Analysis on the Impact of the Blood Sugar Control Levels of Gestational Diabetes Mellitus on the Maternal and Infant Outcomes

Abstract BackgroundPostpartum depression (PPD) negatively affects the health of new mothers and can impair infant development. Both labor pain and gestational diabetes mellitus (GDM) are potential risk factors for PPD. However, the effects of epidural labor analgesia in parturients with GDM on PPD and maternal and infant outcomes have not been characterized.MethodsParturients with GDM in our hospital were assigned to the epidural group (n = 133) and no epidural (control) group (n = 130) according to their choice to receive epidural labor analgesia. The Edinburgh Postnatal Depression Scale (EPDS) was used to evaluate maternal mental status at 24 h and 42 days postpartum. Data for relative variables in the perinatal period were collected, and the potential associations of epidural analgesia with PPD and maternal and infant outcomes were analyzed by univariate analysis and multivariate logistic regression analyses.ResultsEpidural analgesia was a protective factor for PPD at 24 h postpartum (odds ratio [OR], 0.301, 95% confidence interval [CI]: 0.104–0.867, p < 0.05), and the EPDS score at 24 h post-delivery showed significant correlation with that at 42 days post-delivery (Pearson correlation coefficient = 0.527, p < 0.001). The rate of neonatal admission to the neonatal intensive care unit (NICU) for hypoglycemia was higher in the epidural group (6.92%) than in the control group (1.50%; p < 0.05). Epidural analgesia and drug-based diabetes control were independent predictors of the rate of neonate transfer to the NICU for hypoglycemia.ConclusionEpidural analgesia was a protective factor for PPD at 24 h postpartum, but associated with an increased risk of neonatal transfer to the NICU for hypoglycemia. Thus, monitoring of neonatal blood glucose levels after administration of epidural analgesia in parturients with GDM may be beneficial.Clinical Trial Registrationthe study was registered in the China Clinical Registration Center (URL: http://www.chictr.org.cn/listbycreater.aspx, Registration No. ChiCTR-OOC-17013164)

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Gestational Diabetes Mellitus and Infant Adiposity at Birth: A Systematic Review and Meta-Analysis of Therapeutic Interventions

Journal of Clinical Medicine ◽

10.3390/jcm10040835 ◽

2021 ◽

Vol 10 (4) ◽

pp. 835

Author(s):

Manoja P. Herath ◽

Jeffrey M. Beckett ◽

Andrew P. Hills ◽

Nuala M. Byrne ◽

Kiran D. K. Ahuja

Keyword(s):

Diabetes Mellitus ◽

Adipose Tissue ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Fat Mass ◽

Metabolic Disorders ◽

Later Life ◽

Therapeutic Interventions ◽

Increased Risk ◽

The Impact

Exposure to untreated gestational diabetes mellitus (GDM) in utero increases the risk of obesity and type 2 diabetes in adulthood, and increased adiposity in GDM-exposed infants is suggested as a plausible mediator of this increased risk of later-life metabolic disorders. Evidence is equivocal regarding the impact of good glycaemic control in GDM mothers on infant adiposity at birth. We systematically reviewed studies reporting fat mass (FM), percent fat mass (%FM) and skinfold thicknesses (SFT) at birth in infants of mothers with GDM controlled with therapeutic interventions (IGDMtr). While treating GDM lowered FM in newborns compared to no treatment, there was no difference in FM and SFT according to the type of treatment (insulin, metformin, glyburide). IGDMtr had higher overall adiposity (mean difference, 95% confidence interval) measured with FM (68.46 g, 29.91 to 107.01) and %FM (1.98%, 0.54 to 3.42) but similar subcutaneous adiposity measured with SFT, compared to infants exposed to normal glucose tolerance (INGT). This suggests that IGDMtr may be characterised by excess fat accrual in internal adipose tissue. Given that intra-abdominal adiposity is a major risk factor for metabolic disorders, future studies should distinguish adipose tissue distribution of IGDMtr and INGT.

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Gestational Diabetes Mellitus Treatment Schemes Modify Maternal Plasma Cholesterol Levels Dependent to Women´s Weight: Possible Impact on Feto-Placental Vascular Function

Nutrients ◽

10.3390/nu12020506 ◽

2020 ◽

Vol 12 (2) ◽

pp. 506 ◽

Cited By ~ 1

Author(s):

Susana Contreras-Duarte ◽

Lorena Carvajal ◽

María Jesús Garchitorena ◽

Mario Subiabre ◽

Bárbara Fuenzalida ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Vascular Function ◽

Plasma Cholesterol ◽

Umbilical Vein ◽

Maternal Plasma ◽

Maternal Weight ◽

Cholesterol Levels ◽

The Impact

Gestational diabetes mellitus (GDM) associates with fetal endothelial dysfunction (ED), which occurs independently of adequate glycemic control. Scarce information exists about the impact of different GDM therapeutic schemes on maternal dyslipidemia and obesity and their contribution to the development of fetal-ED. The aim of this study was to evaluate the effect of GDM-treatments on lipid levels in nonobese (N) and obese (O) pregnant women and the effect of maternal cholesterol levels in GDM-associated ED in the umbilical vein (UV). O-GDM women treated with diet showed decreased total cholesterol (TC) and low-density lipoproteins (LDL) levels with respect to N-GDM ones. Moreover, O-GDM women treated with diet in addition to insulin showed higher TC and LDL levels than N-GDM women. The maximum relaxation to calcitonin gene-related peptide of the UV rings was lower in the N-GDM group compared to the N one, and increased maternal levels of TC were associated with even lower dilation in the N-GDM group. We conclude that GDM-treatments modulate the TC and LDL levels depending on maternal weight. Additionally, increased TC levels worsen the GDM-associated ED of UV rings. This study suggests that it could be relevant to consider a specific GDM-treatment according to weight in order to prevent fetal-ED, as well as to consider the possible effects of maternal lipids during pregnancy.

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Fetal Sex and Maternal Risk of Gestational Diabetes Mellitus: The Impact of Having a Boy

Diabetes Care ◽

10.2337/dc14-2551 ◽

2015 ◽

Vol 38 (5) ◽

pp. 844-851 ◽

Cited By ~ 59

Author(s):

Ravi Retnakaran ◽

Caroline K. Kramer ◽

Chang Ye ◽

Simone Kew ◽

Anthony J. Hanley ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Fetal Sex ◽

Maternal Risk ◽

The Impact

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Using Resistance Training in Women with Gestational Diabetes Mellitus to Improve Glucose Regulation

10.5772/intechopen.101076 ◽

2021 ◽

Author(s):

Brittany R. Allman ◽

Samantha McDonald ◽

Linda May ◽

Amber W. Kinsey ◽

Elisabet Børsheim

Keyword(s):

Diabetes Mellitus ◽

Resistance Training ◽

Glycemic Control ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Type Ii Diabetes Mellitus ◽

Glucose Regulation ◽

Pharmacological Treatments ◽

Short And Long Term ◽

The Impact

Gestational diabetes mellitus (GDM) poses a significant threat to the short- and long-term health of the mother and baby. Pharmacological treatments for GDM do not fully correct the underlying problem of the disease; however, non-pharmacological treatments such as exercise are increasingly recognized as foundational to glycemic management in other populations with disordered glucose regulation, such as non-gravid women with type II diabetes mellitus (T2DM). Much of the research regarding the impact of exercise on glycemic control in T2DM leverages aerobic training as the primary modality; yet research has demonstrated the effectiveness of resistance training on improving glycemic control in T2DM. This chapter will review the rationale for resistance training in the management of GDM using evidence from individuals with T2DM; then the chapter will review available studies on the effectiveness of resistance training on glucose control in women with GDM.

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The Effect of Oat Bran Supplement on Fasting Blood Sugar and Glycosylated Hemoglobin in Patients with Gestational Diabetes Mellitus: Single-blind Randomized Clinical Trial

Journal of Nutrition and Food Security ◽

10.18502/jnfs.v4i1.395 ◽

2019 ◽

Author(s):

Maedeh Shahzeidi ◽

Azadeh Nadjarzadeh ◽

Masoud Rahmanian ◽

Amin Salehi Abarghuoei ◽

Hossein Fallahzadeh ◽

...

Keyword(s):

Diabetes Mellitus ◽

Clinical Trial ◽

Weight Gain ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Blood Sugar ◽

Glycosylated Hemoglobin ◽

Oat Bran ◽

Single Blind ◽

Hba1c Levels

Background: Gestational diabetes mellitus (GDM) is known as a degree of glucose intolerance that occurs for the first time during pregnancy. There is paucity of evidence regarding the effect of oat bran on GDM. Oat as a source of β-glucan can be effective in reducing the blood sugar levels. This study aimed to investigate the effect of oat bran on fasting blood sugar (FBS) and glycosylated hemoglobin (HbA1c) in patients with GDM. Method: This single-blind clinical trial was conducted on 90 pregnant women with GDM. The experimental group (EG) consumed 30 g of oat bran daily with 100 g of low-fat yogurt before lunch and dinner for 4 weeks. The control group (CG) consumed only low-fat yogurt and both groups received nutrition counseling. The present study investigated the FBS, HbA1c, and weight gain at the beginning and after four weeks of intervention. Results: Out of 90 patients, 80 completed the study. FBS decreased in the EG (P = 0.04, -2.75 ± 8.22), whereas, it increased in the CG (P = 0.003, 4.37 ± 8.72). No significant difference was observed between the two groups in terms of HbA1c levels. Weight gain was controlled more efficiently in the EG than the CG (P = 0.001). Conclusion: The use of oat bran for four weeks decreased the FBS,; whereas, it did not affect HbA1c levels. Weight gain was controlled better in the EG than the CG.

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Risk factor for gestational diabetes mellitus and impact of gestational diabetes mellitus on maternal and fetal health during the antenatal period

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20213169 ◽

2021 ◽

Author(s):

Uma Jain ◽

Kusumlata Singhal ◽

Shikha Jain ◽

Deepali Jain

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Congenital Malformation ◽

Fetal Health ◽

Antenatal Period ◽

Study Results ◽

History Of ◽

The Impact

Background: Gestational diabetes mellitus (GDM) is defined as any degree of dysglycaemia that occurs for the first time or is first detected during pregnancy. The adverse effects of GDM on pregnant women are pre-eclampsia, PIH, PPH, polyhydramanios, PROM, meanwhile, there would be an increase in dystocia, birth injury, and cesarean sectionMethods: This retrospective study was conducted in a Gynecology clinic in District Shivpuri to find out the various risk factors for GDM and to evaluate the impact of GDM on maternal and fetal health during the antenatal period. 84 patients who were diagnosed with GDM were included in the study. Results: Among risk factors; BMI >25 kg/m2 before pregnancy was found in 15.47% of the case, family history of diabetes mellitus 8.33%, Previous history of macrosomia 17.85%, Poor reproductive history 17.85%, baby with congenital malformation 8.33%, H/o unexplained IUFD 11.90%. H/o polyhydramnios 15.47%. History of PCOS 13.09% and preeclampsia was found in 17.85% of cases. In antenatal complications; miscarriages was found in 15.47%. polyhydramnios in 17.85%. Oligohydramnios in 8.33%, preterm labor in 11.90%, PROM in 9.52%, pre-eclampsia in 17.85%, sudden IUFD in 8.33% and congenital malformation was found in 4.76% of cases. On USG; IUGR was found in 7.14% of cases. Large for date fetus in 16.66% of cases and the normal growth was found in 76.19% of cases.Conclusions- In conclusion appropriate and timely diagnosis and treatment of GDM will result in decreased maternal and neonatal adverse outcomes comparable to general population rates, therefore, early diagnosis is important.

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The impact of restricted gestational weight gain by dietary intervention on fetal growth in women with gestational diabetes mellitus

Diabetologia ◽

10.1007/s00125-018-4736-6 ◽

2018 ◽

Vol 61 (12) ◽

pp. 2528-2538 ◽

Cited By ~ 9

Author(s):

Lise L. Kurtzhals ◽

Sidse K. Nørgaard ◽

Anna L. Secher ◽

Vibeke L. Nichum ◽

Helle Ronneby ◽

...

Keyword(s):

Diabetes Mellitus ◽

Weight Gain ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Gestational Weight Gain ◽

Fetal Growth ◽

Dietary Intervention ◽

Gestational Weight ◽

The Impact

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