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Perkovic-Kepeci S, Cirkovic A, Milic N, Dugalic S, Stanisavljevic D, Milincic M, Kostic K, Milic N, Todorovic J, Markovic K, Aleksic Grozdic N, Gojnic Dugalic M. Doppler Indices of the Uterine, Umbilical and Fetal Middle Cerebral Artery in Diabetic versus Non-Diabetic Pregnancy: Systematic Review and Meta-Analysis. Medicina (Kaunas) 2023; 59:1502. [PMID: 37629792 PMCID: PMC10456372 DOI: 10.3390/medicina59081502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/20/2023] [Accepted: 08/12/2023] [Indexed: 08/27/2023]
Abstract
Background and Objectives: The aim of this study was to assess the differences in Doppler indices of the uterine (Ut), umbilical (UA), and middle cerebral artery (MCA) in diabetic versus non-diabetic pregnancies by conducting a comprehensive systematic review of the literature with a meta-analysis. Materials and Methods: PubMed, Web of Science, and SCOPUS were searched for studies that measured the pulsatility index (PI), resistance index (RI), and systolic/diastolic ratio index (S/D ratio) of the umbilical artery, middle cerebral artery, and uterine artery in diabetic versus non-diabetic pregnancies. Two reviewers independently evaluated the eligibility of studies, abstracted data, and performed quality assessments according to standardized protocols. The standardized mean difference (SMD) was used as a measure of effect size. Heterogeneity was assessed using the I2 statistic. Publication bias was evaluated by means of funnel plots. Results: A total of 62 publications were included in the qualitative and 43 in quantitative analysis. The UA-RI, UtA-PI, and UtA-S/D ratios were increased in diabetic compared with non-diabetic pregnancies. Subgroup analysis showed that levels of UtA-PI were significantly higher during the third, but not during the first trimester of pregnancy in diabetic versus non-diabetic pregnancies. No differences were found for the UA-PI, UA-S/D ratio, MCA-PI, MCA-RI, MCA-S/D ratio, or UtA-RI between diabetic and non-diabetic pregnancies. Conclusions: This meta-analysis revealed the presence of hemodynamic changes in uterine and umbilical arteries, but not in the middle cerebral artery in pregnancies complicated by diabetes.
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Affiliation(s)
- Sonja Perkovic-Kepeci
- General Hospital Pancevo, 26000 Pancevo, Serbia;
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (K.K.); (N.M.); (K.M.); (M.G.D.)
| | - Andja Cirkovic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (N.M.); (D.S.)
| | - Natasa Milic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (N.M.); (D.S.)
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905, USA
| | - Stefan Dugalic
- Clinic for Gynecology and Obstetrics, University Clinical Centre of Serbia, 11000 Belgrade, Serbia; (S.D.); (M.M.)
| | - Dejana Stanisavljevic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (N.M.); (D.S.)
| | - Milos Milincic
- Clinic for Gynecology and Obstetrics, University Clinical Centre of Serbia, 11000 Belgrade, Serbia; (S.D.); (M.M.)
| | - Konstantin Kostic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (K.K.); (N.M.); (K.M.); (M.G.D.)
| | - Nikola Milic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (K.K.); (N.M.); (K.M.); (M.G.D.)
| | - Jovana Todorovic
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Ksenija Markovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (K.K.); (N.M.); (K.M.); (M.G.D.)
| | - Natasa Aleksic Grozdic
- Institute for Process Engineering Environmental Engineering and Technical Life Sciences, Technical University of Vienna, 1180 Vienna, Austria;
| | - Miroslava Gojnic Dugalic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (K.K.); (N.M.); (K.M.); (M.G.D.)
- Clinic for Gynecology and Obstetrics, University Clinical Centre of Serbia, 11000 Belgrade, Serbia; (S.D.); (M.M.)
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Dugalic S, Petronijevic M, Vasiljevic B, Todorovic J, Stanisavljevic D, Jotic A, Lukic L, Milicic T, Lalić N, Lalic K, Stoiljkovic M, Terzic-Supic Z, Stanisavljevic T, Stefanovic A, Stefanovic K, Vrzic-Petronijevic S, Macura M, Pantic I, Piperac P, Jovanovic M, Cerovic R, Djurasevic S, Babic S, Perkovic-Kepeci S, Gojnic M. Trends of the Prevalence of Pre-gestational Diabetes in 2030 and 2050 in Belgrade Cohort. Int J Environ Res Public Health 2022; 19:ijerph19116517. [PMID: 35682099 PMCID: PMC9180675 DOI: 10.3390/ijerph19116517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/17/2022] [Accepted: 05/25/2022] [Indexed: 11/16/2022]
Abstract
The aim of this study was to analyze the trends in diabetes in pregnancy in Belgrade, Serbia for the period of the past decade and forecast the number of women with pre-gestational diabetes for the years 2030 and 2050. The study included the data on all pregnant women with diabetes from the registry of the deliveries in Belgrade, by the City Institute of Public Health of Belgrade, Serbia for the period between 2010 and 2020 and the published data on the deliveries on the territory of Belgrade. During the examined period the total number of live births in Belgrade was 196,987, and the prevalence of diabetes in pregnancy was 3.4%, with the total prevalence of pre-gestational diabetes of 0.7% and overall prevalence of GDM of 2.7%. The average age of women in our study was significantly lower in 2010 compared to 2020. The forecasted prevalence of pre-gestational diabetes among all pregnant women for 2030 is 2% and 4% for 2050 in our cohort. Our study showed that the prevalence of pre-gestational diabetes has increased both among all pregnant women and among women with diabetes in pregnancy in the past decade in Belgrade, Serbia and that it is expected to increase further in the next decades and to further double by 2050.
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Affiliation(s)
- Stefan Dugalic
- Faculty of Medicine, Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (S.D.); (M.P.); (A.S.); (K.S.); (S.V.-P.); (M.M.); (R.C.); (S.B.)
| | - Milos Petronijevic
- Faculty of Medicine, Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (S.D.); (M.P.); (A.S.); (K.S.); (S.V.-P.); (M.M.); (R.C.); (S.B.)
| | - Brankica Vasiljevic
- Maternity and Child Health Service, NMC Royal Hospital DIP, Dubai Hospital, Dubai P.O. Box 7832, United Arab Emirates;
| | - Jovana Todorovic
- Faculty of Medicine, Institute of Social Medicine, University of Belgrade, 11000 Belgrade, Serbia; (J.T.); (Z.T.-S.)
| | - Dejana Stanisavljevic
- Faculty of Medicine, Institute for Medical Statistics and Informatics, University of Belgrade, 11000 Belgrade, Serbia;
| | - Aleksandra Jotic
- Faculty of Medicine, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (A.J.); (L.L.); (T.M.); (N.L.); (K.L.); (M.S.)
| | - Ljiljana Lukic
- Faculty of Medicine, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (A.J.); (L.L.); (T.M.); (N.L.); (K.L.); (M.S.)
| | - Tanja Milicic
- Faculty of Medicine, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (A.J.); (L.L.); (T.M.); (N.L.); (K.L.); (M.S.)
| | - Nebojsa Lalić
- Faculty of Medicine, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (A.J.); (L.L.); (T.M.); (N.L.); (K.L.); (M.S.)
| | - Katarina Lalic
- Faculty of Medicine, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (A.J.); (L.L.); (T.M.); (N.L.); (K.L.); (M.S.)
| | - Milica Stoiljkovic
- Faculty of Medicine, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (A.J.); (L.L.); (T.M.); (N.L.); (K.L.); (M.S.)
| | - Zorica Terzic-Supic
- Faculty of Medicine, Institute of Social Medicine, University of Belgrade, 11000 Belgrade, Serbia; (J.T.); (Z.T.-S.)
| | | | - Aleksandar Stefanovic
- Faculty of Medicine, Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (S.D.); (M.P.); (A.S.); (K.S.); (S.V.-P.); (M.M.); (R.C.); (S.B.)
| | - Katarina Stefanovic
- Faculty of Medicine, Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (S.D.); (M.P.); (A.S.); (K.S.); (S.V.-P.); (M.M.); (R.C.); (S.B.)
| | - Svetlana Vrzic-Petronijevic
- Faculty of Medicine, Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (S.D.); (M.P.); (A.S.); (K.S.); (S.V.-P.); (M.M.); (R.C.); (S.B.)
| | - Maja Macura
- Faculty of Medicine, Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (S.D.); (M.P.); (A.S.); (K.S.); (S.V.-P.); (M.M.); (R.C.); (S.B.)
| | - Igor Pantic
- Faculty of Medicine, Institute for Medical Physiology, University of Belgrade, 11000 Belgrade, Serbia;
| | - Pavle Piperac
- Department for Humanities, University of Belgrade, Faculty of Medicine, 11000 Belgrade, Serbia;
| | | | - Radmila Cerovic
- Faculty of Medicine, Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (S.D.); (M.P.); (A.S.); (K.S.); (S.V.-P.); (M.M.); (R.C.); (S.B.)
| | | | - Sandra Babic
- Faculty of Medicine, Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (S.D.); (M.P.); (A.S.); (K.S.); (S.V.-P.); (M.M.); (R.C.); (S.B.)
| | | | - Miroslava Gojnic
- Faculty of Medicine, Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (S.D.); (M.P.); (A.S.); (K.S.); (S.V.-P.); (M.M.); (R.C.); (S.B.)
- Correspondence:
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