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Age-specific risk of fetal loss observed in a second trimester serum screening population.

https://arctichealth.org/en/permalink/ahliterature176464
Source
Am J Obstet Gynecol. 2005 Jan;192(1):240-6
Publication Type
Article
Date
Jan-2005
Author
Philip R Wyatt
Titus Owolabi
Chris Meier
Tianhua Huang
Author Affiliation
Ontario Maternal Serum Screening Database, Toronto, Ontario, Canada. pwyatt@nygh.on.ca
Source
Am J Obstet Gynecol. 2005 Jan;192(1):240-6
Date
Jan-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
African Continental Ancestry Group
Age Distribution
Age Factors
Diabetes, Gestational - blood - epidemiology - etiology - mortality
Down Syndrome - blood - epidemiology - etiology - mortality
Female
Fetal Death
Humans
Maternal Age
Ontario - epidemiology
Pregnancy
Pregnancy Complications - blood - epidemiology - etiology - mortality
Pregnancy outcome
Pregnancy Trimester, Second
Prenatal Diagnosis
Risk factors
Abstract
The purpose of this study was to investigate age-specific spontaneous fetal loss rates of pregnancies without known chromosomal or structural abnormalities from mid-second trimester onward.
The study consisted of 264,653 women screened between October 1995 and September 2000 with available pregnancy outcomes. Pregnancies associated with fetal chromosomal or structural abnormalities, insulin dependent diabetes mellitus, and multiple pregnancies were excluded. Spontaneous fetal losses at or after 15 weeks of gestation were identified. Women were grouped according to maternal age at expected date of delivery. Spontaneous fetal loss rates in each group were evaluated after adjusting fetal losses associated with amniocentesis and identifiable ethnic groups.
Fetal loss rates increased in both younger and older women. The lowest rate was seen in women at mid-20s. Compared with Caucasian and Asian women, black women had higher fetal loss rate at nearly every age group.
The results of the study provided a baseline age-specific spontaneous fetal loss rate of pregnancies at a specified gestational window.
PubMed ID
15672031 View in PubMed
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Cardiometabolic profile of people screened for high risk of type 2 diabetes in a national diabetes prevention programme (FIN-D2D).

https://arctichealth.org/en/permalink/ahliterature138828
Source
Prim Care Diabetes. 2010 Dec;4(4):231-9
Publication Type
Article
Date
Dec-2010
Author
Timo Saaristo
Leena Moilanen
Jari Jokelainen
Eeva Korpi-Hyövälti
Mauno Vanhala
Juha Saltevo
Leo Niskanen
Markku Peltonen
Heikki Oksa
Henna Cederberg
Jaakko Tuomilehto
Matti Uusitupa
Sirkka Keinänen-Kiukaanniemi
Author Affiliation
Pirkanmaa Hospital District, Tampere, Finland. timo.saaristo@pshp.fi
Source
Prim Care Diabetes. 2010 Dec;4(4):231-9
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Analysis of Variance
Blood Glucose - analysis
Cardiovascular Diseases - epidemiology
Chi-Square Distribution
Diabetes Mellitus, Type 2 - blood - diagnosis - epidemiology - prevention & control
Diabetes, Gestational - blood - epidemiology
Female
Finland
Glucose Intolerance - blood - epidemiology
Glucose Tolerance Test
Humans
Male
Mass Screening - methods
Middle Aged
National Health Programs
Predictive value of tests
Pregnancy
Primary Health Care
Risk assessment
Risk factors
Abstract
To study screening of high-risk individuals as part of a national diabetes prevention programme in primary health care settings in Finland between 2003 and 2007, and evaluate the cardiometabolic risk profile of persons identified for intervention.
High-risk individuals were identified by the Finnish Diabetes Risk Score (FINDRISC), history of impaired fasting glucose (IFG), impaired glucose tolerance (IGT), cardiovascular disease (CVD), or gestational diabetes. Participants subsequently underwent an oral glucose tolerance test. CVD morbidity risk was estimated by the Framingham Study Risk Equation and CVD mortality risk by the Systematic Coronary Risk Evaluation Formula (SCORE).
A high-risk cohort of 10,149 (of whom 30.3% men) was identified (mean age 54.7 for men, 53.0 for women). Altogether 18.8% of men and 11.5% of women had screen-detected diabetes. In total 68.1% of men and 49.4% of women had abnormal glucose tolerance (IFG, IGT or screen-detected diabetes). Furthermore, 43.2% and 41.5% of men, and 13.3% and 11.3% of women, respectively, had a high predicted risk of CVD morbidity or mortality.
Prevalence of dysglycemia including undiagnosed diabetes and the predicted risk for CVD was alarmly high in the identified high-risk cohort, particularly in men.
PubMed ID
21134669 View in PubMed
Less detail

Early random capillary glucose level screening and multidisciplinary antenatal teamwork to improve outcome in gestational diabetes mellitus.

https://arctichealth.org/en/permalink/ahliterature78442
Source
Acta Obstet Gynecol Scand. 2007;86(3):283-90
Publication Type
Article
Date
2007
Author
Berg Marie
Adlerberth Annika
Sultan Bo
Wennergren Margareta
Wallin Gunnar
Author Affiliation
The Institute of Health and Care Sciences, Sahlgrenska Academy, Göteborg University, and Department of Obstetrics and Gynaecology, The Institute of Clinical Sciences, Sahlgrenska University Hospital, Sweden. marie.berg@fhs.gu.se
Source
Acta Obstet Gynecol Scand. 2007;86(3):283-90
Date
2007
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Apgar score
Birth weight
Blood Glucose - analysis
Body mass index
Case-Control Studies
Diabetes, Gestational - blood - epidemiology - therapy
Female
Humans
Hypoglycemic agents - therapeutic use
Infant, Newborn
Insulin - therapeutic use
Mass Screening
Obesity - epidemiology
Parity
Patient care team
Pregnancy
Pregnancy outcome
Retrospective Studies
Severity of Illness Index
Stillbirth
Sweden - epidemiology
Abstract
BACKGROUND: This study describes maternal and neonatal characteristics and delivery outcome in women with gestational diabetes mellitus [GDM], compared to a control group. METHODS: A retrospective observational study of 719 women with GDM was undertaken in a Swedish urban district. All other parturients at the same hospital served as the control group. GDM was diagnosed using random capillary glucose levels at fixed intervals, beginning early in pregnancy. An oral glucose tolerance test was performed at glucose levels>or=7.0 mmol/l (127.8 mg/dl). Data was analysed according to glucose levels at diagnosis, ie, mild or severe GDM. RESULTS: GDM was diagnosed in 2.28% of the women who were older and had higher Body Mass Index [BMI]. A high proportion was of non-Nordic origin (44.5%); they had severe GDM more often (49.1%) than the Nordic group (33.1%). The GDM-mild group had less complications and abnormalities, compared to the GDM-severe group, although both groups differed from the control group in this respect. Delivery was spontaneous in 70.2% of GDM-mild, 65.7% of GDM-severe and 81.0% of the control group. LGA (+2 SD) was found in 4.8, 10.5 and 3.2%, respectively. CONCLUSION: Early non-fasting random universal screening and multidisciplinary antenatal teamwork intervention seems to be favourable, with low rates of excessive fetal growth, instrumental vaginal delivery and caesarean section.
PubMed ID
17364301 View in PubMed
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The effectiveness of implementing a reminder system into routine clinical practice: does it increase postpartum screening in women with gestational diabetes?

https://arctichealth.org/en/permalink/ahliterature135548
Source
Chronic Dis Can. 2011 Mar;31(2):58-64
Publication Type
Article
Date
Mar-2011
Author
A K Shea
B R Shah
H D Clark
J. Malcolm
M. Walker
A. Karovitch
E J Keely
Author Affiliation
Faculty of Medicine, University of Ottawa, Ontario, Canada.
Source
Chronic Dis Can. 2011 Mar;31(2):58-64
Date
Mar-2011
Language
English
Publication Type
Article
Keywords
Adult
Analysis of Variance
Blood glucose
Databases, Factual
Diabetes Mellitus, Type 2 - blood - diagnosis
Diabetes, Gestational - blood - epidemiology
Female
Follow-Up Studies
Humans
National Health Programs
Ontario - epidemiology
Postnatal Care - methods
Practice Guidelines as Topic
Pregnancy
Reminder Systems - utilization
Young Adult
Abstract
During regular care, women with previous gestational diabetes mellitus (GDM) rarely receive the recommended screening test for type 2 diabetes, a 2-hour oral glucose tolerance test (OGTT), in the postpartum period. The current study examined whether the implementation of a reminder system improved screening rates.
Based on our previous randomized control trial, we implemented a postpartum reminder (letter or phone call) protocol into routine care at two of three clinical sites. We verified postpartum testing by searching hospital laboratory databases and by linking to the provincial physician service claims database. The primary outcome was the proportion of patients who underwent an OGTT within 6 months of delivery.
Women who received care in a setting using a reminder system were more likely to receive an OGTT within 6 months postpartum (28%) compared with usual care (14%). The OGTT rates for both reminder groups were lower than that found in our randomized control trial (28% vs. 60%).
Although the screening rates remain low, postpartum reminders doubled screening rates using the recommended test, the OGTT.
PubMed ID
21466755 View in PubMed
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Gestational diabetes and offspring birth size at elevated environmental pollutant exposures.

https://arctichealth.org/en/permalink/ahliterature289794
Source
Environ Int. 2017 10; 107:205-215
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Date
10-2017
Author
Damaskini Valvi
Youssef Oulhote
Pal Weihe
Christine Dalgård
Kristian S Bjerve
Ulrike Steuerwald
Philippe Grandjean
Author Affiliation
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States. Electronic address: dvalvi@hsph.harvard.edu.
Source
Environ Int. 2017 10; 107:205-215
Date
10-2017
Language
English
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Keywords
Adult
Birth weight
Diabetes, Gestational - blood - epidemiology
Environmental Pollutants - analysis - blood
Female
Fetal Blood - chemistry
Fetal Macrosomia - blood
Fluorocarbons - blood
Humans
Hydrocarbons, Chlorinated - blood
Infant, Newborn
Male
Maternal Exposure
Mercury - analysis - blood
Pregnancy - blood
Young Adult
Abstract
Gestational diabetes mellitus (GDM) is associated with increased availability of glucose and macronutrients in fetal circulation and macrosomia. Therefore, the role of GDM in the association between metabolism-disrupting chemicals and birth size deserves attention.
We examined whether GDM may mediate or modify the associations between maternal environmental pollutant exposures and offspring birth size measures.
We analyzed 604 Faroese pregnant women and their offsprings born in 1997-2000. Maternal pregnancy serum concentrations of organochlorine compounds (OCs: polychlorinated biphenyl (PCB) congeners and dichlorodiphenyldichloroethylene (DDE)), and five perfluoroalkyl substances (PFASs), and hair and cord blood mercury concentrations were measured. We used regression (single-pollutants) and structural equation models (SEMs) (multiple-pollutant analyses using latent constructs of OCs, PFASs and mercury) to estimate the associations with GDM and birth size measures, accounting for mediation and/or effect modification by GDM.
Serum-DDE and hair-mercury concentrations were associated with GDM (adjusted OR per concentration doubling: 1.29; 95% CI: 0.94, 1.77 for DDE, and 0.79; 95% CI: 0.62, 0.99 for mercury), but in multiple pollutant-adjusted SEMs only a positive association between OC exposure and GDM remained significant (change in GDM odds per OC doubling: 0.45; 95% CI: 0.05, 0.86). PCB and overall OC exposure were positively associated with head circumference (SEM; mean change per OC doubling: 0.13cm; 95% CI, 0.01. 0.25). Overall PFAS exposure was inversely associated with birth weight (SEM; mean change per PFAS doubling: -169g; 95% CI: -359, 21), and for many single-PFASs we found a pattern of inverse associations with birth weight and head circumference in boys, and positive or null associations in girls. None of the environmental pollutants was associated with offspring length. GDM neither modified nor mediated the associations with birth size measures.
We found associations with GDM and offspring birth size to be specific to the environmental pollutant or pollutant group. Associations with birth size measures appear to be independent of GDM occurrence.
Notes
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PubMed ID
28753482 View in PubMed
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Hypoadiponectinaemia in South Asian women during pregnancy: evidence of ethnic variation in adiponectin concentration.

https://arctichealth.org/en/permalink/ahliterature180900
Source
Diabet Med. 2004 Apr;21(4):388-92
Publication Type
Article
Date
Apr-2004
Author
R. Retnakaran
A J G Hanley
N. Raif
P W Connelly
M. Sermer
B. Zinman
Author Affiliation
Division of Endocrinology, University of Toronto, Toronto, Ontario, Canada.
Source
Diabet Med. 2004 Apr;21(4):388-92
Date
Apr-2004
Language
English
Publication Type
Article
Keywords
Adiponectin
Adult
Asia, Southeastern - ethnology
Blood Glucose - analysis
Body mass index
Cross-Sectional Studies
Diabetes Mellitus, Type 2 - blood - epidemiology - ethnology
Diabetes, Gestational - blood - epidemiology - ethnology
Female
Glucose Tolerance Test
Humans
Insulin - blood
Intercellular Signaling Peptides and Proteins
Ontario - epidemiology - ethnology
Pregnancy
Proteins - analysis
Abstract
People of South Asian descent face an increased risk of Type 2 diabetes mellitus (DM) and coronary artery disease (CAD) compared with other ethnic groups. One candidate factor underlying this risk may be adiponectin, as circulating levels of this adipocyte-derived protein are reduced in both Type 2 DM and CAD. In a recent study, we assessed the relationship between adiponectin and gestational diabetes (GDM), a potential model of early events in the natural history of Type 2 DM. Here, we report the impact of ethnicity on plasma adiponectin concentration in that study.
A cross-sectional study was performed in 180 women undergoing oral glucose tolerance testing in late second or early third trimester to investigate the relationship between adiponectin and glucose tolerance in pregnancy. Based on self-reported ethnicity, participants were stratified into three groups: (i) Caucasian (n = 116), (ii) South Asian (n = 31), and (iii) Asian (n = 28).
Median adiponectin concentration was much lower in the South Asian group (9.7 micro g/ml) than in Caucasians (15.8 micro g/ml) or Asians (16.1 micro g/ml) (overall P
PubMed ID
15049945 View in PubMed
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Impact of gestational diabetes on the risk of diabetes following pregnancy among Chinese and South Asian women.

https://arctichealth.org/en/permalink/ahliterature125011
Source
Diabetologia. 2012 Aug;55(8):2148-53
Publication Type
Article
Date
Aug-2012
Author
G. Mukerji
M. Chiu
B R Shah
Author Affiliation
University of Toronto, Toronto, ON, Canada.
Source
Diabetologia. 2012 Aug;55(8):2148-53
Date
Aug-2012
Language
English
Publication Type
Article
Keywords
Adult
Asian Continental Ancestry Group
Blood Glucose - metabolism
Diabetes Mellitus, Type 2 - blood - epidemiology - ethnology
Diabetes, Gestational - blood - epidemiology - ethnology
European Continental Ancestry Group
Female
Humans
Incidence
Maternal Age
Middle Aged
Ontario - epidemiology
Pregnancy
Prevalence
Prospective Studies
Risk factors
Abstract
Ethnicity and gestational diabetes mellitus (GDM) are both risk factors for the development of type 2 diabetes. However, it is uncertain whether ethnicity modifies the effect of GDM on diabetes risk. We aimed to determine the risk of diabetes following pregnancy with and without GDM for Chinese and South Asian women compared with white women.
Using healthcare databases, all 1,050,108 women aged 20-49 with live births between January 1995 and June 2008 in Ontario were identified. They were followed for up to 15 years for the diagnosis of diabetes.
The age-standardised prevalences of GDM were 4.1%, 7.1% and 2.9% for Chinese, South Asian and white women, respectively. The cumulative incidence of diagnosed diabetes at the median follow-up time of 7.6 years was 16.5% and 1.8% for Chinese women with and without GDM, 31.8% and 3.6% for South Asian women with and without GDM, and 25.7% and 1.8% for white women with and without GDM. The presence of GDM conferred an increase in the risk for diabetes after pregnancy of more than 13-fold in white women, but only a nine- to tenfold increase among Chinese and South Asian women.
Although one-third of South Asian women with GDM were diagnosed with diabetes within 8 years postpartum, the incremental impact of GDM on diabetes risk was not as strong among Chinese and South Asian women as it was among white women.
PubMed ID
22526611 View in PubMed
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Levels of the inflammation marker YKL-40 in young adults exposed to intrauterine hyperglycemia.

https://arctichealth.org/en/permalink/ahliterature278220
Source
Diabetes Res Clin Pract. 2016 Apr;114:50-4
Publication Type
Article
Date
Apr-2016
Author
Louise Kelstrup
Thomas F Dejgaard
Tine D Clausen
Elisabeth R Mathiesen
Torben Hansen
Henrik Vestergaard
Peter Damm
Source
Diabetes Res Clin Pract. 2016 Apr;114:50-4
Date
Apr-2016
Language
English
Publication Type
Article
Keywords
Adult
Adult Children
Biomarkers - blood
Chitinase-3-Like Protein 1 - blood
Denmark - epidemiology
Diabetes Mellitus, Type 1 - blood - epidemiology - immunology
Diabetes, Gestational - blood - epidemiology - immunology
Female
Humans
Hyperglycemia - complications - epidemiology - physiopathology
Inflammation - blood - diagnosis - etiology
Male
Pregnancy
Risk factors
Young Adult
Abstract
Plasma levels of the inflammatory marker YKL-40 were investigated in 597 adult offspring born to women with and without diabetes during pregnancy. No association between fetal exposure to maternal hyperglycemia and levels of YKL-40 was found. However, female sex and increasing BMI in the offspring were associated to YKL-40.
PubMed ID
27103369 View in PubMed
Less detail

Low-grade inflammation in young adults exposed to intrauterine hyperglycemia.

https://arctichealth.org/en/permalink/ahliterature124119
Source
Diabetes Res Clin Pract. 2012 Aug;97(2):322-30
Publication Type
Article
Date
Aug-2012
Author
Louise Kelstrup
Tine Dalsgaard Clausen
Elisabeth R Mathiesen
Torben Hansen
Peter Damm
Author Affiliation
Center for Pregnant Women with Diabetes, Department of Obstetrics, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark. louisekelstrup@dadlnet.dk
Source
Diabetes Res Clin Pract. 2012 Aug;97(2):322-30
Date
Aug-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Adult Children
Blood Glucose - metabolism
C-Reactive Protein - metabolism
Denmark - epidemiology
Diabetes Mellitus, Type 1 - blood - epidemiology - immunology
Diabetes, Gestational - blood - epidemiology - immunology
Female
Glucose Tolerance Test
Humans
Hyperglycemia - blood - epidemiology - immunology
Inflammation - blood
Interleukin-6 - blood
Male
Overweight - blood - epidemiology
Pregnancy
Risk factors
Young Adult
Abstract
To investigate associations between fetal exposure to intrauterine hyperglycemia and plasma concentrations of interleukin-6 (IL-6) and high sensitivity C-reactive protein (hs-CRP) in adult offspring.
We studied 597 offspring, aged 18-27 years, from four different groups concerning exposure to intrauterine hyperglycemia and genetic predisposition to type 2 diabetes (offspring of women with: gestational diabetes mellitus (GDM), risk factors for GDM but normal glucose tolerance, type 1 diabetes and women from the background population, respectively). The participants were characterized by fasting plasma levels of IL-6 and hs-CRP, a 75 g oral glucose tolerance test and anthropometric measurements.
No association between intrauterine exposure to hyperglycemia and levels of IL-6 and hs-CRP in the offspring was found. In contrast maternal overweight (body mass index = 25 kg/m(2)) was positively associated with levels of both IL-6 and hs-CRP (p for both=0.003). Offspring who had already developed overweight or conditions of abnormal glucose tolerance were characterized by higher levels of IL-6 and hs-CRP compared with the remaining offspring (all p
PubMed ID
22622155 View in PubMed
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Maternal blood glucose in diabetic pregnancies and cognitive performance in offspring in young adulthood: a Danish cohort study.

https://arctichealth.org/en/permalink/ahliterature142099
Source
Diabet Med. 2010 Jul;27(7):786-90
Publication Type
Article
Date
Jul-2010
Author
G L Nielsen
E. Andersen
S. Lundbye-Christensen
Author Affiliation
Department of Clinical Epidemiology, Aalborg Hospital Aarhus University Hospital, Forskningens Hus, Aalborg, Denmark. guln@rn.dk
Source
Diabet Med. 2010 Jul;27(7):786-90
Date
Jul-2010
Language
English
Publication Type
Article
Keywords
Adult
Blood Glucose - metabolism
Cognition Disorders - blood - etiology
Cohort Studies
Denmark - epidemiology
Diabetes Mellitus - blood - epidemiology
Diabetes, Gestational - blood - epidemiology
Female
Humans
Intelligence
Male
Mothers
Pregnancy
Prenatal Exposure Delayed Effects
Risk assessment
Abstract
Maternal diabetes is a known risk factor for perinatal complications, but there are little data on consequences for long-term intellectual outcome in offspring. We assess cognitive performance in military conscripts according to maternal blood glucose levels during pregnancy.
We identified a cohort of 60 Danish male offspring of insulin-treated diabetic mothers born between 1976 and 1984 and followed this cohort to military conscription. From medical records, we extracted data on all available values of maternal blood glucose categorized as fasting and non-fasting and by day in pregnancy, together with maternal White class, smoking habits and socio-economic status. The main outcome was cognitive performance at conscription measured with a validated intelligence test. The association between maternal blood glucose level and cognitive performance was assessed by multivariate linear regression and a fitted fractional polynomial.
Median fasting blood glucose values in the second half of pregnancy was negatively associated with cognitive scores at conscription [adjusted coefficient -1.7; 95% confidence interval (CI) -3.0; -0.4]. Restriction to only first-born sibling slightly strengthened the association (coefficient -1.9; 95% CI -3.3; -0.5), but after exclusion of two pregnancies with the blood glucose > 10 mmol/l the association became insignificant (coefficient -0.6; 95% CI -2.6; 1.4).
Maternal blood glucose level during diabetic pregnancy is negatively associated with cognitive performance in offspring at military conscription. In pregnancies with fasting blood glucose levels below 10 mmol/l, the association is weak and considered to be without clinical relevance.
PubMed ID
20636959 View in PubMed
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13 records – page 1 of 2.