Gestational diabetes mellitus in women increased the risk of neonatal infection via inflammation and autophagy in the placenta

Li, Yi-xiao; Long, Denglu; Liu, Jia; Qiu, Di; Wang, Jingyun; Cheng, Xiulan; Yang, Xuesong; Li, Ruiman; Wang, Guang

doi:10.1097/md.0000000000022152

Cited by 56 publications

(39 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There was also a significantly higher BMI and incidence of GDM in the FIRS group than in the non‐FIRS group. The risk of GDM was positively associated with the pre‐pregnancy BMI, 23 and GDM led to an increase in the risk of intrauterine infection 24 …”

Section: Discussionmentioning

confidence: 97%

Amniotic fluid neutrophil gelatinase‐associated lipocalin and L‐type fatty acid‐binding protein in predicting fetal inflammatory response syndrome

Katsura

Tsuji

Hayashi

et al. 2021

J of Obstet and Gynaecol

View full text Add to dashboard Cite

Aim To analyze the effectiveness of amniotic fluid neutrophil gelatinase‐associated lipocalin and L‐type fatty acid‐binding protein as predictive factors for fetal inflammatory response syndrome. Methods We classified single pregnancy cases into the fetal inflammatory response syndrome and nonfetal inflammatory response syndrome groups. We collected amniotic fluid at vaginal delivery and cesarean section and compared the patient characteristics, maternal white blood cell count, C‐reactive protein level, and amniotic fluid interleukin‐6; neutrophil gelatinase‐associated lipocalin; and L‐type fatty acid‐binding protein levels between the groups. We further analyzed the relationship between L‐type fatty acid‐binding protein levels and neonatal clinical outcomes. Results We analyzed 129 pregnancies, of which 36 and 93 (27.9% and 72.1%, respectively) were classified into the fetal inflammatory response syndrome and nonfetal inflammatory response syndrome groups, respectively. We observed significant differences in the maternal white blood cell counts and amniotic fluid interleukin‐6 and neutrophil gelatinase‐associated lipocalin levels. On the multivariate analysis, the useful predictive factors were maternal white blood cell count and amniotic fluid interleukin‐6 and neutrophil gelatinase‐associated lipocalin levels. Furthermore, the level of L‐type fatty acid‐binding protein was significantly higher in the transient tachypnea of the newborn and postnatal respiratory support group than in the control group. Conclusions The maternal white blood cell count and amniotic interleukin‐6 and neutrophil gelatinase‐associated lipocalin levels were effective predictors of fetal inflammatory response syndrome. Amniotic fluid L‐type fatty acid‐binding protein level was an effective predictor of neonatal respiratory support.

show abstract

Section: Discussionmentioning

confidence: 97%

Amniotic fluid neutrophil gelatinase‐associated lipocalin and L‐type fatty acid‐binding protein in predicting fetal inflammatory response syndrome

Katsura

Tsuji

Hayashi

et al. 2021

J of Obstet and Gynaecol

View full text Add to dashboard Cite

show abstract

“…50 In contrast, Li et al examined cohorts of 22 pregnant patients with GDM compared to 28 pregnant patients without DM to investigate differences in growth parameters, placental changes including weight and inflammation, and neonatal outcomes. 51 The authors found that patients with a first-time diagnosis of GDM gave birth to neonates with higher rates of neonatal morbidity, including infection (18.1% in GDM vs. 0% in those without DM, P < .05) and hyperbilirubinemia (27.2% in GDM vs. 3.6% without DM, P < .05). 51 When they examined differences in inflammation between pregnant persons with GDM or without, they found significantly higher levels of inflammatory cytokines IL-6 and IL-8 in the gestating parent and cord blood (P < .05).…”

Section: Neonatal Infections Of Infants Exposed To Dm In Uteromentioning

confidence: 97%

“…51 The authors found that patients with a first-time diagnosis of GDM gave birth to neonates with higher rates of neonatal morbidity, including infection (18.1% in GDM vs. 0% in those without DM, P < .05) and hyperbilirubinemia (27.2% in GDM vs. 3.6% without DM, P < .05). 51 When they examined differences in inflammation between pregnant persons with GDM or without, they found significantly higher levels of inflammatory cytokines IL-6 and IL-8 in the gestating parent and cord blood (P < .05). 51 However, limitations of their study included a small sample size (∼50 pregnant patients), lack of consistency in defining neonatal infection, and exclusion of patients with chorioamnionitis and/or preterm rupture of membranes.…”

Section: Neonatal Infections Of Infants Exposed To Dm In Uteromentioning

confidence: 97%

“…51 When they examined differences in inflammation between pregnant persons with GDM or without, they found significantly higher levels of inflammatory cytokines IL-6 and IL-8 in the gestating parent and cord blood (P < .05). 51 However, limitations of their study included a small sample size (∼50 pregnant patients), lack of consistency in defining neonatal infection, and exclusion of patients with chorioamnionitis and/or preterm rupture of membranes.…”

Section: Neonatal Infections Of Infants Exposed To Dm In Uteromentioning

confidence: 99%

See 1 more Smart Citation

Group B streptococcal infection of the genitourinary tract in pregnant and non‐pregnant patients with diabetes mellitus: An immunocompromised host or something more?

Nguyen

Omage

Noble

et al. 2021

American J Rep Immunol

View full text Add to dashboard Cite

Group B Streptococcus (GBS), also known as Streptococcus agalactiae is a Gram-positive bacterium commonly encountered as part of the microbiota within the human gastrointestinal tract. A common cause of infections during pregnancy, GBS is responsible for invasive diseases ranging from urinary tract infections to chorioamnionitis and neonatal sepsis. Diabetes mellitus (DM) is a chronic disease resulting from impaired regulation of blood glucose levels. The incidence of DM has steadily increased worldwide to affecting over 450 million people. Poorly controlled DM is associated with multiple health comorbidities including an increased risk for infection. Epidemiologic studies have clearly demonstrated that DM correlates with an increased risk for invasive GBS infections, including skin and soft tissue infections and sepsis in non-pregnant adults. However, the impact of DM on risk for invasive GBS urogenital infections, particularly during the already vulnerable time of pregnancy, is less clear. We review the evolving epidemiology, immunology, and pathophysiology of GBS urogenital infections including rectovaginal colonization during pregnancy, neonatal infections of infants exposed to DM in utero, and urinary tract infections in pregnant and non-pregnant adults in the context of DM and highlight in vitro studies examining why DM might increase risk for GBS urogenital infection.

show abstract

“…Gestational diabetes mellitus (GDM) is the most common endocrine disease in pregnancy and, by definition, refers to diabetes mellitus disease first diagnosed during pregnancy (1)(2)(3)(4). In a normal pregnancy, some physiological changes, such as hyperinsulinemia, increased insulin sensitivity, and mild postprandial hyperglycemia, occur to meet the increasing needs of the mother and the baby, especially after the second trimester (5,6). If the patient's glucose metabolism before pregnancy is normal, the development of GDM stems from metabolic dysfunction (7,8).…”

Section: Introductionmentioning

confidence: 99%

A key challenge in gestational diabetes screening: resistance to oral glucose tolerance test screening and implications for neonatal health

Tursun

Yeral

Yıldız

et al. 2021

Journal of Health Sciences and Medicine

View full text Add to dashboard Cite

Objective: Gestational diabetes mellitus (GDM) is the most common endocrine disorder in pregnancy, and the number of pregnant women resistant to oral glucose tolerance test (OGTT) has increased significantly in recent years. In this study, we investigated the extent of resistance to OGTT screening among pregnant women followed-up in our hospital and the effects of this situation on the newborn. Materials and Method: We conducted this study with pregnant women and their babies who were regularly followed up in the Obstetrics and Gynecology Department and Pediatrics Department of our hospital between December 1, 2015, and December 31, 2017. While we included those who did not accept an OGTT in the study group (Group 1), and we created the control group with those who accepted the test. Besides, the control group was divided into two groups as those accepted as GDM (Group 2) and normal (Group 3). Ultimately, we scrutinized the relationship between the OGTT and clinicopathological findings. Results: We included a total of 906 pregnant women and their babies in the study. Of women, 374 (41.3%) did not accept the test. The cesarean (C/S) delivery rate was significantly lower in the babies of mothers who did not have an OGTT (p<0.05). In addition, the hospitalization rate of the newborn babies of mothers who had an OGTT but did not have gestational diabetes was significantly lower than the other two groups (p<0.05). Conclusion:Our study revealed that resistance to the OGTT was a far-reaching issue and may lead to an increase in the hospitalization of newborns. Our results suggested that the inability to perform OGTT may have been due to some unidentified problems.

show abstract

Gestational diabetes mellitus in women increased the risk of neonatal infection via inflammation and autophagy in the placenta

Abstract: Supplemental Digital Content is available in the text

Cited by 56 publications

References 52 publications

Amniotic fluid neutrophil gelatinase‐associated lipocalin and L‐type fatty acid‐binding protein in predicting fetal inflammatory response syndrome

Amniotic fluid neutrophil gelatinase‐associated lipocalin and L‐type fatty acid‐binding protein in predicting fetal inflammatory response syndrome

Group B streptococcal infection of the genitourinary tract in pregnant and non‐pregnant patients with diabetes mellitus: An immunocompromised host or something more?

A key challenge in gestational diabetes screening: resistance to oral glucose tolerance test screening and implications for neonatal health

Contact Info

Product

Resources

About