's susceptibility to GDM via the interaction of gene-gene, gene-environment and changes in the regulatory effects of miRNAs on ERBB4 expression.
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Affiliation(s)
- Ruiqi Li
- The Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Health, Guilin Medical University, Guilin, China
| | - Yukun Wang
- Scientific Experiment Center, Guilin Medical University, Guilin, China
| | - Lin Yang
- The Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Health, Guilin Medical University, Guilin, China
| | - Ping Zhong
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Gongchen Huang
- The Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Health, Guilin Medical University, Guilin, China
| | - Qiulian Liang
- The Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Health, Guilin Medical University, Guilin, China
| | - Xiangyuan Yu
- The Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Health, Guilin Medical University, Guilin, China
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Chan YN, Wang P, Chun KH, Lum JTS, Wang H, Zhang Y, Leung KSY. A machine learning approach for early prediction of gestational diabetes mellitus using elemental contents in fingernails. Sci Rep 2023; 13:4184. [PMID: 36918683 PMCID: PMC10015050 DOI: 10.1038/s41598-023-31270-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 03/09/2023] [Indexed: 03/16/2023] Open
Abstract
The aim of this pilot study was to predict the risk of gestational diabetes mellitus (GDM) by the elemental content in fingernails and urine with machine learning analysis. Sixty seven pregnant women (34 control and 33 GDM patient) were included. Fingernails and urine were collected in the first and second trimesters, respectively. The concentrations of elements were determined by inductively coupled plasma-mass spectrometry. Logistic regression model was applied to estimate the adjusted odd ratios and 95% confidence intervals. The predictive performances of multiple machine learning algorithms were evaluated, and an ensemble model was built to predict the risk for GDM based on the elemental contents in the fingernails. Beryllium, selenium, tin and copper were positively associated with the risk of GDM while nickel and mercury showed opposite result. The trained ensemble model showed larger area under curve (AUC) of receiver operating characteristic curve (0.81) using fingernail Ni, Cu and Se concentrations. The model was validated by external data set with AUC = 0.71. In summary, the results of the present study highlight the potential of fingernails, as an alternative sample, together with machine learning in human biomonitoring studies.
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Affiliation(s)
- Yun-Nam Chan
- Department of Chemistry, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR
| | - Pengpeng Wang
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, 200032, China
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), Shanghai, China
| | - Ka-Him Chun
- Department of Chemistry, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR
| | - Judy Tsz-Shan Lum
- Department of Chemistry, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR
| | - Hang Wang
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, 200032, China
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), Shanghai, China
| | - Yunhui Zhang
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, 200032, China
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), Shanghai, China
| | - Kelvin Sze-Yin Leung
- Department of Chemistry, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR.
- HKBU Institute of Research and Continuing Education, Shenzhen Virtual University Park, Shenzhen, China.
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Lin B, Zhang X. Vitamin E Supplement Protects Against Gestational Diabetes Mellitus in Mice Through nuclear factor-erythroid factor 2-related factor 2/heme oxygenase-1 Signaling Pathway. Diabetes Metab Syndr Obes 2023; 16:565-574. [PMID: 36883138 PMCID: PMC9985888 DOI: 10.2147/dmso.s397255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 02/14/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is the most common pregnant disorder worldwide. In this study, we aimed to explore whether vitamin E (VE) treatment alone could protect against GDM in a mouse model. METHODS 6-week-old C57BL/6J female mice were fed on high-fat diet for two weeks and continued with high-fat diet after pregnancy to induce GDM. The pregnant mice were orally administrated with 2.5, 25 or 250 mg/kg VE twice per day during pregnancy together with high-fat diet. Oral glucose tolerance test, insulin amounts, oxidative stress and inflammation were then measured. RESULTS Only 250 mg/kg VE could improve glucose tolerance and insulin level in pregnant mice. VE (250 mg/kg) effectively inhibited GDM-induced hyperlipidemia, and secretion of inflammatory cytokines such as tumor necrosis factor-α and interleukin-6. VE also significantly ameliorated maternal oxidative stress at the late stage of pregnancy, and also improved reproductive outcomes, including increasing the litter size and birth weight in GDM mice. Moreover, VE also activated GDM-reduced nuclear factor-erythroid factor 2-related factor 2 (Nrf2) / heme oxygenase-1 signaling pathway in the maternal liver tissues of GDM mice. CONCLUSION Our data clearly demonstrated that 250 mg/kg VE twice a day during pregnancy could significantly ameliorate the symptoms of GDM by alleviating oxidative stress, inflammation, hyperglycemia, and hyperlipidemia through Nrf2/HO-1 signaling pathway in GDM mice. Thus, additional VE supplement might be beneficial to GDM.
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Affiliation(s)
- Bozhu Lin
- Gynaecology and Obstetrics Department, Longyan People’s Hospital, Longyan, People’s Republic of China
| | - Xiaorong Zhang
- Neonatal Department, Longyan People’s Hospital, Longyan, People’s Republic of China
- Correspondence: Xiaorong Zhang, Neonatal Department, Longyan People’s Hospital, No. 31, Denggaoxi Road, Xinluo District, Longyan, 364000, People’s Republic of China, Tel +86-13605936060, Email
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Leonco L, Kallel H, Nacher M, Thelusme L, Dueymes M, Mhiri R, Lalanne-Mistrih ML, Sabbah N. Does Universal Screening for Gestational Diabetes Mellitus Improve Neonatal Outcomes in a Socially Vulnerable Population: A Prospective Study in French Guiana. Front Endocrinol (Lausanne) 2021; 12:644770. [PMID: 34093431 PMCID: PMC8176854 DOI: 10.3389/fendo.2021.644770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 04/27/2021] [Indexed: 12/15/2022] Open
Abstract
AIMS/INTRODUCTION French Guiana has a high prevalence of metabolic diseases, which are risk factors for gestational diabetes mellitus. Despite routine screening for gestational diabetes, treatment is still challenging because of health inequalities and different cultural representations of disease and pregnancy. This study was conducted to assess the role of early and universal GDM screening on obstetrical and neonatal complications in a socially deprived population. MATERIALS AND METHODS A prospective study was conducted, in the level III maternity in French Guiana. Of 2136 deliveries, 223 had gestational diabetes mellitus, 110 of whom were followed-up for 6 month to detail their social and laboratory parameters. RESULTS The prevalence of gestational diabetes in French Guiana (Cayenne Hospital) was estimated at 10.3%. The study population was very precarious with 70% of patients on welfare (universal health coverage or state medical assistance). The following obstetrical complications were observed: cesarean delivery (32%), history of miscarriage (26%) and preeclampsia (7.4%). Nevertheless, neonatal complications were rarely present and included hypoglycemia (2.8%) and macrosomia (2.8%). CONCLUSION In French Guiana, gestational diabetes mellitus is very common. However, in a context of widespread poverty and diverse cultural representations, universal screening and monitoring limited the risk of macrosomia.
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Affiliation(s)
- Loic Leonco
- Department of Endocrinology and Metabolic Diseases, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - Hatem Kallel
- Department of Intensive Care, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - Mathieu Nacher
- Clinical Investigation Center, West Indies, French Guiana (INSERM CIC 14 24), Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - Liliane Thelusme
- Department of Endocrinology and Metabolic Diseases, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - Maryvonne Dueymes
- Department of Biology, Immunology and Parasitology, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - Raoudha Mhiri
- Department of Gynecology and Obstetrics, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - Marie Laure Lalanne-Mistrih
- Department of Nutrition (UTDN-CSO), Centre Hospitalier Universitaire de Guadeloupe, Pointe à Pitre, Guadeloupe, France
| | - Nadia Sabbah
- Department of Endocrinology and Metabolic Diseases, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
- Clinical Investigation Center, West Indies, French Guiana (INSERM CIC 14 24), Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
- EA3593, Amazon Ecosystems and Tropical Diseases, Université de Guyane, Cayenne, French Guiana, France
- *Correspondence: Nadia Sabbah,
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Dong X, Yang L. Inhibition of fatty acid binding protein 4 attenuates gestational diabetes mellitus. Prostaglandins Leukot Essent Fatty Acids 2020; 161:102179. [PMID: 32977290 DOI: 10.1016/j.plefa.2020.102179] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 08/13/2020] [Accepted: 09/09/2020] [Indexed: 02/06/2023]
Abstract
Accumulatig evidence demonstrated that inflammation is associated with the development of gestational diabetes mellitus (GDM). Fatty acid-binding protein 4 (FABP4) was reported to be involved in immune response. However, the effect of FABP4 in GDM remians unclear. This study focused on the effect of FABP4 in GDM. C57BL/KsJdb/+ (db/+) mice were used for GDM mouse model . BMS-309403 (BMS) was used to inhibit FABP4 levels in GDM mouse model. IL-6 and TNF-α concentrations in serum were determined via ELISA. Serum glucose and insulin concentrations were tested using commercial glucometer and mouse insulin ELISA kit, respectively. IL-6 and TNF-α mRNA and protein levels were detected using RT-PCR and western blot, respectively. FABP4 levels were upregulated in GDM group compared with control group and were positively associated with serum IL-6 and TNF-α levels. FABP4 inhibition by BMS significantly decreased body weight and serum glucose concentrations, increasd serum insulin concentration, suppressed IL-6 and TNF-α expression both in the serum and the pancreas, enhanced little size and inhibited birth weight in GDM mouse model. Inhibition of FABP4 attenuates GDM in genetic mice.
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Affiliation(s)
- Xiujuan Dong
- Department of Second Obstetrics, Cangzhou Central Hospital, No. 16 Xinhua West Road, Cangzhou 061000, Hebei, China.
| | - Long Yang
- Department of Brain Emergency, Cangzhou Central Hospital, No. 16 Xinhua West Road, Cangzhou 061000, Hebei, China
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Risk of small for gestational age is reduced after frozen compared with fresh embryo transfer in endometriosis. Reprod Biomed Online 2020; 42:133-141. [PMID: 33077356 DOI: 10.1016/j.rbmo.2020.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 07/24/2020] [Accepted: 08/12/2020] [Indexed: 01/01/2023]
Abstract
RESEARCH QUESTION What are the perinatal outcomes and especially the risk of small for gestational age (SGA) babies born after frozen versus fresh embryo transfer in mothers affected by endometriosis undergoing treatment with assisted reproductive technology (ART)? DESIGN A cohort study conducted between November 2012 and October 2017, in which infertile women with endometriosis undergoing ART and achieving singleton pregnancies that lasted beyond 12 weeks of gestation were included. Pregnancies obtained after a frozen embryo transfer (FET) were compared with those obtained after a fresh embryo transfer. A total of 339 pregnant women were included: 112 patients in the fresh embryo transfer group and 227 in the FET group. The main outcome was the rate of SGA. Secondary analyses were performed for adverse pregnancy outcomes and perinatal complications. RESULTS Of the included women, 109/112 (97.3%) and 222/227 (97.8%) delivered a live child after at least 24 weeks of gestation in the fresh and in the frozen embryo transfer groups, respectively (P = 0.53). The risk of SGA decreased after a FET compared with a fresh embryo transfer (odds ratio [OR] 0.49 [0.25-0.98], P = 0.04) after multivariable analysis. The mean birthweight and the gestational age at delivery were not significantly different between the two study groups. Other pregnancy and perinatal complications were not statistically different between the two study populations. CONCLUSIONS The present study of endometriosis-affected women found a significantly lower risk of SGA in patients undergoing frozen, mainly blastocyst, embryo transfer compared with patients undergoing fresh, mainly cleavage stage, embryo transfer.
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Jin H. Increased levels of glycosylated hemoglobin, microalbuminuria and serum cystatin C predict adverse outcomes in high-risk pregnancies with gestational diabetes mellitus. Exp Ther Med 2020; 19:1281-1287. [PMID: 32010300 PMCID: PMC6966206 DOI: 10.3892/etm.2019.8336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 04/05/2019] [Indexed: 11/06/2022] Open
Abstract
In the present study, the predictive value of glycosylated hemoglobin (HbA1c), microalbuminuria (24 h mAlb) and serum cystatin C (Cys-C) levels on the outcome of pregnancy in patients with gestational diabetes mellitus (GDM) was investigated. Samples of 144 females with GDM and 117 normal pregnant females as controls were selected for retrospective analysis. The following parameters were compared between the two groups: Levels of HbA1c, Cys-C and 24 h mAlb, maternal pregnancy outcome and adverse pregnancy rate. The predictive value of elevated 24 h mAlb, HbA1c and Cys-C regarding an adverse pregnancy outcome was then determined. Cys-C, 24 h mAlb and HbA1c levels in the GDM group were significantly higher than those in the control group (P<0.001). The adverse pregnancy rate in the GDM group was significantly higher than that in the control group (40.97 vs. 16.24%; P<0.001). Logistic regression and receiver operating characteristics (ROC) analyses indicated that, in subjects with GDM, HbA1c, Cys-C and 24 h mAlb levels were closely associated with adverse pregnancy outcomes (P<0.050) and may be considered as predictors for an adverse pregnancy outcome (risk ratio >1). Linear correlation analyses indicated that HbA1c, Cys-C and 24 h mAlb were negatively correlated with the neonatal Apgar scores (r=-0.509, -0.954 and -0.954, respectively; P<0.001). According to ROC analysis, the combined predictive sensitivity of HbAlc, Cys-C and 24 h mAlb for adverse pregnancy outcome in patients with GDM was 96.49% and the specificity was 77.19%. The increase in HbAlc, Cys-C and 24 h mAlb levels is expected to be an effective predictor of adverse pregnancy outcomes in high-risk pregnant women.
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Affiliation(s)
- Hongmei Jin
- Department of Obstetrics, Qingpu Branch, Zhongshan Hospital Affiliated to Fudan University, Shanghai 201700, P.R. China
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Boudet-Berquier J, Salanave B, Desenclos JC, Castetbon K. Sociodemographic factors and pregnancy outcomes associated with prepregnancy obesity: effect modification of parity in the nationwide Epifane birth-cohort. BMC Pregnancy Childbirth 2017; 17:273. [PMID: 28841845 PMCID: PMC5574108 DOI: 10.1186/s12884-017-1456-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 08/17/2017] [Indexed: 01/16/2023] Open
Abstract
Background In light of the adverse outcomes for mothers and offspring related to maternal obesity, identification of subgroups of women at risk of prepregnancy obesity and its related-adverse issues is crucial for optimizing antenatal care. We aimed to identify sociodemographic factors and maternal and neonatal outcomes associated with prepregnancy obesity, and we tested the effect modification of parity on these associations. Methods In 2012, 3368 mothers who had delivered in 136 randomly selected maternity wards were included just after birth in the French birth cohort, Epifane. Maternal height and weight before and at the last month of pregnancy were self-reported. Maternal and neonatal outcomes were collected in medical records. Prepregnancy Body Mass Index (pBMI) was classified into underweight (<18.5), normal (18.5-24.9), overweight (25.0-29.9) and obesity (≥30.0). Since we found statistically significant interactions with parity, the multinomial logistic regression model estimating associations of pBMI class with sociodemographic characteristics and pregnancy outcomes was stratified on parity (1335 primiparous and 1814 multiparous). Results Before pregnancy, 7.6% of women were underweight, 64.2% were of normal weight, 18.0% were overweight and 10.2% were obese. Among the primiparous, maternal age of 25-29 years (OR = 2.09 [1.13-3.87]; vs. 30-34 years), high school level (OR = 2.22 [1.33-3.73]; vs. university level), gestational diabetes (OR = 2.80 [1.56-5.01]) and hypertensive complications (OR = 3.80 [1.83-7.89]) were independently associated with prepregnancy obesity. Among the multiparous, primary (OR = 6.30 [2.40-16.57]), junior high (OR = 2.89 [1.81-4.64]) and high school (OR = 1.86 [1.18-2.93]) education levels (vs. university level), no attendance at antenatal classes (OR = 1.77 [1.16-2.72]), excess gestational weight gain (OR = 1.82 [1.20-2.76]), gestational diabetes (OR =5.16 [3.15-8.46]), hypertensive complications (OR = 8.13 [3.97-16.64]), caesarean delivery (OR = 1.80 [1.18-2.77]) and infant birth weight ≥ 4 kg (OR = 1.70 [1.03-2.80]; vs. birth weight between 2.5 kg and 4 kg) were independently associated with prepregnancy obesity. Conclusion Obesity before pregnancy is associated with a set of sociodemographic characteristics and adverse pregnancy outcomes that differ across parity groups. Such findings are useful for targeted health policies aimed at attaining healthy prepregnancy weight and organizing perinatal care. Electronic supplementary material The online version of this article (doi:10.1186/s12884-017-1456-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Julie Boudet-Berquier
- Nutritional Surveillance and Epidemiology Team (ESEN), French Public Health Agency, Paris-13 University, Centre de Recherche en Epidémiologie et Statistiques, COMUE Sorbonne Paris Cité, SMBH Building, 1st floor, door 136, 74 rue Marcel Cachin, 93017, Bobigny Cedex, France.
| | - Benoit Salanave
- Nutritional Surveillance and Epidemiology Team (ESEN), French Public Health Agency, Paris-13 University, Centre de Recherche en Epidémiologie et Statistiques, COMUE Sorbonne Paris Cité, SMBH Building, 1st floor, door 136, 74 rue Marcel Cachin, 93017, Bobigny Cedex, France
| | - Jean-Claude Desenclos
- French Public Health Agency (Agence nationale de Santé publique), Saint Maurice, France
| | - Katia Castetbon
- Centre de Recherche « Epidémiologie, Biostatistique et Recherche clinique », School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium
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