Time and mode of delivery in diabetic pregnancy: a review

Kapustin, Roman V.; Arzhanova, Olga N.; Alekseenkova, Elena N.; Глотов, А. С.

doi:10.1080/09513590.2020.1816718

Cited by 5 publications

(5 citation statements)

References 48 publications

(68 reference statements)

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“…While prevalence of adverse birth outcomes among WLWH-GD from 2010-2014 to 2015-2020 declined, stillbirth, preterm delivery and CS remained more common among WLWH-GD than WLWH-C. These findings are comparable to results from studies in the general population that indicate that women who develop GD in pregnancy are more likely to have a preterm delivery [64] and have a CS [65], partly due to fetal macrosomia [66]. The CS rate in our study was similar to the general population in other high-income countries, but the preterm delivery and stillbirth rate were greater [67].…”

Section: Table 2 Selected Outcomes Of Pregnancies Affected By Gestati...supporting

confidence: 59%

Gestational diabetes in women living with HIV in the UK and Ireland: insights from population‐based surveillance data

et al. 2023

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Introduction The prevalence of gestational diabetes (GD) is increasing globally. While universal risk factors for GD are reasonably well understood, questions remain regarding risks for women living with HIV (WLWH). We aimed to describe GD prevalence, evaluate associated maternal risk factors and assess specific birth outcomes in WLWH in the UK and Ireland. Methods We analysed all pregnancies (≥24 weeks’ gestation) in women diagnosed with HIV before delivery, reported to the UK‐based Integrated Screening Outcomes Surveillance Service between 2010 and 2020. Every report of GD was considered as a case. A multivariable logistic regression model, adjusted for women with more than one pregnancy fitted with generalized estimating equations (GEE) assessed the effect of independent risk factors. Results There were 10,553 pregnancies in 7916 women, of which 460 (4.72%) pregnancies had reported GD. Overall, the median maternal age was 33 years (Q1:29–Q3:37), and 73% of pregnancies were in Black African women. WLWH with GD (WLWH‐GD) were older (61% vs. 41% aged ≥35 years, p < 0.001) and more likely to be on treatment at conception (74% vs. 64%, p < 0.001) than women without GD. WLWH‐GD were more likely to have a stillbirth (odds ratio [OR]: 5.38, 95% CI: 2.14–13.5), preterm delivery (OR: 2.54, 95% CI: 1.95–3.32) and fetal macrosomia (OR: 1.14, 95% CI: 1.04–1.24). Independent risk factors for GD included estimated year of delivery (GEE‐adjusted odds ratio [GEE‐aOR]: 1.14, 95% CI: 1.10–1.18), advanced maternal age (≥35 years) (GEE‐aOR: 2.87, 95% CI: 1.54–5.34), Asian (GEE‐aOR: 2.63, 95% CI: 1.40–4.63) and Black African (GEE‐aOR: 1.55, 95% CI: 1.13–2.12) ethnicity. Timing and type of antiretroviral therapy showed no evidence of a relationship with GD in multivariable analyses; however, women with a CD4 count ≤350 cells/μl were 27% less likely to have GD than women with CD4 counts >350 cells/μl (GEE‐aOR: 0.73, 95% CI: 0.50–0.96). Conclusions GD prevalence increased over time among WLWH but was not significantly different from the general population. Maternal age, ethnicity and CD4 count were risk factors based on available data. Stillbirth and preterm delivery were more common in WLWH‐GD than other WLWH over the study period. Further studies are required to build upon these results.

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Section: Table 2 Selected Outcomes Of Pregnancies Affected By Gestati...supporting

confidence: 59%

Gestational diabetes in women living with HIV in the UK and Ireland: insights from population‐based surveillance data

et al. 2023

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“…Kapustin and others said that the effectiveness of the treatment can be judged by the regularity of the patient's menstrual cycle and menstrual color, in which case complete recovery to normal is significant, significant improvement is effective, and no significant effect is ineffective [ 1 ]. Prsa and Serdinsek believe that gynecological endocrine disorder is a common disease in clinical diagnosis.…”

Section: Literature Reviewmentioning

confidence: 99%

[Retracted] Application of Color Ultrasound in the Diagnosis of Gynecological Endocrine Disorders and Study of Ultrasonic Image Characteristics

Zhang

Xiao³

2022

Contrast Media & Molecular Imaging

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In order to study gynecological endocrine disorders, color ultrasound and image examination were used for in-depth study. After examining the clinical significance, research methods, strengthening treatment measures, and adjusting physical and mental health, the research and examination of endocrine disorders under ultrasound and ultrasound images are successfully analyzed. Endocrine is like a woman’s umbrella. When it is in harmony with the body, it will make women as beautiful as flowers. Once it becomes an endocrine disorder, it will cause a lot of trouble to women. According to the statistics of a magazine, the incidence of facial chloasma in young and middle-aged women is 28.2%; breast cancer in women over 30 years old has a breast mass of 38.8–49.3%, of which 1–2% may be converted to breast cancer. For the treatment of patients with gynecological endocrine disorders, we mainly use simple western medicine, but the curative effect is not ideal. The rehabilitation speed of patients is relatively slow, which has certain treatment limitations. After the ultrasound research on endocrine disorders, the ultrasound can not only determine the female endocrine function but also diagnose diseases related to endocrine disorders, which basically meets the general understanding of clinicians on the screening of endocrine disorders and physiological functions.

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“…Deciding when and how to deliver is complex, striving towards keeping the fetus in the womb until term versus risks of severe fetal complications. 29 In this study, the 90th percentile for GA at birth declined over time, and risks of induced preterm delivery demonstrated a small, but statistically significant increase over time which may reflect a more active obstetric approach.…”

Section: % Preterm Birthmentioning

confidence: 55%

“…There is no generally accepted consensus on optimal timing of delivery in pregnancies with type 1 diabetes, but most national guidelines suggest induction of delivery or elective Caesarean section between 37 and 39 gestational weeks in case of no fetal or maternal complications. Deciding when and how to deliver is complex, striving towards keeping the fetus in the womb until term versus risks of severe fetal complications 29 . In this study, the 90th percentile for GA at birth declined over time, and risks of induced preterm delivery demonstrated a small, but statistically significant increase over time which may reflect a more active obstetric approach.…”

Section: Discussionmentioning

confidence: 70%

Preterm delivery and maternal obesity remain common complications in pregnancies with type 1 diabetes—A nationwide study in Sweden

Sandin,

Järnbert‐Pettersson,

Persson

2024

Diabet Med

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AimA primary goal of obstetric care of women with type 1 diabetes (T1D) is to reduce the risks of preterm birth (PTB). Besides hyperglycaemia, maternal obesity is an important risk factor for PTB in T1D. However, it's unclear if public health efforts decreased risks of maternal obesity and PTB in pregnancies with T1D. We examined time‐trends over the last 20 years in the distribution of gestational ages at birth (GA) in offspring of women with T1D in Sweden, and in maternal BMI in the same mothers.MethodsPopulation‐based cohort study, using data from national registries in Sweden. To capture differences not only in the median values, we used quantile regression models to compare the whole distributions of GA's and early pregnancy BMI between deliveries in 1998–2007 (P1) and 2008–2016 (P2). Multivariable models were adjusted for differences in maternal age, smoking and education between periods 1 and 2.ResultsThe study included 7639 offspring of women with T1D between 1998 and 2016. The 10% percentile GA, increased with 0.09 days (95% CI: −0.11 to 0.35) between P1 and P2. The 90% percentile for BMI was 1.20 kg/m2 higher (95% CI: 0.57 to 1.83) in P2. Risks of PTB remained stable over time also when adjusting for maternal BMI.ConclusionDespite modern diabetes management, the distribution of GA, and consequently the risk of PTB in T1D, remained unchanged from 1998 to 2016. During the same time, maternal BMI increased, particularly in the already obese.

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Time and mode of delivery in diabetic pregnancy: a review

Cited by 5 publications

References 48 publications

Gestational diabetes in women living with HIV in the UK and Ireland: insights from population‐based surveillance data

Gestational diabetes in women living with HIV in the UK and Ireland: insights from population‐based surveillance data

[Retracted] Application of Color Ultrasound in the Diagnosis of Gynecological Endocrine Disorders and Study of Ultrasonic Image Characteristics

Preterm delivery and maternal obesity remain common complications in pregnancies with type 1 diabetes—A nationwide study in Sweden

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