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Francis EC, Powe CE, Lowe WL, White SL, Scholtens DM, Yang J, Zhu Y, Zhang C, Hivert MF, Kwak SH, Sweeting A. Refining the diagnosis of gestational diabetes mellitus: a systematic review and meta-analysis. COMMUNICATIONS MEDICINE 2023; 3:185. [PMID: 38110524 PMCID: PMC10728189 DOI: 10.1038/s43856-023-00393-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/25/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Perinatal outcomes vary for women with gestational diabetes mellitus (GDM). The precise factors beyond glycemic status that may refine GDM diagnosis remain unclear. We conducted a systematic review and meta-analysis of potential precision markers for GDM. METHODS Systematic literature searches were performed in PubMed and EMBASE from inception to March 2022 for studies comparing perinatal outcomes among women with GDM. We searched for precision markers in the following categories: maternal anthropometrics, clinical/sociocultural factors, non-glycemic biochemical markers, genetics/genomics or other -omics, and fetal biometry. We conducted post-hoc meta-analyses of a subset of studies with data on the association of maternal body mass index (BMI, kg/m2) with offspring macrosomia or large-for-gestational age (LGA). RESULTS A total of 5905 titles/abstracts were screened, 775 full-texts reviewed, and 137 studies synthesized. Maternal anthropometrics were the most frequent risk marker. Meta-analysis demonstrated that women with GDM and overweight/obesity vs. GDM with normal range BMI are at higher risk of offspring macrosomia (13 studies [n = 28,763]; odds ratio [OR] 2.65; 95% Confidence Interval [CI] 1.91, 3.68), and LGA (10 studies [n = 20,070]; OR 2.23; 95% CI 2.00, 2.49). Lipids and insulin resistance/secretion indices were the most studied non-glycemic biochemical markers, with increased triglycerides and insulin resistance generally associated with greater risk of offspring macrosomia or LGA. Studies evaluating other markers had inconsistent findings as to whether they could be used as precision markers. CONCLUSIONS Maternal overweight/obesity is associated with greater risk of offspring macrosomia or LGA in women with GDM. Pregnancy insulin resistance or hypertriglyceridemia may be useful in GDM risk stratification. Future studies examining non-glycemic biochemical, genetic, other -omic, or sociocultural precision markers among women with GDM are warranted.
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Affiliation(s)
- Ellen C Francis
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA.
| | - Camille E Powe
- Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
| | - William L Lowe
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sara L White
- Department of Women and Children's Health, King's College London, London, UK
| | - Denise M Scholtens
- Department of Preventive Medicine, Division of Biostatistics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jiaxi Yang
- Global Center for Asian Women's Health (GloW), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Bia-Echo Asia Centre for Reproductive Longevity & Equality (ACRLE), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yeyi Zhu
- Kaiser Permanente Northern California Division of Research, Oakland, CA, USA
| | - Cuilin Zhang
- Global Center for Asian Women's Health (GloW), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Bia-Echo Asia Centre for Reproductive Longevity & Equality (ACRLE), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Marie-France Hivert
- Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
- Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Soo Heon Kwak
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Arianne Sweeting
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
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Rademaker D, van der Wel AWT, van Eekelen R, Voormolen DN, de Valk HW, Evers IM, Mol BW, Franx A, Siegelaar SE, van Rijn BB, DeVries JH, Painter RC. Continuous glucose monitoring metrics and pregnancy outcomes in insulin-treated diabetes: A post-hoc analysis of the GlucoMOMS trial. Diabetes Obes Metab 2023; 25:3798-3806. [PMID: 37735847 DOI: 10.1111/dom.15276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/23/2023] [Accepted: 08/28/2023] [Indexed: 09/23/2023]
Abstract
AIM To investigate the association between continuous glucose monitoring (CGM) metrics and perinatal outcomes in insulin-treated diabetes mellitus in pregnancy. MATERIALS AND METHODS In a post-hoc analysis of the GlucoMOMS randomized controlled trial, we investigated the association between the metrics of an offline, intermittent CGM, glycated haemoglobin (HbA1c) and perinatal outcomes per trimester in different types of diabetes (type 1, 2 or insulin-treated gestational diabetes mellitus [GDM]). Data were analysed using multivariable binary logistic regression. Outcomes of interest were neonatal hypoglycaemia, pre-eclampsia, preterm birth, large for gestational age (LGA) and Neonatal Intensive Care Unit (NICU) admission. The glucose target range was defined as 3.5-7.8 mmol/L (63-140 mg/dL). RESULTS Of the 147 participants (N = 50 type 1 diabetes, N = 94 type 2 diabetes/insulin-treated GDM) randomized to the CGM group of the GlucoMOMS trial, 115 participants had CGM metrics available and were included in the current study. We found that, in pregnancies with type 1 diabetes, a higher second trimester mean glucose was associated with LGA (odds ratio 2.6 [95% confidence interval 1.1-6.2]). In type 2 and insulin-treated gestational diabetes, an increased area under the curve above limit was associated with LGA (odds ratio 10.0 [95% confidence interval 1.4-72.8]). None of the CGM metrics were associated with neonatal hypoglycaemia, pre-eclampsia, shoulder dystocia, preterm birth and NICU admission rates for pregnancies complicated by any type of diabetes. CONCLUSION In this study, in type 2 diabetes or insulin-treated GDM, the glucose increased area under the curve above limit was associated with increased LGA. In type 1 diabetes, the mean glucose was the major determinant of LGA. Our study found no evidence that other CGM metrics determined adverse pregnancy outcomes.
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Affiliation(s)
- Doortje Rademaker
- Amsterdam UMC location University of Amsterdam, Department of Obstetrics and Gynecology, Amsterdam, The Netherlands
- Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands
| | - Anne W T van der Wel
- Amsterdam UMC location University of Amsterdam, Department of Obstetrics and Gynecology, Amsterdam, The Netherlands
| | - Rik van Eekelen
- Amsterdam UMC location University of Amsterdam, Department of Obstetrics and Gynecology, Amsterdam, The Netherlands
| | | | - Harold W de Valk
- Department of Endocrinology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Inge M Evers
- Department of Obstetrics and Gynecology, Amersfoort, The Netherlands
| | - Ben Willem Mol
- Department of Obstetrics and Gynecology, Monash University, Clayton, Victoria, Australia
- Aberdeen Centre for Women's Health Research, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Abderdeen, UK
| | - Arie Franx
- Department of Obstetrics and Gynecology, Erasmus University, Rotterdam, The Netherlands
| | - Sarah E Siegelaar
- Amsterdam UMC location University of Amsterdam, Department of Endocrinology and Metabolism, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam, The Netherlands
| | - Bas B van Rijn
- Department of Obstetrics and Gynecology, Erasmus University, Rotterdam, The Netherlands
| | - J Hans DeVries
- Amsterdam UMC location University of Amsterdam, Department of Endocrinology and Metabolism, Amsterdam, The Netherlands
| | - Rebecca C Painter
- Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Obstetrics and Gynecology, Amsterdam, The Netherlands
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3
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Anouilh F, de Moreuil C, Trémouilhac C, Jacquot M, Salnelle G, Bellec V, Touffet N, Cornec C, Muller M, Dupré PF, Bellot C, Morcel K, Joliff DL, Drugmanne G, Gelebart E, Lucier S, Nowak E, Bihan L, Couturaud F, Tromeur C, Moigne EL, Pan-Petesch B. Family history of postpartum hemorrhage is a risk factor for postpartum hemorrhage after vaginal delivery: results from the French prospective multicenter Haemorrhages and Thromboembolic Venous Disease of the Postpartum cohort study. Am J Obstet Gynecol MFM 2023; 5:101062. [PMID: 37343695 DOI: 10.1016/j.ajogmf.2023.101062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/08/2023] [Accepted: 06/12/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Postpartum hemorrhage is a major component of perinatal morbidity and mortality that affects young women worldwide and is still often unpredictable. Reducing the incidence of postpartum hemorrhage is a major health issue and identifying women at risk for postpartum hemorrhage is a key element in preventing this complication. OBJECTIVE This study aimed to estimate postpartum hemorrhage prevalence after vaginal delivery and to identify postpartum hemorrhage risk factors. STUDY DESIGN Unselected pregnant women ≥16 years of age admitted to 1 of 6 maternity wards in Brittany (France) for vaginal birth after 15 weeks of gestation were recruited in this prospective, multicenter cohort study between June 1, 2015, and January 31, 2019. Postpartum hemorrhage was defined as blood loss ≥500 mL in the 24 hours following delivery. Independent risk factors for postpartum hemorrhage were determined using logistic regression. Missing data were imputed using the Multivariate Imputation by Chained Equations method. RESULTS Among 16,382 included women, the postpartum hemorrhage prevalence was 5.37%. A first-degree family history of postpartum hemorrhage (adjusted odds ratio, 1.63; 95% confidence interval, 1.24-2.14) and a personal transfusion history (adjusted odds ratio, 1.90; 95% confidence interval, 1.23-2.92) were significantly associated with postpartum hemorrhage. The use of oxytocin during labor was also a risk factor for postpartum hemorrhage (adjusted odds ratio, 1.24; 95% confidence interval, 1.06-1.44). Inversely, smoking during pregnancy and intrauterine growth restriction were associated with a reduced risk for postpartum hemorrhage (adjusted odds ratio, 0.76; 95% confidence interval, 0.63-0.91, and 0.34; 95% confidence interval, 0.13-0.87, respectively). CONCLUSION In addition to classical risk factors, this study identified a family history of postpartum hemorrhage and personal transfusion history as new characteristics associated with postpartum hemorrhage after vaginal delivery. The association of postpartum hemorrhage with a family history of postpartum hemorrhage suggests a hereditary hemorrhagic phenotype and calls for genetic studies. Identifying women at risk for postpartum hemorrhage is a key element of being prepared for this complication.
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Affiliation(s)
- François Anouilh
- Ecole Universitaire de Maïeutique de Brest, UFR Santé - Brest, Brest, France (Mr Anouilh); UMR 1304, GETBO, Université de Bretagne Occidentale - Brest (France), Brest, France (Mr Anouilh, Drs de Moreuil, Trémouilhac, Morcel, Couturaud, Tromeur, Le Moigne, and Pan-Petesch)
| | - Claire de Moreuil
- UMR 1304, GETBO, Université de Bretagne Occidentale - Brest (France), Brest, France (Mr Anouilh, Drs de Moreuil, Trémouilhac, Morcel, Couturaud, Tromeur, Le Moigne, and Pan-Petesch); Département de Médecine Interne, Médecine Vasculaire et Pneumologie, Centre Hospitalier Universitaire Brest, Brest, France (Drs Moreuil, Couturaud, Tromeur, and Le Moigne).
| | - Christophe Trémouilhac
- UMR 1304, GETBO, Université de Bretagne Occidentale - Brest (France), Brest, France (Mr Anouilh, Drs de Moreuil, Trémouilhac, Morcel, Couturaud, Tromeur, Le Moigne, and Pan-Petesch); Service de Gynécologie Obstétrique, Centre Hospitalier Universitaire Brest, Brest, France (Dr Trémouilhac, Ms Cornec, and Drs Dupré and Morcel)
| | - Matthieu Jacquot
- Service de Gynécologie Obstétrique, CHIC de Quimper, Quimper, France (Drs Jacquot, Bellot, and Le Joliff)
| | - Gilles Salnelle
- Service de Gynécologie Obstétrique, CH des Pays de Morlaix, Morlaix, France (Drs Salnelle and Muller)
| | - Violaine Bellec
- Service de Gynécologie Obstétrique, Centre Hospitalier Privé de Brest - Keraudren, Brest, France (Dr Bellec)
| | - Nathalie Touffet
- Service de Gynécologie Obstétrique, CH de Landerneau, Landerneau, France (Dr Touffet)
| | - Caroline Cornec
- Service de Gynécologie Obstétrique, Centre Hospitalier Universitaire Brest, Brest, France (Dr Trémouilhac, Ms Cornec, and Drs Dupré and Morcel)
| | - Matthieu Muller
- Service de Gynécologie Obstétrique, CH des Pays de Morlaix, Morlaix, France (Drs Salnelle and Muller)
| | - Pierre-François Dupré
- Service de Gynécologie Obstétrique, Centre Hospitalier Universitaire Brest, Brest, France (Dr Trémouilhac, Ms Cornec, and Drs Dupré and Morcel)
| | - Charles Bellot
- Service de Gynécologie Obstétrique, CHIC de Quimper, Quimper, France (Drs Jacquot, Bellot, and Le Joliff)
| | - Karine Morcel
- UMR 1304, GETBO, Université de Bretagne Occidentale - Brest (France), Brest, France (Mr Anouilh, Drs de Moreuil, Trémouilhac, Morcel, Couturaud, Tromeur, Le Moigne, and Pan-Petesch); Service de Gynécologie Obstétrique, Centre Hospitalier Universitaire Brest, Brest, France (Dr Trémouilhac, Ms Cornec, and Drs Dupré and Morcel)
| | - Delphine Le Joliff
- Service de Gynécologie Obstétrique, CHIC de Quimper, Quimper, France (Drs Jacquot, Bellot, and Le Joliff)
| | - Guillaume Drugmanne
- CIC1412, Institut National de la Sante et de la Recherche Medicale, Brest, France (Mr Drugmanne, Ms Gelebart, Ms Lucier, Dr Nowak, and Ms Bihan)
| | - Elodie Gelebart
- CIC1412, Institut National de la Sante et de la Recherche Medicale, Brest, France (Mr Drugmanne, Ms Gelebart, Ms Lucier, Dr Nowak, and Ms Bihan)
| | - Sandy Lucier
- CIC1412, Institut National de la Sante et de la Recherche Medicale, Brest, France (Mr Drugmanne, Ms Gelebart, Ms Lucier, Dr Nowak, and Ms Bihan)
| | - Emmanuel Nowak
- CIC1412, Institut National de la Sante et de la Recherche Medicale, Brest, France (Mr Drugmanne, Ms Gelebart, Ms Lucier, Dr Nowak, and Ms Bihan)
| | - Line Bihan
- CIC1412, Institut National de la Sante et de la Recherche Medicale, Brest, France (Mr Drugmanne, Ms Gelebart, Ms Lucier, Dr Nowak, and Ms Bihan)
| | - Francis Couturaud
- UMR 1304, GETBO, Université de Bretagne Occidentale - Brest (France), Brest, France (Mr Anouilh, Drs de Moreuil, Trémouilhac, Morcel, Couturaud, Tromeur, Le Moigne, and Pan-Petesch); Département de Médecine Interne, Médecine Vasculaire et Pneumologie, Centre Hospitalier Universitaire Brest, Brest, France (Drs Moreuil, Couturaud, Tromeur, and Le Moigne)
| | - Cécile Tromeur
- UMR 1304, GETBO, Université de Bretagne Occidentale - Brest (France), Brest, France (Mr Anouilh, Drs de Moreuil, Trémouilhac, Morcel, Couturaud, Tromeur, Le Moigne, and Pan-Petesch); Département de Médecine Interne, Médecine Vasculaire et Pneumologie, Centre Hospitalier Universitaire Brest, Brest, France (Drs Moreuil, Couturaud, Tromeur, and Le Moigne)
| | - Emmanuelle Le Moigne
- UMR 1304, GETBO, Université de Bretagne Occidentale - Brest (France), Brest, France (Mr Anouilh, Drs de Moreuil, Trémouilhac, Morcel, Couturaud, Tromeur, Le Moigne, and Pan-Petesch); Département de Médecine Interne, Médecine Vasculaire et Pneumologie, Centre Hospitalier Universitaire Brest, Brest, France (Drs Moreuil, Couturaud, Tromeur, and Le Moigne)
| | - Brigitte Pan-Petesch
- UMR 1304, GETBO, Université de Bretagne Occidentale - Brest (France), Brest, France (Mr Anouilh, Drs de Moreuil, Trémouilhac, Morcel, Couturaud, Tromeur, Le Moigne, and Pan-Petesch); Centre de Ressources et de Compétence des Maladies Hémorragiques, Centre de Ressources et de Compétence des Maladies Hémorragiques, Hémostase, Service Hématologie, Centre Hospitalier Universitaire Brest, Brest, France (Dr Pan-Petesch)
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Durlach V, Vergès B, Al-Salameh A, Bahougne T, Benzerouk F, Berlin I, Clair C, Mansourati J, Rouland A, Thomas D, Thuillier P, Tramunt B, Le Faou AL. Smoking and diabetes interplay: A comprehensive review and joint statement. DIABETES & METABOLISM 2022; 48:101370. [PMID: 35779852 DOI: 10.1016/j.diabet.2022.101370] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/28/2022] [Accepted: 06/28/2022] [Indexed: 06/15/2023]
Abstract
Evidence shows that smoking increases the risk of pre-diabetes and diabetes in the general population. Among persons with diabetes, smoking has been found to increase the risk of all-cause mortality and aggravate chronic diabetic complications and glycemic control. The current paper, which is a joint position statement by the French-Speaking Society on Tobacco (Société Francophone de Tabacologie) and the French-Speaking Society of Diabetes (Société Francophone du Diabète), summarizes the data available on the association between smoking and diabetes and on the impact of smoking and smoking cessation among individuals with type 1, type 2, and gestational diabetes mellitus. It also provides evidence-based information about the pharmacological and behavioral strategies for smoking cessation in these patients.
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Affiliation(s)
- Vincent Durlach
- Champagne-Ardenne University, UMR CNRS 7369 MEDyC & Cardio-Thoracic Department, Reims University Hospital, Reims, France.
| | - Bruno Vergès
- Department of Endocrinology, Diabetology and Metabolic Diseases, CHU Dijon, Dijon, France; INSERM LNC-UMR1231, University of Burgundy, Dijon, France
| | - Abdallah Al-Salameh
- Department of Endocrinology, Diabetes Mellitus and Nutrition, Amiens University Hospital, Amiens, France; PériTox = UMR-I 01, University of Picardy Jules Verne, Amiens, France
| | - Thibault Bahougne
- Department of Endocrinology and Diabetology, Strasbourg University Hospital, Strasbourg, France; Institute of Cellular and Integrative Neuroscience, CNRS UPR-3212, Strasbourg, France
| | - Farid Benzerouk
- Cognition Health and Society Laboratory (EA 6291), University of Reims Champagne-Ardenne, Reims, France; Department of Psychiatry, Reims University Hospital, Reims, France
| | - Ivan Berlin
- Department of Pharmacology, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France
| | - Carole Clair
- Department of Training, Research and Innovation, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Jacques Mansourati
- EA 4324 ORPHY, University of Western Brittany, Brest, France; Department of Cardiology, University Hospital of Brest, Brest, France
| | - Alexia Rouland
- Department of Endocrinology, Diabetology and Metabolic Diseases, CHU Dijon, Dijon, France
| | - Daniel Thomas
- Institute of Cardiology, Hôpital Pitié-Salpêtrière, Sorbonne University, Paris, France
| | - Philippe Thuillier
- Department of Endocrinology, Diabetology and Metabolic Diseases, University Hospital of Brest, Brest, France
| | - Blandine Tramunt
- Institute of Metabolic and Cardiovascular Diseases, UMR1297 INSERM/UPS, Toulouse University, Toulouse, Franc; Department of Diabetology, Metabolic Diseases and Nutrition, Toulouse University Hospital, Toulouse, France
| | - Anne-Laurence Le Faou
- Outpatient Addiction Center, Georges Pompidou European Hospital, AP-HP, Sorbonne Paris Cité, Paris, France
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Koo S, Kim JY, Park JH, Roh GS, Lim NK, Park HY, Kim WH. Binge alcohol drinking before pregnancy is closely associated with the development of macrosomia: Korean pregnancy registry cohort. PLoS One 2022; 17:e0271291. [PMID: 35819975 PMCID: PMC9275693 DOI: 10.1371/journal.pone.0271291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 06/27/2022] [Indexed: 11/18/2022] Open
Abstract
Background Alcohol drinking during pregnancy has been well-known to cause the detrimental effects on fetal development; however, the adverse effects of pre-pregnancy drinking are largely unknown. We investigate whether alcohol drinking status before pregnancy is associated with the risk for macrosomia, an offspring’s adverse outcome, in a Korean pregnancy registry cohort (n = 4,542) enrolled between 2013 and 2017. Methods Binge drinking was defined as consuming ≥5 drinks on one occasion and ≥2 times a week, and a total 2,886 pregnant, included in the final statistical analysis, were divided into 3 groups: never, non-binge, and binge drinking. Results The prevalence of macrosomia was higher in binge drinking before pregnancy than those with never or non-binge drinking (7.5% vs. 3.2% or 2.9%, p = 0.002). Multivariable logistic regression analysis demonstrated an independent association between macrosomia and prepregnancy binge drinking after adjusting for other confounders (adjusted odds ratio = 2.29; 95% CI, 1.08–4.86; p = 0.031). The model added binge drinking before pregnancy led to improvement of 10.6% (95% CI, 2.03–19.07; p = 0.0006) in discrimination from traditional risk prediction models. Conclusion Together, binge drinking before pregnancy might be an independent risk factor for developing macrosomia. Intensified intervention for drinking alcohol in women who are planning a pregnancy is important and may help prevent macrosomia.
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Affiliation(s)
- Seul Koo
- Division of Cardiovascular Disease Research, Department of Chronic Disease Converengence Research, Korea National Institute of Health, Cheongju, Chungbuk, Republic of Korea
| | - Ji Yeon Kim
- Division of Cardiovascular Disease Research, Department of Chronic Disease Converengence Research, Korea National Institute of Health, Cheongju, Chungbuk, Republic of Korea
| | - Ji Hye Park
- Division of Cardiovascular Disease Research, Department of Chronic Disease Converengence Research, Korea National Institute of Health, Cheongju, Chungbuk, Republic of Korea
| | - Gu Seob Roh
- Department of Anatomy and Neurobiology, Gyeongsang National University, Jinju, Gyeongnam, Republic of Korea
| | - Nam Kyoo Lim
- Division of Cardiovascular Disease Research, Department of Chronic Disease Converengence Research, Korea National Institute of Health, Cheongju, Chungbuk, Republic of Korea
| | - Hyun Young Park
- Division of Cardiovascular Disease Research, Department of Chronic Disease Converengence Research, Korea National Institute of Health, Cheongju, Chungbuk, Republic of Korea
| | - Won-Ho Kim
- Division of Cardiovascular Disease Research, Department of Chronic Disease Converengence Research, Korea National Institute of Health, Cheongju, Chungbuk, Republic of Korea
- * E-mail:
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6
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Yang Y, Wu N. Gestational Diabetes Mellitus and Preeclampsia: Correlation and Influencing Factors. Front Cardiovasc Med 2022; 9:831297. [PMID: 35252402 PMCID: PMC8889031 DOI: 10.3389/fcvm.2022.831297] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 01/20/2022] [Indexed: 12/16/2022] Open
Abstract
Gestational diabetes mellitus (GDM) and preeclampsia (PE) are common pregnancy complications with similar risk factors and pathophysiological changes. Evidence from previous studies suggests that the incidence of PE is significantly increased in women with GDM, but whether GDM is independently related to the occurrence of PE has remained controversial. GDM complicated by PE further increases perinatal adverse events with greater impact on the future maternal and offspring health. Identify factors associated with PE in women with GDM women, specifically those that are controllable, is important for improving pregnancy outcomes. This paper provides the findings of a review on the correlation between GDM and PE, factors associated with PE in women with GDM, possible mechanisms, and predictive markers. Most studies concluded that GDM is independently associated with PE in singleton pregnancy, and optimizing the treatment and management of GDM can reduce the incidence of PE, which is very helpful to improve pregnancy outcomes.
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Affiliation(s)
- Ying Yang
- Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Na Wu
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Skills Practice Teaching Center, Shengjing Hospital of China Medical University, Shenyang, China
- *Correspondence: Na Wu
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Silva AI, Camelo A, Madureira J, Reis AT, Machado AP, Teixeira JP, Costa C. Urinary cotinine assessment of maternal smoking and environmental tobacco smoke exposure status and its associations with perinatal outcomes: a cross-sectional birth study. ENVIRONMENTAL RESEARCH 2022; 203:111827. [PMID: 34363802 DOI: 10.1016/j.envres.2021.111827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/28/2021] [Accepted: 07/31/2021] [Indexed: 06/13/2023]
Abstract
Tobacco consumption and environmental tobacco smoke (ETS) exposure remains an important public health concern. Pregnant women require particular attention as active and passive smoking during pregnancy are associated with multiple adverse perinatal outcomes. This study aimed to biochemically validate self-reported smoking and ETS exposure status among pregnant women, to more precisely ascertain its association with adverse perinatal outcomes. Data refers to 595 pregnant women who sought prenatal care in a public hospital in Porto, Portugal. A standard questionnaire on smoking and ETS-related variables was completed. Urinary cotinine (UC) concentrations were assessed by solid-phase competitive ELISA, in maternal urine samples collected on the day of delivery. The results showed that the optimal UC cut-off value to distinguish smokers from non-smokers and within non-smokers those who were exposed to ETS from those non-exposed in the third trimester of pregnancy was 74.1 ng/mL (sensitivity and specificity of 96.7% and 98.0%, respectively) and 1.6 ng/mL (sensitivity of 66.2% and specificity of 75.7%, respectively). The agreement between maternal self-reported and UC-based smoking status was very good (κ=0.919, p<0.001), but much lower for ETS exposure (κ=0.386, p<0.001). Maternal active smoking in the third trimester of pregnancy was associated with a significant decrease in birth weight, length and head circumference of 157.66 g (95% CI: -245.81, -69.52; p<0.001), 0.78 cm (95% CI: -1.22, -0.34; p=0.001) and 0.39 cm (95% CI: -0.70, -0.07; p=0.016), respectively. Maternal ETS exposure in the third trimester of pregnancy was associated with a non-significant increase in birth weight of 38.37 g (95% CI: -28.91, 105.64; p=0.263). Furthermore, maternal smoking cessation was associated with the increase of approximately 172 g in birth weight (95% CI: 50.00, 293.19). As such, there is an urgent need for increased public health awareness campaigns to encourage smoking cessation during pregnancy, in order to improve perinatal outcomes.
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Affiliation(s)
- Ana Inês Silva
- Environmental Health Department, National Institute of Health, Rua Alexandre Herculano 321, 4000-055, Porto, Portugal; EPIUnit, Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-600, Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Rua das Taipas 135, 4050-600, Porto, Portugal; ICBAS - Institute of Biomedical Sciences Abel Salazar, University of Porto, Rua de Jorge Viterbo Ferreira 228, 4050-313, Porto, Portugal
| | - Alexandra Camelo
- Environmental Health Department, National Institute of Health, Rua Alexandre Herculano 321, 4000-055, Porto, Portugal; EPIUnit, Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-600, Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Rua das Taipas 135, 4050-600, Porto, Portugal
| | - Joana Madureira
- Environmental Health Department, National Institute of Health, Rua Alexandre Herculano 321, 4000-055, Porto, Portugal; EPIUnit, Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-600, Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Rua das Taipas 135, 4050-600, Porto, Portugal.
| | - Ana Teresa Reis
- Environmental Health Department, National Institute of Health, Rua Alexandre Herculano 321, 4000-055, Porto, Portugal; EPIUnit, Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-600, Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Rua das Taipas 135, 4050-600, Porto, Portugal
| | - Ana Paula Machado
- Department of Obstetrics and Gynaecology, Centro Hospitalar de São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - João Paulo Teixeira
- Environmental Health Department, National Institute of Health, Rua Alexandre Herculano 321, 4000-055, Porto, Portugal; EPIUnit, Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-600, Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Rua das Taipas 135, 4050-600, Porto, Portugal
| | - Carla Costa
- Environmental Health Department, National Institute of Health, Rua Alexandre Herculano 321, 4000-055, Porto, Portugal; EPIUnit, Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-600, Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Rua das Taipas 135, 4050-600, Porto, Portugal
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8
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Ratsch A, Bogossian F, Burmeister EA, Steadman K. Central Australian Aboriginal women's placental and neonatal outcomes following maternal smokeless tobacco, cigarette or no tobacco use. Aust N Z J Public Health 2021; 46:186-195. [PMID: 34821425 DOI: 10.1111/1753-6405.13186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 09/01/2021] [Accepted: 10/01/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To describe the placental characteristics and neonatal outcomes of Central Australian Aboriginal women based on maternal self-report of tobacco use. METHODS Placental and neonatal variables were collected from a prospective maternal cohort of 19 smokeless tobacco chewers, 23 smokers and 31 no-tobacco users. RESULTS Chewers had the lowest placental weight (460 g) while the no-tobacco group had the heaviest placental weight (565 g). Chewers and the no-tobacco group had placental areas of similar size (285 cm2 and 288 cm2 , respectively) while the placentas of smokers were at least 13 cm2 smaller (272 cm2 ). There were two stillbirths in the study and more than one-third (36%) of neonates (newborns) were admitted to the Special Care Nursery, with the chewers' neonates having a higher admission rate compared with smokers' neonates (44% vs. 23%). The cohort mean birthweight (3348 g) was not significantly different between the groups. When stratified for elevated maternal glucose, the chewers' neonates had the lowest mean birthweight (2906 g) compared to the neonates of the no-tobacco group (3242 g) and smokers (3398 g). CONCLUSIONS This research is the first to demonstrate that the maternal use of Australian Nicotiana spp. (pituri) as smokeless tobacco may negatively impact placental and neonatal outcomes. Implications for public health: Maternal smokeless tobacco use is a potential source of placental and foetal nicotine exposure. Maternal antenatal screening should be expanded to capture a broader range of tobacco and nicotine products, and appropriate cessation support is required.
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Affiliation(s)
- Angela Ratsch
- Wide Bay Hospital and Health Services, Queensland.,Rural Clinical School, The University of Queensland, Queensland
| | - Fiona Bogossian
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Queensland.,School of Nursing, Midwifery and Social Work, The University of Queensland, Queensland
| | - Elizabeth A Burmeister
- Wide Bay Hospital and Health Services, Queensland.,School of Nursing, Midwifery and Social Work, The University of Queensland, Queensland
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9
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Morales-Prieto DM, Fuentes-Zacarías P, Murrieta-Coxca JM, Gutierrez-Samudio RN, Favaro RR, Fitzgerald JS, Markert UR. Smoking for two- effects of tobacco consumption on placenta. Mol Aspects Med 2021; 87:101023. [PMID: 34521556 DOI: 10.1016/j.mam.2021.101023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/22/2021] [Accepted: 09/07/2021] [Indexed: 12/14/2022]
Abstract
Tobacco smoking is an important public health issue recognized by the world health organization as one of the most serious, preventable risk factors for developing a series of pregnancy pathologies. Maternal smoking is positively associated with intrauterine growth restriction (IUGR) and gestational diabetes (GDM), but negatively associated with preeclampsia (PE). In this review, we examine epidemiological, clinical and laboratory studies of smoking effects on immunoregulation during pregnancy, trophoblast function, and placental vasculature development and metabolism. We aim to identify effects of tobacco smoke components on specific placental compartments or cells, which may contribute to the understanding of the influences of maternal smoking on placenta function in normal and pathological pregnancies. Data corroborates that in any trimester, smoking is unsafe for pregnancy and that its detrimental effects outweigh questionable benefits. The effects of maternal smoking on the maternal immune regulation throughout pregnancy and the impact of different tobacco products on fetal growth have not yet been fully understood. Smoking cessation rather than treatment with replacement therapies is recommended for future mothers because also single components of tobacco and its smoke may have detrimental effects on placental function.
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Affiliation(s)
| | | | | | | | - Rodolfo R Favaro
- Placenta Lab, Department of Obstetrics, University Hospital Jena, Jena, Germany
| | - Justine S Fitzgerald
- Placenta Lab, Department of Obstetrics, University Hospital Jena, Jena, Germany; Zentrum für ambulante Medizin, University Hospital Jena, Jena, Germany
| | - Udo R Markert
- Placenta Lab, Department of Obstetrics, University Hospital Jena, Jena, Germany.
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10
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Cui D, Yang W, Shao P, Li J, Wang P, Leng J, Wang S, Liu E, Chan JC, Yu Z, Hu G, Yang X. Interactions between Prepregnancy Overweight and Passive Smoking for Macrosomia and Large for Gestational Age in Chinese Pregnant Women. Obes Facts 2021; 14:520-530. [PMID: 34419951 PMCID: PMC8546448 DOI: 10.1159/000517846] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 06/07/2021] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION Previous analysis showed that passive smoking and overweight were associated with an increased risk of gestational diabetes mellitus (GDM) in a synergistic manner, while GDM increased the risk of macrosomia/large for gestational age (LGA). This study aimed to examine any interactive effects between passive smoking and overweight/obesity on risk of macrosomia/LGA. METHODS From 2010 to 2012, 22,302 pregnant women registered for pregnancy at a primary hospital in Tianjin, China. Data were collected longitudinally; that is, from their first antenatal care visit, at the glucose challenge test (GCT) time (24-28 weeks of gestation) and at delivery. Passive smoking was self-reported. Macrosomia was defined as birth weight ≥4,000 g. Binary logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs). Additive interaction was used to test the synergistic effect. RESULTS Passive smokers accounted for 57.4% of women (n = 8,230). Using nonpassive smoking and prepregnancy body mass index (BMI) <24.0 kg/m2 as the reference, the adjusted ORs of overweight alone and passive smoking alone for macrosomia were 2.39 (95% CI: 2.11-2.71) and 1.17 (95% CI: 1.04-1.32). Copresence of passive smoking and prepregnancy BMI ≥24.0 kg/m2 increased the OR to 2.70 (95% CI: 2.28-3.20), with a significant additive interaction. After further adjustment for GDM or GCT, the OR of copresence of both risk factors was slightly attenuated to 2.52 (2.13-3.00) and 2.51 (2.11-2.98), with significant additive interaction. However, the additive interaction between prepregnancy overweight/obesity and passive smoking for LGA was nonsignificant. CONCLUSIONS Prepregnancy overweight/obesity was associated with an increased risk of macrosomia in Chinese women synergistically with passive smoking during pregnancy, and most of the association was not modified by hyperglycemia during pregnancy.
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Affiliation(s)
- Dingyu Cui
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wen Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Ping Shao
- Project Office, Tianjin Women and Children's Health Center, Tianjin, China
| | - Jing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
- Tianjin Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Peng Wang
- Project Office, Tianjin Women and Children's Health Center, Tianjin, China
| | - Junhong Leng
- Department of Child Health, Tianjin Women and Children's Health Center, Tianjin, China
| | - Shuo Wang
- Project Office, Tianjin Women and Children's Health Center, Tianjin, China
| | - Enqing Liu
- Department of Child Health, Tianjin Women and Children's Health Center, Tianjin, China
| | - Juliana C.N. Chan
- Department of Medicine and Therapeutics, Hong Kong Institute of Diabetes and Obesity and The Chinese University of Hong Kong-Prince of Wales Hospital-International Diabetes Federation Centre of Education, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Zhijie Yu
- Population Cancer Research Program, Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Gang Hu
- Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Xilin Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
- Tianjin Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
- *Xilin Yang,
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11
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Chee C, Hibbert EJ, Lam P, Nanan R, Liu A. Sonographic and other nonglycemic factors can predict large-for-gestational-age infants in diet-managed gestational diabetes mellitus: A retrospective cohort study. J Diabetes 2020; 12:562-572. [PMID: 32250016 DOI: 10.1111/1753-0407.13042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 03/01/2020] [Accepted: 03/27/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy. Left untreated or poorly controlled, GDM results in adverse infant outcomes such as large for gestational age (LGA). This study aims to identify nonglycemic maternal and fetal factors predictive of LGA outcomes in pregnancies complicated by diet-managed GDM. METHODS This was a retrospective cohort study of singleton pregnancies complicated by diet-managed GDM from 2004 to 2015. Multiple logistic regression analysis was performed on maternal and perinatal factors to identify risk factors for LGA. In addition, a subset univariate analysis was conducted for pregnancies in which fetal ultrasound abdominal circumference measurements were available at gestational weeks 18 to 22, 24 to 28, and 29 to 33. RESULTS A total of 1064 women were included, delivering 123 LGA infants. Women with higher parity (odds ratio [OR] 1.44; CI, 1.23-1.68; P < .001) and higher prepregnancy body mass index (BMI) (OR 1.09; CI, 1.06-1.12; P < .001) were more likely to have LGA infants. Maternal smoking (OR 0.30; CI, 0.14-0.62; P = .001) and higher gestational age at birth (OR 0.91; CI, 0.84-0.99; P = .018) were associated with reduced risk. Subset univariate analysis showed that fetal abdominal circumference measurements at weeks 24 to 28 and 29 to 33 beyond the 75th percentile (OR 5.92 and 13.74, respectively) and 90th percentile (OR 4.57 and 15.89, respectively) were highly predictive of LGA. CONCLUSIONS Parity, smoking status, maternal BMI, gestational age, and ultrasound fetal abdominal circumference measurements were identified as useful predictors of LGA. Presence of these predictors may prompt closer monitoring of pregnancy and early therapeutic intervention to improve management and reduce the risk of adverse fetal and maternal outcomes.
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Affiliation(s)
- Chermaine Chee
- Discipline of Paediatrics, The University of Sydney Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Penrith, New South Wales, Australia
| | - Emily Jane Hibbert
- Department of Endocrinology and Diabetes, Division of Medicine, The University of Sydney Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Penrith, New South Wales, Australia
| | - Penny Lam
- Department of Perinatal Ultrasound, Nepean Hospital, Penrith, New South Wales, Australia
| | - Ralph Nanan
- Discipline of Paediatrics, The University of Sydney Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Penrith, New South Wales, Australia
- Charles Perkins Centre Nepean, The University of Sydney, Penrith, New South Wales, Australia
| | - Anthony Liu
- Discipline of Paediatrics, The University of Sydney Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Penrith, New South Wales, Australia
- Charles Perkins Centre Nepean, The University of Sydney, Penrith, New South Wales, Australia
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12
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Fazel N, Kundi M, Kazemzadeh A, Esmaily H, Akbarzadeh R, Ahmadi R. Environmental tobacco smoke exposure during pregnancy affects complications and birth outcomes in women with and without asthma. BMC Pregnancy Childbirth 2020; 20:314. [PMID: 32434494 PMCID: PMC7240917 DOI: 10.1186/s12884-020-03000-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 05/08/2020] [Indexed: 01/21/2023] Open
Abstract
Background It is known that environmental tobacco smoke (ETS) has adverse effects on pregnancy and birth outcomes. We aimed to assess the impact of ETS in pregnant women with and without asthma. Methods A cohort study was conducted from August 2014 to June 2015 enrolling 1603 pregnant women during their 2nd trimester. Data on tobacco exposure were collected at first visit and women were followed through pregnancy till postpartum. Results Of the 1603 women, 231 reported passive smoking, 223 non-asthmatics and 8 asthmatics. Women exposed to ETS during pregnancy were more likely to have an infant admitted to the pediatric ward (10.8% vs. 6.5%, p = 0.026) and to have low one- and five-minute Apgar scores (1 min: 6.1% vs. 2.6%, p = 0.011; 5 min: 2.2% vs. 0.7%, p = 0.039). Complications of pregnancy were also elevated in women exposed to ETS (53.7% vs. 42.3%, p = 0.002). Asthma had no additional effect beyond the impact of ETS except for cesarean sections that were more frequent in women with asthma exposed to ETS. Conclusions Due to the small number of women with asthma exposed to ETS, combined effects of asthma and ETS were only found for cesarean sections. Still counseling of pregnant women about adverse effects of ETS should consider women’s asthma as an additional reason to avoid ETS.
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Affiliation(s)
- Nasrin Fazel
- Sabzevar University of Medical Sciences, Sabzevar, Iran.,Center for Public Health, Medical University Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria
| | - Michael Kundi
- Center for Public Health, Medical University Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria.
| | - Asghar Kazemzadeh
- Department of Internal Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Habibollah Esmaily
- Department of Biostatistics & Epidemiology, Neonatal Research Center, Mashhad University of Medical Sciences, Mashad, Iran
| | - Roya Akbarzadeh
- Department of Anesthesia & Operating Room, College of Paramedics, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Raheleh Ahmadi
- Department of Obstetrics and Gynecology, Mobini Hospital, Sabzevar University of Medical Sciences, Sabzevar, Iran
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13
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Ducos C, Rigalleau V, Foussard N, Cambos S, Poupon P, Monlun M, Blanco L, Haissaguerre M, Grouthier V, Velayoudom-Cephise FL, Mohammedi K. Why might pumps fail in pregnant women with Type 1 diabetes? Diabet Med 2020; 37:159-160. [PMID: 31264729 DOI: 10.1111/dme.14063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/01/2019] [Indexed: 11/26/2022]
Affiliation(s)
- C Ducos
- Endocrinology-Nutrition Department, Centre Hospitalier Universitaire de Bordeaux, France
| | - V Rigalleau
- Endocrinology-Nutrition Department, Centre Hospitalier Universitaire de Bordeaux, France
| | - N Foussard
- Endocrinology-Nutrition Department, Centre Hospitalier Universitaire de Bordeaux, France
| | - S Cambos
- Endocrinology-Nutrition Department, Centre Hospitalier Universitaire de Bordeaux, France
| | - P Poupon
- Endocrinology-Nutrition Department, Centre Hospitalier Universitaire de Bordeaux, France
| | - M Monlun
- Endocrinology-Nutrition Department, Centre Hospitalier Universitaire de Bordeaux, France
| | - L Blanco
- Endocrinology-Nutrition Department, Centre Hospitalier Universitaire de Bordeaux, France
| | - M Haissaguerre
- Endocrinology-Nutrition Department, Centre Hospitalier Universitaire de Bordeaux, France
| | - V Grouthier
- Endocrinology-Nutrition Department, Centre Hospitalier Universitaire de Bordeaux, France
| | - F-L Velayoudom-Cephise
- Endocrinology-Nutrition Department, Centre Hospitalier Universitaire de Bordeaux, France
| | - K Mohammedi
- Endocrinology-Nutrition Department, Centre Hospitalier Universitaire de Bordeaux, France
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14
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Debost-Legrand A, Rivière O, Dossou M, Vendittelli F. Risk Factors for Severe Secondary Postpartum Hemorrhages: A Historical Cohort Study. Birth 2015; 42:235-41. [PMID: 26032774 DOI: 10.1111/birt.12175] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/10/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND The predictive factors of secondary postpartum hemorrhage (PPH) are little known. Our principal objective was to determine if immediate PPH is a risk factor for severe secondary PPH. We also sought to identify other factors associated with severe secondary PPH. METHODS Our historical cohort study included all women who gave birth (≥ 22 weeks) in our level III hospital from 2004 through 2013. The hospital discharge database enabled us to identify all women readmitted during the 42-day postpartum period or who underwent a surgical, medical, or interventional radiology procedure during their immediate postpartum hospitalization. We then examined all medical records to identify the cases involving severe secondary PPH. We studied the known risk factors of secondary PPH and assessed other potential ones: maternal age, multiple pregnancy, induction of labor, cesarean birth, preterm birth, and stillbirth. RESULTS The study included 63 women with a severe secondary PPH and 25,696 women without a secondary PPH. Immediate PPH (aOR 2.7 [95% CI 1.3-5.6]) and maternal age ≥ 35 years (aOR 2.0 [95% CI 1.1-3.7]) were the only factors associated with severe secondary PPH. DISCUSSION This cohort study confirms that immediate PPH is a risk factor for severe secondary PPH and reports for the first time an association between secondary PPH and advanced maternal age. It is likely that risk factors for immediate PPH are also risk factors for severe secondary PPH and thus that immediate PPH may be an intermediate factor between its own known risk factors and secondary PPH.
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Affiliation(s)
- Anne Debost-Legrand
- Department of Public Health, Clermont-Ferrand University Hospital Center, Clermont-Ferrand, EA, France.,PEPRADE, University of Auvergne, Clermont-Ferrand, France
| | - Olivier Rivière
- AUDIPOG Sentinel Network, medical university RTH Laennec, Lyon, France
| | - Mathieu Dossou
- Department of Obstetrics & Gynecology, Clermont-Ferrand University Hospital Center, Clermont-Ferrand, France
| | - Françoise Vendittelli
- Department of Public Health, Department of Obstetrics & Gynecology, Clermont-Ferrand University Hospital Center, Clermont-Ferrand, EA, France.,PEPRADE, University of Auvergne, Clermont-Ferrand, AUDIPOG Sentinel Network, medical university RTH Laennec, Lyon, France
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15
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Britton GR, James GD, Collier R, Sprague LM, Brinthaupt J. The effects of smoking cessation and a programme intervention on birth and other perinatal outcomes among rural pregnant smokers. Ann Hum Biol 2013; 40:256-65. [DOI: 10.3109/03014460.2012.761727] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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16
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Jeyabalan A, Powers RW, Clifton RG, Van Dorsten P, Hauth JC, Klebanoff MA, Lindheimer MD, Sibai B, Landon M, Miodovnik M. Effect of smoking on circulating angiogenic factors in high risk pregnancies. PLoS One 2010; 5:e13270. [PMID: 20967275 PMCID: PMC2953508 DOI: 10.1371/journal.pone.0013270] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2010] [Accepted: 09/04/2010] [Indexed: 11/18/2022] Open
Abstract
Objective Changes in maternal concentrations of the anti-angiogenic factors, soluble fms-like tyrosine kinase 1 (sFlt1) and soluble endoglin (sEng), and the pro-angiogenic placental growth factor (PlGF) precede the development of preeclampsia in healthy women. The risk of preeclampsia is reduced in women who smoke during pregnancy. The objective of this study was to investigate whether smoking affects concentrations of angiogenic factors (sFlt1, PlGF, and sEng) in women at high risk for developing preeclampsia. Study Design We performed a secondary analysis of serum samples from 993 high-risk women (chronic hypertension, diabetes, multifetal gestation, and previous preeclampsia) in a preeclampsia prevention trial. sFlt1, sEng and PlGF were measured in serum samples obtained at study entry, which was prior to initiation of aspirin (median 19.0 weeks' [interquartile range of 16.0–22.6 weeks']). Smoking status was determined by self-report. Results sFlt1 was not significantly different in smokers from any high-risk groups compared to their nonsmoking counterparts. PlGF was higher among smokers compared to nonsmokers among diabetic women (142.7 [77.4–337.3] vs 95.9 [48.5–180.7] pg/ml, p = 0.005) and women with a history of preeclampsia (252.2 [137.1–486.0] vs 152.2 [73.6–253.7] pg/ml, p = 0.001). sEng was lower in smokers with multifetal gestations (5.8 [4.6–6.5] vs 6.8 [5.5–8.7] ng/ml, p = 0.002) and trended lower among smokers with diabetes (4.9 [3.8–5.6] vs 5.3 [4.3–6.3] ng/ml, p = 0.05). Smoking was not associated with a lower incidence of preeclampsia in any of these groups. Conclusions In certain high-risk groups, smoking is associated with changes in the concentrations of these factors towards a pro-angiogenic direction during early pregnancy; however, there was no apparent association between smoking and the development of preeclampsia in our cohort.
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Affiliation(s)
- Arun Jeyabalan
- Department of Obstetrics, Gynecology and Women's Health, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America.
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