Perinatal Maternal and Neonatal Outcomes in Women With Gestational Diabetes Mellitus According to Fetal Sex

Tundidor, Diana; García‐Patterson, Apolonia; María, Miguel Angel María; Ubeda, Justa; Ginovart, Gemma; Adelantado, Juan M.; Leiva, Alberto de; Corcoy, Rosa

doi:10.1016/j.genm.2012.09.002

Cited by 28 publications

(27 citation statements)

References 29 publications

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“…This percentage is slightly higher than the 48% reported in a recent large retrospective survey (1981–2007) of 2,299 women with GDM in a population similar to ours using the same diagnostic criteria for GDM (16). The higher BMI (26.5 vs. 23.3) of our study population and the strict criteria applied to make changes in the prescribed diet until the primary objective of the study was reached could explain these differences.…”

Section: Discussioncontrasting

confidence: 69%

Low-Carbohydrate Diet for the Treatment of Gestational Diabetes Mellitus

et al. 2013

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OBJECTIVEMedical nutrition therapy based on the control of the amount and distribution of carbohydrates (CHO) is the initial treatment for gestational diabetes mellitus (GDM), but there is a need for randomized controlled trials comparing different dietary strategies. The purpose of this study was to test the hypothesis that a low-CHO diet for the treatment of GDM would lead to a lower rate of insulin treatment with similar pregnancy outcomes compared with a control diet.RESEARCH DESIGN AND METHODSA total of 152 women with GDM were included in this open, randomized controlled trial and assigned to follow either a diet with low-CHO content (40% of the total diet energy content as CHO) or a control diet (55% of the total diet energy content as CHO). CHO intake was assessed by 3-day food records. The main pregnancy outcomes were also assessed.RESULTSThe rate of women requiring insulin was not significantly different between the treatment groups (low CHO 54.7% vs. control 54.7%; P = 1). Daily food records confirmed a difference in the amount of CHO consumed between the groups (P = 0.0001). No differences were found in the obstetric and perinatal outcomes between the treatment groups.CONCLUSIONSTreatment of women with GDM using a low-CHO diet did not reduce the number of women needing insulin and produced similar pregnancy outcomes. In GDM, CHO amount (40 vs. 55% of calories) did not influence insulin need or pregnancy outcomes.

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Section: Discussioncontrasting

confidence: 69%

Low-Carbohydrate Diet for the Treatment of Gestational Diabetes Mellitus

et al. 2013

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“…However, our findings may be explained by exposure to GDM in utero , which previous studies had not investigated. Importantly, there is some evidence that exposure to GDM in utero affects offspring differently, depending on sex [21–23]. Given the possibility that GDM exposure could have sexually dimorphic consequences, our findings require further investigation and replication in other cohorts.…”

Section: Discussionmentioning

confidence: 83%

Exposure to maternal diabetes in utero and offspring eating behavior: The EPOCH study

et al. 2017

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The risk of becoming overweight among offspring exposed to gestational diabetes (GDM) in utero is two-fold higher than in the general population. The responsible mechanisms are likely multifactorial, with some evidence that GDM exposure alters brain satiety signaling, which may impact eating behavior. To better understand these effects, we investigated the relationship between GDM exposure, eating behavior, and total energy intake in 268 adolescents from the Exploring Perinatal Outcomes among Children cohort, who were exposed (n =50) or not exposed (n =217) to GDM in utero. Eating behavior was measured by the Eating in the Absence of Hunger in Children and Adolescents (EAH-C) questionnaire, which included subscale scores for Negative Affect, External Stimuli, and Fatigue/Boredom. Total energy intake (kcal/day) was derived from the Block Kid’s Food Questionnaire. The associations between GDM exposure and the outcomes of total score and each EAH-C subscale were evaluated in separate multivariable models. In addition to the main predictor, GDM, the models included a GDM-by-sex interaction term and were adjusted for important covariates. The associations between EAH-C total and subscale scores and the outcome of total energy intake were also tested in separate multivariable models. Female offspring exposed to GDM in utero (vs unexposed males and females) were more likely to continue eating beyond satiation due to feelings of boredom and fatigue (β =0.47, 95% CI: 0.11, 0.83), and in general (EAH-C total score; β =4.20, 95% CI: 0.56, 7.86) compared to unexposed males. All EAH-C subscale and total scores were significantly, positively associated with higher energy intake (p <0.05 for all, respectively). Our findings highlight the need for further investigation into the possible early life programming of eating behaviors by GDM exposure in utero.

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Section: Hypoglycemiamentioning

confidence: 95%

“…Another study found that a pre-pregnancy BMI greater than 25 kg/m2 in women with GDM also predicts neonatal hypoglycemia independent of maternal glucose concentrations [44]. Furthermore, male sex is found to be associated with neonatal hypoglycemia [45].Neonatal hypoglycemia is considered a risk factor for brain pathology and neurodevelopmental impairment in moderately preterm and term infants [46,47]. The frequency, rather than the severity of hypoglycemic episodes, predicts the adverse longterm effects.…”

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confidence: 99%

The First Sixty Minutes in Preterm Neonates’ Life: Predicted Morbidities and Interventions

El-Atawi¹

2018

JPNC

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Preterm neonates are more vulnerable to many diseases and complications than full-term infants as most of their biological systems are still underdeveloped. Fortunately, most of these morbidities are preventable as there are many interventions that could be performed in the first 60 minutes of neonatal life to avoid them and their long-term consequences, thus rightfully defining 'the golden hour'. The objective of this article is to review the potential morbidities that neonates might experience and understand their mechanisms, risk factors and its possible outcomes. We also reviewed the possible actions that could be implemented during the golden hour to prevent these morbidities and investigated their effectiveness. Medline and Cochrane database for systematic review were the main two electronic database that we used to search for studies. Studies pertaining to morbidities, such as hypothermia, hypoglycemia, respiratory distress, intraventricular hemorrhage (IVH), Chronic lung disease (CLD) and retinopathy of prematurity (ROP) have been selected according to their full text accessibility for us. Reports related to possible interventions that could be performed to prevent these morbidities have also been involved that include but not only restricted to drying & head coverings, polyethylene occlusive skin wraps, ambient room temperature, pre-warmed incubator, heated humidified gases, heated mattress and skin-to-skin contact for hypothermia; dextrose infusion pump, dextrose burette and oral dextrose for hypoglycemia; indomethacin, ibuprofen, antithrombin and heparin for IVH; surfactant and CPAP for respiratory distress; controlling oxygen saturation for ROP. Keywords: The First Sixty Minutes in Preterm Neonates' Life: Predicted Morbidities and Interventions 2/8Copyright: ©2018 El-Atawi et al. the relation between severe hypothermia (<32°C) and shortand long-term neurodevelopmental outcomes are required. Moderate hypothermia was found to be associated with severe intraventricular hemorrhage, intraventricular leukomalacia, and necrotizing enterocolitis. Yet, these associations should be analyzed carefully since they were based on studies with a wide confidence interval. More studies with larger sample size are warranted to accurately illustrate these associations [5]. Moreover, hypothermia increases oxygen consumption, thus leading to hypoxia and subsequently pulmonary vasoconstriction which, in turn, declines surfactant production and worsens respiratory distress. The presence of comorbidities with hypothermia increases the fatality rate, so adding a higher category to the severity of hypothermia would represent an effective addition to the WHO classification of the severity of hypothermia [8].Large surface area of neonates in relation to their small body weight makes them more vulnerable to hypothermia than fullterm babies. Preterm neonates have a higher transepidermal water loss than term due to their immature epidermal layer [9]. Their premature vasomotor control which acts as a thermoregulatory mec...

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Perinatal Maternal and Neonatal Outcomes in Women With Gestational Diabetes Mellitus According to Fetal Sex

Cited by 28 publications

References 29 publications

Low-Carbohydrate Diet for the Treatment of Gestational Diabetes Mellitus

Low-Carbohydrate Diet for the Treatment of Gestational Diabetes Mellitus

Exposure to maternal diabetes in utero and offspring eating behavior: The EPOCH study

The First Sixty Minutes in Preterm Neonates’ Life: Predicted Morbidities and Interventions

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