Prior breastfeeding experience and infant feeding at discharge among women with pregestational diabetes mellitus

2020 ◽  
Vol 13 (4) ◽  
pp. 563-570 ◽  
Author(s):  
L. Cordero ◽  
M.R. Stenger ◽  
S.D. Blaney ◽  
M.M. Finneran ◽  
C.A. Nankervis
Keyword(s):  
Diabetes Mellitus ◽  
Infant Feeding ◽  
Mode Of Delivery ◽  
Feeding Preference ◽  
Pregestational Diabetes ◽  
First Feeding ◽  
Multiparous Women ◽  
Nicu Admission ◽  
Living Children ◽  
Exclusive Or

OBJECTIVE: To compare multiparous women with pregestational diabetes mellitus (PGDM) with and without prior breastfeeding (BF) experience and to ascertain their infants’ feeding type during hospitalization and at discharge. METHODS: A retrospective cohort study of 304 women with PGDM who delivered at ≥34 weeks gestational age (GA). Prior BF experience and infant feeding preference was declared prenatally. At discharge, BF was defined as exclusive or partial. RESULTS: BF experience and no experience groups were similar in diabetes type 1 and 2, race and number of pregnancies. Women with no experience had more spontaneous abortions (35 vs 27%), fewer term deliveries (51 vs 61%) and living children (median 1 vs 2). In the current pregnancy, mode of delivery: vaginal (36 & 37%), cesarean (64 & 63%), birthweight (3592 & 3515 g), GA (38 & 37 w), NICU admission (14 & 11%) and hypoglycemia (44 & 43%) were similar. Women with experience intended to BF (79 vs 46%), their infants’ first feeding was BF (64 vs 36%) and had lactation consults (96 vs 63%) more often than those without experience. At discharge, women with BF experience were different in rate of exclusive BF (33 vs 11%), partial BF (48 vs 25%) and formula feeding (19 vs 64%). CONCLUSION: Prior BF experience leads to better BF initiation rates while the absence of BF experience adds a risk for BF initiation failure. A detailed BF history could provide insight into obstacles that lead to unsuccessful BF experiences and may help define appropriate preventive or corrective strategies.

Breastfeeding initiation among women with chronic hypertension superimposed on pregestational diabetes mellitus

2021 ◽  
pp. 1-7
Author(s):  
L. Cordero ◽  
M.R. Stenger ◽  
M.B. Landon ◽  
C.A. Nankervis
Keyword(s):  
Diabetes Mellitus ◽  
Retrospective Cohort ◽  
Chronic Hypertension ◽  
Breastfeeding Initiation ◽  
Neonatal Hypoglycemia ◽  
Pregestational Diabetes ◽  
Targeted Interventions ◽  
Expressed Breast Milk ◽  
Nicu Admission ◽  
Exclusive Or

OBJECTIVE: To compare breastfeeding (BF) initiation among 317 women with chronic hypertension (CHTN) and 106 women with CHTN superimposed on pregestational diabetes (CHTN-DM) who intended exclusive or partial BF. METHODS: Retrospective cohort study of women who delivered at≥34 weeks of gestation. At discharge, exclusive BF was defined by direct BF or BF complemented with expressed breast milk (EBM), partial BF was defined by formula supplementation. RESULTS: CHTN and CHTN-DM groups were similar in prior BF experience (42 vs 52%), intention to BF exclusively (89 vs 79%) and intention to partially BF (11 vs 21%). Women in the CHTN group were younger (31 vs 33y), more likely primiparous (44 vs 27%), and who delivered vaginally (59 vs 36%) at term (85 vs 75%). Women in the CHTN-DM group had higher repeat cesarean rates (32 vs 18%), preterm birth (25 vs 15%), neonatal hypoglycemia (42 vs 14%) and NICU admission (38 vs 16%). At discharge, exclusive BF rates among CHTN was higher (48 vs 19%), while rates of partial BF (34 vs 44%) and FF (18 vs 37%) were lower than in the CHTN-DM group. BF initiation (exclusive plus partial BF) occurred in 82%of CHTN and in 63%of CHTN-DM. CONCLUSION: Although intention to BF was similar, BF initiation rates were higher for the CHTN compared to the CHTN-DM group. Exclusive BF was low in the CHTN and even lower in the CHTN-DM group signaling the need for targeted interventions if BF initiation rates are to be improved.

Lack of Evidence Linking Infant Feeding Regimen and Type 1 or Type 2 Diabetes Mellitus

PEDIATRICS ◽  
2016 ◽  
Vol 137 (Supplement 3) ◽  
pp. 237A-237A
Author(s):  
Robin S. Feldman ◽  
Michael Falk ◽  
Kathy A. Grako ◽  
Dawn A. Groenke ◽  
Allison Cooke ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Infant Feeding ◽  
Feeding Regimen

scholarly journals Women’s empowerment and elective cesarean section for a single pregnancy: a population-based and multivariate study in Vietnam

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Myriam de Loenzien ◽  
Quoc Nhu Hung Mac ◽  
Alexandre Dumont
Keyword(s):  
Cesarean Section ◽  
Partner Violence ◽  
Negative Impact ◽  
Mode Of Delivery ◽  
Women's Empowerment ◽  
Women’S Empowerment ◽  
Elective Cesarean Section ◽  
Multiparous Women ◽  
Elective Cesarean ◽  
Primiparous Women

Abstract Background Women’s empowerment, and maternal and neonatal health are important targets of the Sustainable Development Goals. Our objective is to examine the relationship between women’s empowerment and elective cesarean section (ECS), focusing on Vietnam, a country where the use of CS has increased rapidly in recent decades, which raises public health concerns. Methods We hypothesized that in the context of the developing biomedicalization of childbirth, women’s empowerment increases the use of ECS due to a woman’s enhanced ability to decide her mode of delivery. By using microdata from the 2013–2014 Multiple Indicator Clusters Survey, we conducted a multivariate analysis of the correlates of ECS. We studied a representative sample of 1343 institutional single birth deliveries. Due to higher ECS rates among multiparous (18.4%) than primiparous women (10.1%) and the potential interaction between parity and other correlates, we used separate models for primiparous and multiparous women. Results Among the indicators of women’s external resources, which include a higher level of education, having worked during the previous 12 months, and having one’s own mobile phone, only education differed between primiparous and multiparous women, with a higher level among primiparous women. Among primiparous women, no resource indicator was significantly linked to ECS. However, considering women’s empowerment facilitated the identification of the negative impact of having had fewer than 3 antenatal care visits on the use of ECS. Among multiparous women, disapproval of intimate partner violence (IPV) was associated with a doubled likelihood of undergoing ECS (odds ratio = 2.415), and living in an urban area also doubled the likelihood of ECS. The positive association with living in the richest household quintile was no longer significant when attitude towards IPV was included in the model. In both groups, being aged 35 or older increased the likelihood of undergoing ECS, and this impact was stronger in primiparous women. Conclusions These results underline the multidimensionality of empowerment, its links to other correlates and its contribution to clarifying the influence of these correlates, particularly for distinguishing between medical and sociocultural determinants. The results advocate for the integration of women's empowerment into policies aimed at reducing ECS rates.

Lactation Consultation by an International Board Certified Lactation Consultant Improves Breastfeeding Rates for Mothers With Gestational Diabetes Mellitus

2021 ◽  
pp. 089033442110186
Author(s):  
Laurie Beth Griffin ◽  
Jia Jennifer Ding ◽  
Phinnara Has ◽  
Nina Ayala ◽  
Martha B. Kole-White
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Gestational Diabetes ◽  
Hospital Discharge ◽  
Exclusive Breastfeeding ◽  
Secondary Analysis ◽  
Feeding Preference ◽  
Lactation Consultant ◽  
Breastfeeding Rates

Background In patients with gestational diabetes, breastfeeding decreases the lifetime risk of Type 2 diabetes by half. Lactation consultation has been shown to increase breastfeeding rates in the general population but has not been assessed in a gestational diabetes population. Research Aims To determine if (1) a postpartum International Board Certified Lactation Consultant (IBCLC) consultation during delivery hospitalization improved inclusive (any) or exclusive breastfeeding rates at hospital discharge and 3 months postpartum in participants with GDM; and if (2) obstetrical providers’ acknowledgement of maternal feeding preference affected the rates of IBCLC consultation for patients. Methods This was a retrospective, comparative, secondary analysis of a prospective cohort ( N = 517) study of women gestational diabetes. Participants who received a IBCLC consultation ( n = 386; 74.5%) were compared to those who did not ( n = 131; 25.5%). Baseline demographics, antepartum characteristics, neonatal information, mode of infant feeding at hospital discharge and 3 months postpartum, and IBCLC consultation during postpartum hospitalization were measured. Results After adjusting for baseline differences, participants who received an IBCLC consultation were more likely to report any breastfeeding at postpartum discharge (aOR 4.87; 95% CI [2.67, 8.86]) and at 3 months postpartum (aOR 5.39; 95% CI [2.61, 11.16]) compared to participants who did not. However, there was no difference in exclusive breastfeeding rates between those who did and did not receive IBCLC consultation. Conclusion Inpatient IBCLC consultation during the immediate postpartum period was associated with improved rates of any breastfeeding in participants with GDM.

Gestational diabetes mellitus: Beliefs, emotions and treatment compliance: A Pakistani Cohort.

2021 ◽  
Vol 28 (03) ◽  
pp. 361-365
Author(s):  
Maryam Zulfiqar ◽  
Muhammad Imran Hasan Khan ◽  
Salman Shakeel ◽  
Usama Azhar
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Mode Of Delivery ◽  
Treatment Compliance ◽  
Subsequent Pregnancy ◽  
Medical Institute ◽  
Lifestyle Modifications ◽  
Diabetes Clinic ◽  
Adverse Pregnancy

To find out the factors regarding patient’s beliefs and concerns about Gestational Diabetes and its treatment. Study Design: Purposive Sampling. Setting: Diabetes Clinic & Antenatal Clinic of Lahore General Hospital/ Post Graduate Medical Institute/ Ameer ud Din Medical College, Lahore. Period: July 2019 to December 2019. Material & Methods: 46 females who were 24-38 weeks pregnant and having gestational diabetes mellitus, type1 diabetes mellitus or having type 2 diabetes mellitus first diagnosed during pregnancy were enrolled. Data was collected by an interview based questionnaire, analyzed using SPSS version 23, and 95% confidence interval was used as test of significance. Results: The mean age was 27±9 years. 20% of the participants were Illiterate 80% were literate. GDM in the all three trimesters was 45.6%, 39% and15% respectively.  30.5% were hypertensive and 100% adopted lifestyle modifications, 89% were using insulin and 10.8% were taking metformin. 33% had history of instruments delivery and 36% had adverse pregnancy or perinatal outcomes. Regarding patients belief’s, 10% believed in diet control, 26% were not comfortable with lab and physician’s counselling, 38% were in state of denial, 26% were unaware of screening, 70% were frightened of unexpected diagnosis and consequences. 18% were concerned of target organs damage, 16% were concerned of mode of delivery, 25% regarding subsequent pregnancy, 53% were concerned about insulin treatment and its duration and 33% were keen to know about adverse pregnancy outcomes. Conclusions: Educational status is not known to influence gestational diabetes mellitus, Major concern of patient with GDM was her health and surroundings, treatment options, adverse effect on baby and subsequent pregnancies outcomes.

scholarly journals Sutureless elastic ring silo for the gastroschisis

2010 ◽  
Vol 4 (5) ◽  
pp. 747-755 ◽  
Author(s):  
Piyawan Chiengkriwate ◽  
Surasak Sangkhathat ◽  
Sakda Patrapinyokul ◽  
Vorapong Chowchuvech ◽  
Waricha Janjindamai ◽  
...  
Keyword(s):  
Operative Time ◽  
Primary Repair ◽  
Demographic Data ◽  
Mode Of Delivery ◽  
Length Of Hospital Stay ◽  
Elastic Ring ◽  
First Feeding ◽  
Closure Duration ◽  
Abdominal Content ◽  
Average Operative Time

Abstract Background: The definitive surgical management of gastroschisis is the return of the eviscerated abdominal content into the abdomen as soon as possible. Objectives: Assess the efficacy of using a sutureless elastic ring silo (SERS) for the management of gastroschisis. Methods: Neonates with gastroschisis were enrolled at Songklanagarind Hospital between January 2006 and December 2008. A primary repair (PR) was attempted in all cases. If this was not possible due to concerns about abdominal compartment syndrome, a stage abdominal closure with a silo pouch was fashioned: a traditional silo (TS) or SERS. When the bowel was completely reduced, a second-stage closure was performed in the operating room. Data collected included general demographic data, size of defect, associated anomalies, hospital course, mode of gastroschisis closure, duration of parenteral nutrition (PN) and ventilator, first feeding age, complications, and length of hospital stay (LOS). Results: Twenty-nine children with gastroschisis were treated (PR: 9, TS: 9, and SERS: 11). There were no differences (p >0.05) concerning gender, mode of delivery, APGAR scores, gestational age, birth weight, or defect size. A preformed silo was employed in 20 of 29 cases, TS in nine (31%), and SERS in 11 (38%) cases in an average operative time of 80.6 and 40 minutes, respectively, a significantly shorter operative time in the SERS (p =0.007). Overall, there were no differences (p >0.05) concerning duration of ventilator support (10.2 days), duration of PN (21.3 days), first feeding age (15 days), LOS (26.5 days), and complication. Conclusion: The use of a sutureless elastic ring silo with readily available inexpensive materials is simple, safe and efficacious in our setting.

scholarly journals Analysis of Risk Factors and Perinatal Mortality Structure in Pregnant Patients with Diabetes Mellitus

Doctor Ru ◽  
2021 ◽  
Vol 20 (6) ◽  
pp. 46-52
Author(s):  
R.V. Kapustin ◽  
◽  
E.V. Kopteeva ◽  
E.N. Alexeenkova ◽  
E.M. Tsybuk ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Perinatal Mortality ◽  
Perinatal Death ◽  
Mode Of Delivery ◽  
Overweight And Obesity ◽  
Study Objective ◽  
Study Materials ◽  
Study Results ◽  
Patients With Diabetes

Study Objective: To analyse risk factors and perinatal mortality structure in patients with various types of diabetes mellitus (DM) over the last 30 years in specialised settings. Study Design: retrospective single-site cohort study. Materials and Methods. We have studied 42 medical records containing cases of perinatal death of foetus or newborn in 1988–2018 in patients with DM1 (n = 20), DM2 (n = 10), gestational DM (n = 12). Study Results. The most common complication in pregnancy was preeclampsia combined with chronic placental insufficiency (47.6%). The most common risk factors of perinatal death were inadequate glycemic control in 1st trimester (69.0%), absence of preconception preparations (66.7%), preconception overweight and obesity (42.8%), and chronic arterial hypertension (28.6%). There were 38.1% antenatal deaths, 16.7% intranatal deaths, and 45.2% cases of postnatal mortality. The major causes of perinatal foetal mortality in 26.2% cases were placental disorders, 16.7% were associated with foetus growth retardation, diabetic fetopathy and respiratory distress syndrome. Conclusion. DM during pregnancy was associated with a higher risk of perinatal death. Timely preconception preparation, BMI normalization and a consolidated approach to term and mode of delivery can reduce the risk of perinatal mortality in women with various types of DM. Keywords: diabetes mellitus, gestational diabetes mellitus, perinatal mortality, stillbirth, obesity, preeclampsia

scholarly journals Neonatal and Maternal Outcomes in Spontaneously-Conceived Twin Pregnancies According to Mode of Delivery

Folia Medica ◽  
2020 ◽  
Vol 62 (3) ◽  
pp. 468-476
Author(s):  
Samantha Mc Kenzie Stancu ◽  
Manuela Cristina Russu
Keyword(s):  
Neonatal Intensive Care ◽  
Statistical Significance ◽  
Mode Of Delivery ◽  
Statistical Correlation ◽  
P Value ◽  
Maternal Outcomes ◽  
Chi Square ◽  
Chi Square Test ◽  
Nicu Admission ◽  
Twin Pregnancies

Introduction: Appropriate intrapartum conduct in a twin delivery remains a challenging aspect of obstetric practice. The objective of this study was to compare neonatal and maternal outcomes in twin pregnancies according to mode of delivery.&nbsp; Materials and methods: This is a single centre retrospective cohort study of all consecutive spontaneously-conceived twin deliver-ies (&ge; 24 weeks, estimated fetal weight &ge; 500 grams) over a nine-year period between 01/01/2007 - 31/12/2016 at a tertiary-level centre. Neonatal outcomes included survival, APGAR score, prematurity-associated pathology (PAP), admission to the neonatal intensive care unit (NICU) and length of stay (LOS). Maternal outcomes included postpartum complications and LOS. Statistical analysis comprised Chi-square test with subsequent p-value and odds-ratio with 95% confidence interval. Statistical significance was set at p<0.05. Results: A total of 173 consecutive women with spontaneously-conceived twin deliveries were enrolled in this study, 129 (74.6%) women delivered by caesarean section (CS). The success rate of vaginal delivery (VD) was 93.6% (44/47). A strong statistical correlation was identified between CS and NICU admission; 53.2% vs. 1.5% (p=0.0001). Neonatal LOS in the NICU was significantly longer in the CS group. Prematurity-associated pathology (PAP) was noted in 75 pairs of twins (75/173); 61 pairs were delivered by CS, bearing strong statistical significance (p<0.0001). Postpartum complications occurred in 14.7% of CS compared to 13.6% of VDs.&nbsp; Conclusion: Neonates delivered by CS had a higher rate of PAP, NICU admission, lower birth weight and longer LOS. This study showed that VD is safe, especially when the first twin is in cephalic presentation

scholarly journals Can navigation and interpregnancy care improve outcomes in patients with pregestational diabetes mellitus (PGDM)?

2022 ◽  
Vol 226 (1) ◽  
pp. S647-S648
Author(s):  
Kaila Krishnamoorthy ◽  
Kimone Powell ◽  
Shauna F. Williams ◽  
Lisa Gittens-Williams ◽  
Joseph J. Apuzzio
Keyword(s):  
Diabetes Mellitus ◽  
Pregestational Diabetes
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