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  • 1
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    Online Resource
    Consequences of gestational diabetes mellitus on neonatal cardiovascular health: MySweetHeart Cohort study
    Springer Science and Business Media LLC ; 2023
    In:  Pediatric Research Vol. 94, No. 1 ( 2023-07), p. 231-238
    Details
    In: Pediatric Research, Springer Science and Business Media LLC, Vol. 94, No. 1 ( 2023-07), p. 231-238
    Abstract: Hyperglycaemic disorders of pregnancy are associated with offspring cardiovascular alterations. Methods MySweetHeart cohort study aimed to assess the effect of maternal gestational diabetes (GDM) on offsprings’ cardiovascular health. Newborns underwent clinical and echocardiographic examinations between 2016 and 2020. Results Compared to mothers without GDM ( n  = 141), mothers with GDM ( n  = 123) were more likely to have had GDM in previous pregnancies and had higher weight, BMI, blood glucose, and HbA1c. Newborns of both groups showed similar clinical characteristics. Echocardiography was performed on the 3rd (interquartile range, IQR, 2nd–4th) day of life in 101 offsprings of mothers without and 116 offsprings of mothers with GDM. Left ventricular (LV) mass was similar. Children born to mothers with GDM had a thicker posterior LV wall ( z -score +0.15, IQR –0.38/0.62, versus +0.47, IQR –0.11/+1.1, p  = 0.004), a smaller end-systolic (1.3 mL, IQR 1.0–1.5 mL, versus 1.4 mL, IQR 1.2–1.8 mL, p  = 0.044) but a similar end-diastolic LV volume. They also had shorter tricuspid valve flow duration and aortic valve ejection time, lower tricuspid E-wave and pulmonary valve velocities. Conclusions Newborns of mothers with or without GDM had similar clinical characteristics and LV mass. However, some echocardiographic differences were detected, suggesting an altered myocardial physiology among infants of mothers with GDM. Registration ClinicalTrials.gov (NCT02872974). Impact Hyperglycaemic disorders of pregnancy are known to be associated with offspring cardiovascular alterations. Clinical characteristics and estimated left ventricular (LV) mass were similar in children issued from mothers with and without gestational diabetes (GDM). Children born to mothers with GDM had a thicker posterior LV wall and a smaller end-systolic LV volume. Although LV mass is not different, myocardial physiology may be altered in these infants. Further studies should investigate the endothelial function of this population and the cardiovascular evolution of these children over time.
    Type of Medium: Online Resource
    ISSN: 0031-3998 , 1530-0447
    URL: Article
    DOI: 10.1038/s41390-022-02390-4
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2031217-9
    SSG: 12
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  • 2
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    Online Resource
    Sex-dependent influence of maternal predictors on fetal anthropometry in pregnancies with gestational diabetes mellitus
    Springer Science and Business Media LLC ; 2022
    In:  BMC Pregnancy and Childbirth Vol. 22, No. 1 ( 2022-12)
    Details
    In: BMC Pregnancy and Childbirth, Springer Science and Business Media LLC, Vol. 22, No. 1 ( 2022-12)
    Abstract: Third trimester fetal anthropometric parameters are known to predict neonatal complications. A better understanding of predictors of adverse fetal parameters might help to personalize the use and frequency of fetal ultrasound. The objectives of this study were: (a) to evaluate the utility of maternal sociodemographic, anthropometric and metabolic predictors to predict 3 rd trimester fetal anthropometric parameters in women with gestational diabetes mellitus (GDM), (b) to assess whether the impact of these maternal predictors is fetal sex-dependent, and (c) to provide a risk stratification for markers of fetal overgrowth (fetal weight centile (FWC) and fetal abdominal circumference centile (FACC) depending on prepregnancy BMI and gestational weight gain (GWG) until the 1 st GDM visit. Methods This prospective study included 189 women with GDM. Maternal predictors were age, ethnicity, prepregnancy BMI, GWG and excessive weight gain until the 1 st GDM visit, fasting, 1-hour and 2-hour blood glucose oral glucose tolerance test values, HbA1c at the 1 st visit and medical treatment requirement. Fetal outcomes included FWC, FWC 〉 90% and 〈 10%, FACC, FACC 〉 90% and 〈 10%, at 29 0/7 to 35 6/7 weeks of gestational age. We performed univariate and multivariate regression analyses and probability analyses. Results In multivariate analyses, prepregnancy BMI was associated with FWC, FWC 〉 90% and FACC. GWG until the 1 st GDM visit was associated with FWC, FACC and FACC 〉 90% (all p ≤ 0.045) . Other maternal parameters were not significantly associated with fetal anthropometry in multivariate analyses (all p ≥ 0.054) . In female fetuses, only GWG was associated with FACC ( p= 0.044 ). However, in male fetuses, prepregnancy BMI was associated with FWC, FWC 〉 90% and FACC and GWG with FWC in multivariate analyses (all p ≤ 0.030). In women with a prepregnancy BMI of ≥ 25 kg/m 2 and a GWG until the 1 st GDM visit ≥ 10.3 kg (mean GWG), the risk for FWC 〉 90% and FACC 〉 90% was 5.3 and 4 times higher than in their counterparts. Conclusions A personalized fetal ultrasound surveillance guided by fetal sex, prepregnancy BMI and GWG may be beneficial in reducing adverse fetal and neonatal outcomes.
    Type of Medium: Online Resource
    ISSN: 1471-2393
    URL: Article
    DOI: 10.1186/s12884-022-04767-z
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2059869-5
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  • 3
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    Online Resource
    Improving cardiometabolic and mental health in women with gestational diabetes mellitus and their offspring: study protocol for MySweetHeart Trial , a randomised controlled trial
    BMJ ; 2018
    In:  BMJ Open Vol. 8, No. 2 ( 2018-02), p. e020462-
    Details
    In: BMJ Open, BMJ, Vol. 8, No. 2 ( 2018-02), p. e020462-
    Abstract: Gestational diabetes mellitus (GDM) carries prenatal and perinatal risk for the mother and her offspring as well as longer-term risks for both the mother (obesity, diabetes, cardiovascular disease) and her child (obesity, type 2 diabetes). Compared with women without GDM, women with GDM are twice as likely to develop perinatal or postpartum depression. Lifestyle interventions for GDM are generally limited to physical activity and/or nutrition, often focus separately on the mother or the child and take place either during or after pregnancy, while their results are inconsistent. To increase efficacy of intervention, the multifactorial origins of GDM and the tight link between mental and metabolic as well as maternal and child health need to be heeded. This calls for an interdisciplinary transgenerational approach starting in, but continuing beyond pregnancy. Methods and analysis This randomised controlled trial will assess the effect of a multidimensional interdisciplinary lifestyle and psychosocial intervention aimed at improving the metabolic and mental health of 200 women with GDM and their offspring. Women with GDM at 24–32 weeks gestational age who understand French or English, and their offspring and partners can participate. The intervention components will be delivered on top of usual care during pregnancy and the first year postpartum. Metabolic and mental health outcomes will be measured at 24–32 weeks of pregnancy, shortly after birth and at 6–8 weeks and 1 year after childbirth. Data will be analysed using intention-to-treat analyses. The MySweetHeart Trial is linked to the MySweetHeart Cohort ( clinicaltrials.gov/ct2/show/NCT02872974 ). Ethics and dissemination We will disseminate the findings through regional, national and international conferences and through peer-reviewed journals. Trial registration number NCT02890693 ; Pre-results.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2017-020462
    Language: English
    Publisher: BMJ
    Publication Date: 2018
    detail.hit.zdb_id: 2599832-8
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  • 4
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    Online Resource
    Diabète gestationnel
    EMH Swiss Medical Publishers, Ltd. ; 2017
    In:  Forum Médical Suisse ‒ Swiss Medical Forum Vol. 17, No. 46 ( 2017-11-15)
    Details
    In: Forum Médical Suisse ‒ Swiss Medical Forum, EMH Swiss Medical Publishers, Ltd., Vol. 17, No. 46 ( 2017-11-15)
    Type of Medium: Online Resource
    ISSN: 1661-6146 , 1661-6138
    URL: Article
    DOI: 10.4414/fms.2017.03112
    Language: French
    Publisher: EMH Swiss Medical Publishers, Ltd.
    Publication Date: 2017
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  • 5
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    Online Resource
    Gestationsdiabetes
    EMH Swiss Medical Publishers, Ltd. ; 2017
    In:  Swiss Medical Forum ‒ Schweizerisches Medizin-Forum Vol. 17, No. 46 ( 2017-11-15)
    Details
    In: Swiss Medical Forum ‒ Schweizerisches Medizin-Forum, EMH Swiss Medical Publishers, Ltd., Vol. 17, No. 46 ( 2017-11-15)
    Type of Medium: Online Resource
    ISSN: 1424-4020 , 1424-3784
    URL: Article
    DOI: 10.4414/smf.2017.03112
    Language: German
    Publisher: EMH Swiss Medical Publishers, Ltd.
    Publication Date: 2017
    detail.hit.zdb_id: 2059452-5
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  • 6
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    Online Resource
    Main Fetal Predictors of Adverse Neonatal Outcomes in Pregnancies with Gestational Diabetes Mellitus
    MDPI AG ; 2020
    In:  Journal of Clinical Medicine Vol. 9, No. 8 ( 2020-07-28), p. 2409-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 9, No. 8 ( 2020-07-28), p. 2409-
    Abstract: The objectives of this study were to (a) assess the utility of fetal anthropometric variables to predict the most relevant adverse neonatal outcomes in a treated population with gestational diabetes mellitus (GDM) beyond the known impact of maternal anthropometric and metabolic parameters and (b) to identify the most important fetal predictors. A total of 189 patients with GDM were included. The fetal predictors included sonographically assessed fetal weight centile (FWC), FWC 〉 90% and 〈 10%, and fetal abdominal circumference centile (FACC), FACC 〉 90% and 〈 10%, at 29 0/7 to 35 6/7 weeks. Neonatal outcomes comprising neonatal weight centile (NWC), large and small for gestational age (LGA, SGA), hypoglycemia, prematurity, hospitalization for neonatal complication, and (emergency) cesarean section were evaluated. Regression analyses were conducted. Fetal variables predicted anthropometric neonatal outcomes, prematurity, cesarean section and emergency cesarean section. These associations were independent of maternal anthropometric and metabolic predictors, with the exception of cesarean section. FWC was the most significant predictor for NWC, LGA and SGA, while FACC was the most significant predictor for prematurity and FACC 〉 90% for emergency cesarean section. In women with GDM, third-trimester fetal anthropometric parameters have an important role in predicting adverse neonatal outcomes beyond the impact of maternal predictors.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm9082409
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2662592-1
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  • 7
    Online Resource
    Online Resource
    Potentially modifiable predictors of adverse neonatal and maternal outcomes in pregnancies with gestational diabetes mellitus: can they help for future risk stratification and risk-adapted patient care?
    Springer Science and Business Media LLC ; 2019
    In:  BMC Pregnancy and Childbirth Vol. 19, No. 1 ( 2019-12)
    Details
    In: BMC Pregnancy and Childbirth, Springer Science and Business Media LLC, Vol. 19, No. 1 ( 2019-12)
    Abstract: Gestational diabetes mellitus (GDM) exposes mothers and their offspring to short and long-term complications. The objective of this study was to identify the importance of potentially modifiable predictors of adverse outcomes in pregnancies with GDM. We also aimed to assess the relationship between maternal predictors and pregnancy outcomes depending on HbA1c values and to provide a risk stratification for adverse pregnancy outcomes according to the prepregnancy BMI (Body mass index) and HbA1c at the 1st booking. Methods This prospective study included 576 patients with GDM. Predictors were prepregnancy BMI, gestational weight gain (GWG), excessive weight gain, fasting, 1 and 2-h glucose values after the 75 g oral glucose challenge test (oGTT), HbA1c at the 1st GDM booking and at the end of pregnancy and maternal treatment requirement. Maternal and neonatal outcomes such as cesarean section, macrosomia, large and small for gestational age (LGA, SGA), neonatal hypoglycemia, prematurity, hospitalization in the neonatal unit and Apgar score at 5 min 〈  7 were evaluated. Univariate and multivariate regression analyses and probability analyses were performed. Results One-hour glucose after oGTT and prepregnancy BMI were correlated with cesarean section. GWG and HbA1c at the end pregnancy were associated with macrosomia and LGA, while prepregnancy BMI was inversely associated with SGA. The requirement for maternal treatment was correlated with neonatal hypoglycemia, and HbA1c at the end of pregnancy with prematurity (all p   〈  0.05). The correlations between predictors and pregnancy complications were exclusively observed when HbA1c was ≥5.5% (37 mmol/mol). In women with prepregnancy BMI ≥ 25 kg/m 2 and HbA1c ≥ 5.5% (37 mmol/mol) at the 1st booking, the risk for cesarean section and LGA was nearly doubled compared to women with BMI with 〈  25 kg/m 2 and HbA1c  〈   5.5% (37 mmol/mol). Conclusions Prepregnancy BMI, GWG, maternal treatment requirement and HbA1c at the end of pregnancy can predict adverse pregnancy outcomes in women with GDM, particularly when HbA1c is ≥5.5% (37 mmol/mol). Stratification based on prepregnancy BMI and HbA1c at the 1st booking may allow for future risk-adapted care in these patients.
    Type of Medium: Online Resource
    ISSN: 1471-2393
    URL: Article
    DOI: 10.1186/s12884-019-2610-2
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2019
    detail.hit.zdb_id: 2059869-5
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