Introduction: It has been estimated that approximately 16% of pregnancies worldwide are affected by preexisting or gestational insulin-dependent (type 1) or independent (type 2) diabetes mellitus (DM). Diabetes mellitus in pregnancy remains a high-risk condition for both mother and child. This study aimed to investigate pregnancy outcomes regarding DM types.Material and methods: The study included 323 DM patients delivered for 6 years (2012)(2013)(2014)(2015)(2016)(2017). General and obstetric history data and all complications throughout the pregnancy and the early neonatal period were noted. Based on DM type, women were divided into 4 groups: pre-pregnancy/pre-existing DM, insulin-dependent or independent, and gestational diabetes mellitus with or without insulin therapy.Results: The majority of women had pre-existing insulin-independent DM (type II 62%). Some types of pregnancy/maternal complications were registered in almost 85% of examined pregnancies. However, all babies were live born and mostly with good outcome (36.85% with early neonatal complications). Diabetes mellitus type could not predict the occurrence of neonatal complications (p = 0.342). Pre-existing insulin-dependent DM increased the risk for pregnancy complications (p = 0.031; OR = 1.656).Conclusions: Diabetes mellitus type has a limited impact on pregnancy outcomes and the occurrence of maternal and neonatal complications. With adequate therapy the pregnancy outcome can be good regardless of DM type.
Introduction Older women are at greater risk of suffering from a series of comorbidities such as obesity, diabetes, and hypertension that could negatively affect pregnancy course and outcomes. This study aims to investigate the impact of maternal age and pre-pregnancy body mass index (BMI) on pregnancy outcomes of women with diabetes mellitus (DM). Material and methods The study included 323 diabetic pregnant women. All complications throughout pregnancy and the early neonatal period were noted. The women were divided into groups according to age decade and BMI. Results 84.8% of women reported pregnancy complications, with a higher prevalence in obese women ( p = 0.003). However, most children had a good outcome with few early neonatal complications (36.85%). Old and obese women with DM often showed complications, and their newborns had higher birth weight ( p = 0.003) and more neonatal complications ( p = 0.041). Maternal BMI ( p = 0.016; OR = 1.064), but not age ( p = 0.801), was found to be a significant predictor of pregnancy complications. Conclusions Pregnant women with DM should be considered as high-risk patients. Advanced age and increased BMI prior to pregnancy are risk factors for pregnancy complications. Maternal obesity is the most important predictor of pregnancy complications in women with DM. Pregnancy outcome can be good for both mothers and children with a timely and adequate approach.
Gestational diabetes mellitus (GDM) is a pregnancy complication in which women without previously diagnosed diabetes develop chronic hyperglycemia during gestation. The diet and lifestyle of the mother during pregnancy as well as lactation have long-term effects on the child’s health and development. Detection of early risk markers of adult-age chronic diseases that begin during prenatal life and the application of complex nutritional interventions at the right time may reduce the risk of these diseases. Newborns adapt to the ectopic environment by developing intestinal immune homeostasis. Adequate initial colonization of bacteria is necessary for sufficient development of intestinal immunity. The environmental determinant of adequate colonization is breast milk. Although a developing newborn is capable of producing an immune response, the effector immune component requires bacterial stimulation. Breast milk stimulates the proliferation of a well-balanced and diverse microbiota, which initially influences the switch from an intrauterine TH2 predominant to a TH1/TH2 balanced response and the activation of T-regulatory cells by breast milk-stimulated specific organisms (Bifidobacteria, Lactobacillus, and Bacteroides). Breastfeeding in newborns of mothers with diabetes mellitus regulates the adequate immune response of the newborn and prevents diseases of the neonatal and postnatal period.
Background: There, we review the pathogenesis of gestational diabetes mellitus (GDM), its influence on fetal physiology, and neonatal outcomes, as well as the usage of antenatal corticosteroid therapy (ACST) in pregnancies complicated by GDM. Methods: MEDLINE and PubMed search was performed for the years 1990–2022, using a combination of keywords on such topics. According to the aim of the investigation, appropriate articles were identified and included in this narrative review. Results: GDM is a multifactorial disease related to unwanted pregnancy course and outcomes. Although GDM has an influence on the fetal cardiovascular and nervous system, especially in preterm neonates, the usage of ACST in pregnancy must be considered taking into account maternal and fetal characteristics. Conclusions: GDM has no influence on neonatal outcomes after ACST introduction. The ACST usage must be personalized and considered according to its gestational age-specific effects on the developing fetus.
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