Gestational Diabetic Mothers Research Articles

A Study on Morphohistometric Changes of Placenta in Gestational Diabetes- A Comparative Analysis

Introduction:The placenta is a complex fetal organ that fulfills pleotrophic roles during fetal growth. Placenta is the most accurate record of the infant’s prenatal experience. Gestational diabetes is much common than preexisting diabetes .i.e. it complicates 2% to 5% of pregnancies. It seems reasonable to expect that biochemical changes occurring in the pregnant women with diabetes should be reflected in the placental structure. Aim & objectives: In the present study an attempt is made to know the morphological changes of placenta in gestational diabetes mellitus.Subjects and Methods:In this study totally 60 placentae were studied, of which 30 were nondiabetic placentae and 30 from Gestational Diabetic mothers were studied macroscopically. Morphologically the shape, site of attachment of umbilical cord, central thickness of placenta was noted. Birth weight of the neonate and the placental ratio were also recorded. By using routine staining techniques and direct microscopy tissues of Gestational Diabetic placenta were studied qualitatively and compared them with normal placenta.Results:Our study demonstrates that there is a significant increase in weight and central thickness of placenta. Neonatal weight and placental ratio were also increased; there was no change in shape and site of attachment of umbilical cord in case of diabetic placenta when compared to normal. Conclusion:On the basis of results of present study it is concluded that diabetic placentae showed increase in weight and central thickness. Neonatal weight and placental ratio were also increased. These findings indicate that control of hyperglycemia only partially prevents the development of placental abnormalities.

A Survey on the Relationship between Ages above 35 Years and Gestational Diabetes Mellitus

Background: The aim of this study was to determine the relationship between ages above 35 years old and gestational diabetes mellitus in Zabol. Methods: This study was conducted in Zabol city during 2016-2017. Analyzing the data to check the validity of the hypothesis in any type of research is of particular importance and is performed nowadays in most research studies based on the data gathered from the subjects under study. Data analysis is one of the main and most important parts of any research. Raw data is analyzed using statistical software. Results: The results of this study showed that according to the gestational diabetes mellitus score of 150 mothers, about gestational diabetes, 11 cases (7.3%) had gestational diabetes, and 132 (92.7%) others have not experienced gestational diabetes. Generally, according to the average score (1.92), there is no gestational diabetes in mothers. Conclusion: The most important risk factors for gestational diabetes are age-obesity and familial history, respectively.

Cardiac Doppler in poorly controlled gestational diabetics and its link to markers of intra-uterine hypoxia and adverse outcome

The aim of the study was to investigate foetal cardiac function using the modified myocardial performance index (Mod-MPI) in poorly controlled gestational diabetics and its link with intrauterine markers for hypoxia and to an adverse outcome. In a prospective, cross sectional study, 44 consecutive women with severe or poorly controlled gestational diabetic pregnancies in their third trimester on insulin therapy were recruited and matched with 44 women with normal pregnancies which served as the control group. Using Doppler echocardiography the foetal Mod-MPI was calculated. The foetal Mod-MPI was significantly higher in the diabetic group compared to the controls indicating significant myocardial dysfunction. The Mod-MPI served as an excellent marker of adverse outcomes. Foetal myocardial function was significantly impaired in poorly controlled gestational diabetics and there was a significant link of Mod-MPI to intrauterine markers of hypoxia, as well as to an adverse outcome. Mod-MPI has the potential to improve foetal surveillance in gestational diabetes. IMPACT STATEMENT What is already known on this subject? Abnormal foetal cardiac function, as reflected in the modified myocardial performance index, has been reported to be significantly increased in foetuses of poorly controlled diabetics managed on insulin. What do the results of this study add? There is a significant link between abnormal foetal cardiac function to intrauterine markers of hypoxia, as well as to an adverse outcome; and that development of myocardial dysfunction could be one of the main mechanisms, inducing foetal compromise in poorly controlled gestational diabetes. What are the implications of these findings for clinical practice and/or further research? This study explores an interesting concept of foetal pathophysiology in gestational diabetes, namely the concept of “pseudo-hypoxia” in a foetus of a gestational diabetic mother, and this intrauterine “hypoxic stress” in turn leading to myocardial dysfunction. The Mod-MPI, a clinical marker for cardiac dysfunction, can therefore be used in the clinical setting to track a deteriorating metabolic state.

Assessment of Subtle Myocardial Dysfunction in Asymptomatic Infants of Diabetic Mothers

Abstract Background Cardiovascular abnormalities in infants of diabetic mothers (IDMS) occur in the form of congenital heart diseases (CHD), and hypertrophic cardiomyopathy (HCM). Aim of the Work We hypothesized that two dimensional speckle tracking imaging and pulsed wave tissue Doppler imaging (TM) may uncover subtle myocardial dysfunction in asymptomatic IDMs. Patients and Methods This study was a cross sectional descriptive study conducted at Ain shams University Children’s Hospital Pediatric cardiology unit during the period from June 2017 till January 2018. Thirty IDMs were recruited. IDMs with CHD and HCM were excluded. We further subdivided them into 2 groups; Infants of gestational diabetic mothers (IGDM) and infants of pregestational diabetic mothers (IPGDM). They were all examined using TDI and STI echocardiography in the first week of life. This group was compared to a group of age and sex matched healthy controls. Results All IDMs had normal cardiac dimensions and global cardiac functions as controls, IVS (P = 0.434), LVED (P = 0.318), EF (P = 0.291), LVFS(P = 0.644) and GLS(P = 0.240). However, evidence of LV dysfunction proved by increased Tei index (p = 0.018). This subtle affection of myocardial function was more prominent in infants of IPGDM when compared to IGDMs (P = 0.004). Conclusion Subtle affection of myocardial functions may occur in IDMs even in the absence of morphological cardiac changes. This was detected by TDI. Neither conventional assessment of myocardial functions, nor STI are sensitive tools in detecting these changes. IPGDMs are at risk of more profound affection of myocardial function than infants of IGDMs.

Bushfire smoke: urgent need for a national health protection strategy.

This research was undertaken with support from the Australian National University College of Health and Medicine, and the assistance of resources from the Centre for Air pollution, energy and health Research (CAR). We used the CAR Data and Analysis Technology platform (https://cardat.github.io) to analyse data

537: Sonographic evaluation of fetal fractional limb volume across gestation in gestational diabetes

Fractional limb volume has recently been proposed as a useful parameter of fetal growth, quantifying fetal soft tissue volume of upper arm and thigh. However, the investigation about the growth characteristics of fractional limb volume in mothers with gestational diabetes is limited. The aim of this study was to investigate the difference in growth trajectory of fractional arm volume and thigh volume between fetuses of gestational diabetes (GDM) and normal glucose tolerance (NGT) mothers. Fetal fractional limb volume was prospectively assessed in 158 singleton pregnancies (121 NGT and 37 GDM) between 20 and 37 weeks gestation. Fractional arm volume and thigh volume were measured as cylindrical limb volume based on 50% of humeral or femoral diaphysis length using a 5-slice technique. First, Student’s t-test was performed to compare fractional arm volume and thigh volume between NGT and GDM group across gestation. Multiple regression analyses were then performed to investigate the difference of fractional limb volume between NGT and GDM group, with adjustment for potential confounding factors (maternal age, parity, pregravid body mass index and fetal sex). Maternal and neonatal characteristics of each group are shown in Table 1. A total of 276 ultrasound scans were obtained, a mean of 1.7 scans (range: 1 - 4) per pregnancy. Fractional arm volume was not different between NGT and GDM group before 32 weeks gestation. However, fractional arm volume of GDM group was significantly larger than NGT group after 32 weeks gestation (Figure 1). These results remained significant even after controlling for the confounding factors. Fractional thigh volume was not statistically different between the two groups across gestation. Fetalfractional arm volume is significantly greater in women with GDM compared with NGT, particularly after 32 weeks gestation. This finding is consistent with the characteristic soft tissue accrual (including fat deposition) in the upper part of the fetal body in GDM, which possibly explains the higher occurrence of shoulder dystocia at delivery.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Spectrum of Cardiovascular Abnormalities in Infants Born to Diabetic Mother in a Tertiary Care Center

Abstract Background Diabetes mellitus is one of the most common medical problems among pregnant women. Now, gestational diabetes mellitus (GDM) is increasing and amounts to 17% in Asian women but only in 4% of American and European women. In southern India, the prevalence of GDM is 17% in urban women, 13.8% in semiurban, and 9.8% in rural women. Aim The aim of the study is to find the cardiovascular abnormalities in infants born to a diabetic mother (IDM) and the association between infant’s heart lesion and diabetes mellitus in pregnant mother in a tertiary care center. Materials and Methods All babies born to both pregestational and gestational diabetic mother were included. Information regarding maternal type of diabetes, treatment regimen, maternal glycemic control status, antenatal ultrasonogram, baby’s sex, birth weight, gestational age, and clinical features were collected. Echocardiogram was done for all the babies. Results Out of the 100 IDM, 28 babies had cardiac disease, 5 babies had cyanotic heart disease, and 23 babies had acyanotic heart disease. Out of 100 diabetic mothers, 66 were on meal plan, 21 were on oral hypoglycemic agent (OHA) metformin, and 13 were on insulin therapy. Among 66 babies whose mother was on the meal plan, 8 had cardiac abnormality. Among the 21 mothers on OHA, 7 babies had cardiac abnormality and all the 13 babies of mothers who were on insulin had cardiac abnormality which was a significant finding among the IDM. Conclusion Maternal diabetes is a significant risk factor for heart disease in the newborn. Careful evaluation and early diagnosis of heart diseases in this high-risk group is of great value. Both pregestational and gestational diabetic mothers should monitor their blood sugar and maintain it in a normal range at the time of conception and early in pregnancy to reduce the risk of congenital heart disease in IDM.

1872-P: Hepatic miR-582-5p Is Programmed by Maternal Diet-Induced Obesity in Male Mice and Contributes to Nonalcoholic Fatty Liver Disease

Obesity during pregnancy is associated with increased risk of nonalcoholic fatty liver disease (NAFLD) in the offspring; however, the underlying molecular mechanisms remain largely unknown. The aim of the current study was to explore the contribution of microRNAs (miRs) as mediators of programming by maternal obesity. To achieve this, we used a mouse model of maternal-diet induced obesity where dams develop gestational diabetes and offspring demonstrate increased hepatic triglyceride content. We carried out small RNA next generation sequencing analysis of liver from twelve-week-old male offspring and identified miR-582-5p as the most dysregulated, showing a threefold increase. Binding site prediction (TargetScan 7.2) and pathway enrichment analysis (Reactome v67) suggested a number of miR-582-5p target genes related to lipid metabolism including Insulin Induced Gene 2 (INSIG2) and Translocase of Inner Mitochondrial Membrane 23 (TIMM23). Overexpression of miR-582-5p in AML12 (mouse) and HEPG2 (human) cell lines caused increased triglyceride accumulation, downregulation of INSIG2 and TIMM23, increased nuclear localization of Sterol Regulatory Element-Binding Protein 1 (SREBP-1), and overexpression of lipogenic genes. These findings suggest that overexpression of miR-582-5p induces hepatic intracellular lipid accumulation through mechanisms that involve mitochondrial malfunction and activation of de novo lipogenesis. We therefore conclude that an epigenetically programmed increase in hepatic miR-582 is a likely contributing mechanism underlying the programming of fatty liver disease in the offspring of obese gestational diabetic mothers. Disclosure L. Pantaleao: None. D. Fernandez-Twinn: None. A. Carpenter: None. E. Loche: None. L. Dearden: None. D. Duque Guimaraes: None. N.C. Penfold: None. T.J. Ashmore: None. M. Bushell: None. S. Ozanne: Advisory Panel; Self; Nestlé. Funding Brazilian National Council for the Improvement of Higher Education (BEX 10594/13-2); Brazilian National Council for Scientific and Technological Development (PDE/204416/2014-0)

The Impact of Mediterranean Dietary Patterns During Pregnancy on Maternal and Offspring Health.

(1) Background: Pregnancy outcomes for both mother and child are affected by many environmental factors. The importance of pregnancy for ‘early life programming’ is well established and maternal nutrition is an important factor contributing to a favourable environment for developing offspring. We aim to assess whether following a Mediterranean Diet during pregnancy is beneficial for maternal and offspring outcomes; (2) Methods: a systematic review was performed using standardized reporting guidelines with the National Heart Lung and Blood Iinstitute quality assessment tool for selection and extraction; (3) Results: results show that being on a Mediterranean Diet during pregnancy is associated with favourable outcomes for both maternal and offspring health, particularly for gestational diabetes in mothers and congenital defects in offspring (4) Conclusions: Following a Mediterranean dietary pattern during gestation is beneficial for the health of both the mother and offspring. Pregnant women and those trying to conceive should be advised to follow a Mediterranean Diet to potentially decrease, for example, the likelihood of atopy (OR 0.55) in the offspring and Gestational Diabetes Mellitus in the mother (OR 0.73).

The Diagnosis of Early Fetal Cardiac Changes of the Gestational Diabetic Mothers: Presenting the Preload Index

Objectives: To evaluate fetal cardiac changes in gestational diabetic mothers, compared to healthy ones by means of different indices and to determine which index can first represent the alterations. Methods: The study was conducted as an observational cross-sectional study, including 25 pregnant women with gestational diabetes as the cases and 50 healthy pregnant women as the controls. The preload index, left and right side myocardial performance index (MPI), Interventricular septal hypertrophy, the left and right side cardiac output were assessed in all the patients. Results: The gestational ages were 31.65 ± 8.02 and 31.64 ± 5.37 weeks in case and control group respectively, without any significant difference. Both of the left and right ventricular MPI did not differ statistically between the case and controls. The cases had a greater Interventricular septal hypertrophy but the cardiac output was similar. The preload index was higher in the fetuses of the gestational diabetic mothers. Conclusions: In our study, the MPI did not show any difference between the fetuses of the gestational diabetic mothers and non-diabetic ones; but, fetuses of gestational diabetic mothers had a greater value of PLI, representing early diastolic function changes in right heart even before the overt heart failure occurred. This could be a sign of vasculopathy in gestational diabetic mothers.

Adipokine levels and their association with insulin resistance and fetal outcomes among the newborns of Indian gestational diabetic mothers.

Objectives:To investigate the cord blood levels of adipokine and to assess their association with the fetal insulin resistance and fetal outcomes in newborns of gestational diabetic women (GDM).Methods:This cross-sectional study was performed in 40 GDM women and 40 healthy pregnant women (HPW) in the Department of Obstetrics and Gynecology at Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) hospital in Puducherry, India, during the period from May 2016 to December 2017. Cord blood samples were collected at delivery from GDM and HPW groups. Cord plasma biochemical parameters such as insulin, C-peptide, adiponectin, leptin, resistin, and visfatin concentrations were measured. Leptin/adiponectin ratio (L/A), homeostasis model assessment of insulin resistance (HOMA2-IR), insulin sensitivity (HOMA2-%S) and beta cell function (HOMA2-%B) were calculated. The pregnancy outcomes such as birth weight (BW), Ponderal index and Apgar scores of the baby were measured.Results:The BW and Ponderal index of the baby were found to be significantly higher in GDM newborns compared to HPW newborns. Cord plasma insulin, C-peptide, HOMA2 –IR, visfatin, leptin, and L/A ratio were significantly higher whereas adiponectin level was lower in GDM compared to HPW. A significant positive correlation was observed between L/A ratio and fetal HOMA2-IR.Conclusion:Altered adipokine levels with increased L/A ratio was observed among the new-borns of Indian gestational diabetic mothers. There was an association between increased L/A ratio, insulin resistance and increased Ponderal index among the new-borns.

Maternal exposure to fine particulate matter from a coal mine fire and birth outcomes in Victoria, Australia

IntroductionThe Hazelwood coal mine fire was an unprecedented event in Australian history that resulted in the surrounding towns in regional Victoria being covered in plumes of smoke and ash for six weeks in 2014. Evidence concerning adverse reproductive impacts associated with maternal exposure to ambient air pollution is expanding. Gaps remain regarding the relative impact of acute changes in outdoor air quality lasting days to months, such as that resulting from coal mine fires. MethodsRoutinely collected perinatal data was used to define a complete cohort of singleton babies born within the affected region. Maternal average, and peak, fine particulate matter (PM2.5) was assigned to residential address at time of delivery using a chemical transport model. Maternal, infant, meteorological and temporal variables were adjusted for in final linear and log-binomial regression models. ResultsThere were a total of 3591 singleton livebirths during the study period; 763 of which were in utero during the coal mine fire. Average PM2.5 exposure was 4.4 μg/m3 (median 1.9; IQR 2.1 μg/m3) and peak was 45.0 μg/m3 (median 30.4; IQR 35.1 μg/m3). There was no association between coal mine fire-attributable PM2.5 and fetal growth or gestational maturity outcomes. However, there was weak evidence that gestational diabetes mellitus was an effect modifier in the relationship between maternal PM2.5 exposure and birth weight. Babies born to exposed gestational diabetic mothers were 97 g heavier per 10 μg/m3 increase in average PM2.5 exposure (95%CI 74, 120 g). No association was observed among mothers without gestational diabetes. ConclusionMaternal exposure to fine particulate matter resulting from the 2014 Hazelwood coal mine fire did not appear to adversely effect fetal maturity. However, there was weak evidence of a trophic response among babies born to exposed mothers with gestational diabetes, a possible susceptibility that requires further exploration.

Estimation of Serum Uric Acid Levels in Bangladeshi Gestational Diabetic Mothers Attending a Tertiary Care Hospital

Background: The hyperuricaemia in gestational diabetes mellitus (GDM) has been explained to be a component of the metabolic syndrome which reflects insulin resistance. Gestational huperuricaemia was found to be significantly associated with a high rate of maternal and foetal complications along with proteinuria and hypertension. Aims of this study were to evaluate the serum uric acid levels in Bangladeshi women with GDM in their second and third trimesters of pregnancy.
 Methods: This descriptive cross-sectional study was conducted at Mymensingh Medical College Hospital from July 2013 to June 2014. Pregnant women, in their second and third trimester, attending the outpatient department of Obstetrics and Gynecology and the Department of Endocrinology were enrolled by purposive sampling technique. GDM was diagnosed on the basis of oral glucose tolerance test (OGTT) as defined in WHO criteria 2013.
 Results: Out of 172 participants, 86 had GDM (case) and 86 were normoglycemic (control). The mean age of GDM and control groups was 28.6±3.2 years and 27.3±3.1 years respectively. The BMI was 26.4±1.5 kg / m 2 and 26.3±1.3 kg / m 2. In this study we found serum uric acid levels in GDM and without GDM were 4.47±0.42 mg/dl and 4.48±0.41 mg/dl respectively (p>0.05). Serum uric acid level in GDM group was significantly (p<0.001) higher in third trimesters (4.48 ±0.41 mg/dl) compared to those without GDM (3.52 ±0.74 mg/dl).
 Conclusion: There was distinct alteration of serum uric acid level in GDM compared to normal pregnancy. Estimation of serum uric acid levels might be incorporated in every GDM cases for prevention of complications. Birdem Med J 2019; 9(1): 55-58

Knowledge and Satisfaction among Mothers with Gestational Diabetes

This study aimed to assess knowledge and satisfaction among mothers with gestational diabetes (GDM). A descriptive study design was utilized. The study was conducted at outpatient clinics and inpatient departments of Ain Shams Maternity University Hospital, on a convenience sample consisting of 200 gestational diabetes mothers. Two tools of data collection were used: a structured interview questionnaire, and ―satisfaction part‖ of QOL scale to evaluated satisfaction among gestational diabetes mothers. The study results showed that, half of studied mothers were satisfied with a correct knowledge regarding gestational diabetes management as well as 85.3% of them were satisfied with management of hypoglycemia. There were highly significant association between mothers’ knowledge and their age, education, and area of residence. Also the results revealed that, studied mothers were satisfied with social/economic, psychological/spiritual and family domains (66%, 64% & 50.5% respectively); however 65.5% of them were un-satisfied with health/functioning domain. The study concluded that, the studied mothers had correct knowledge regarding management of GD, effect of GD on mother’s health, effect of GD on fetus health, management of hypoglycemia, and measuring blood glucose at home (62.1%, 64.2%, 67.4%, 90.5% & 63.2 & respectively). More than two thirds of the studied mothers were more satisfied with social/economic and psychological/ spiritual domains and GDM affects studied mother's health and functioning domains Recommendation: Developing awareness program to enhance pregnant mothers’ knowledge and satisfaction regarding promotion of their health in relation to gestational diabetes

Visual evoked potentials in offspring born to mothers with overweight, obesity and gestational diabetes.

BackgroundOverweight, obesity, and gestational diabetes (GD) during pregnancy may negatively affect neurodevelopment in the offspring. However, the mechanisms are unclear and objective measures of neurodevelopment in infancy are scarce. We hypothesized that these maternal metabolic pathologies impair cortical visual evoked potentials (cVEPs), a proxy for visual and neuronal maturity.DesignThe PREOBE study included 331 pregnant women stratified into four groups; normal weight (controls), overweight, obesity, and GD (the latter including mothers with normal weight, overweight and obesity). In a subsample of the offspring at 3 months (n = 157) and at 18 months (n = 136), we assessed the latencies and amplitudes of the P100 wave from cVEPs and calculated visual acuity.ResultsAt 3 months of age, visual acuity was significantly poorer in offspring born to GD mothers. At 18 months of age, there were no differences in visual acuity but infants born to GD mothers had significantly longer latencies of cVEPs when measured at 15’, and 30’ of arc. The group differences at 30’ remained significant after confounder adjustment (mean [SD] 121.0 [16.0] vs. 112.6 [7.6] ms in controls, p = 0.007) and the most prolonged latencies were observed in offspring to GD mothers with concurrent overweight (128.9 [26.9] ms, p = 0.002) and obesity (118.5 [5.1] ms, p = 0.020).ConclusionsInfants born to mothers with GD, particularly those with concurrent overweight or obesity, have prolonged latencies of visual evoked potentials at 18 months of age, suggesting that this maternal metabolic profile have a long lasting, non-optimal, effect on infants´ brain development.

Knowledge and health beliefs about gestational diabetes and healthy pregnancy's breastfeeding intention.

If the knowledge and health beliefs relating to gestational diabetes mellitus during pregnancy are associated with behaviours during pregnancy and lactation, this suggests potential educational interventions. Women with gestational diabetes mellitus are more likely to develop type 2 diabetes mellitus, and babies with gestational diabetes mellitus incur increased risk of neonatal hypoglycaemia and childhood obesity. Breastfeeding is an effective way to improve maternal and lipid metabolism of gestational diabetes mothers, and to lower the risk of type 2 diabetes mellitus after birth, to prevent conception. Nurses have an important role in encouraging mothers to breastfeed for health promotion. The importance of cognitive factors such as knowledge, beliefs and attitudes is emphasised to increase the breastfeeding rate and to improve the quality of breastfeeding for pregnant women. Little research has been undertaken exploring cognitive factors and breastfeeding intention. Cross-sectional descriptive survey in healthy pregnant women. A questionnaire about gestational diabetes mellitus-related knowledge and health beliefs of gestational diabetes mellitus management composed of perceived susceptibility, severity, benefits, barriers and self-efficacy was developed by investigators. The association of two predictor variables of interest, gestational diabetes mellitus-related knowledge and health beliefs of gestational diabetes mellitus management, was tested with the outcome variable, breastfeeding intention, using chi-square test, t test, ANOVA and multiple logistic regression. Two hundred and thirty-seven of the 250 participants returned questionnaires for a final response rate of 94.8%. Breastfeeding intention after childbirth was associated with stronger perceived benefit, higher levels of self-efficacy and lower alcohol consumption. History of drinking and health beliefs such as perceived benefits and self-efficacy were highly associated with breastfeeding intention relating to gestational diabetes mellitus. Education for breastfeeding in gestational diabetes mellitus mothers should focus upon the benefit of breastfeeding and strengthening self-efficacy.

Gestasyonel diyabetik anne bebeklerinde kalp fonksiyonlarının ekokardiyografik bulguları ve somatomedin c ile ilişkisi

Gestasyonel diyabetik anne bebeklerinde kalp fonksiyonlarının ekokardiyografik bulguları ve somatomedin c ile ilişkisi

Comparative study of the intestinal microbiota in children from Mexican mothers with or without gestational diabetes

Pregnancy includes the development of an individual, from fertilization to labor. This development is influenced by genetic and environmental modifications during the intrauterine period, which continues until the first 1000 days of life. Important lapse in health and disease programming. The presence of gestational diabetes (GDM) favors the development of metabolic diseases in adult life and has an 18% prevalence in Mexico. The diversity of the intestinal microbiota is affected by maternal diabetes status, and this could contribute to the abundance of different phylas that contribute to the generation of new associated diseases. The aim of this study was to compare the fecal microbiota of children between 3 months and 3 years of age born to mothers with and without GDM. Anthropometric measures and fecal sample were collected from 29 patients (without GDM=24; GDM=5). The V4 region of bacterial 16S rRNA gene was sequenced by Illumina MiSeq. There were no significant differences between the birth weight of the infant and the weeks of gestation. Our data showed differences in composition of the microbiota in the study groups. We observed a decrease in Firmicutes, in addition with an increase in Bacteroidetes and Proteobacterias in GDM group. Also, LefSe analysis indicated a significant increment in Desulfovibrionaceae in this group compared with the control group. These results suggest the presence of dysbiosis in child from gestational diabetic mothers.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Umbilical Cord Blood Acidosis in Term Pregnancies With Gestational Diabetes Mellitus and Its Relations to Maternal Factors and Neonatal Outcomes

Background: Umbilical cord blood (UCB) gas analysis is recommended in high-risk pregnancies. However, in chronic medical conditions, cord blood acidosis might not indicate acute fetal stress, rather it might be due to fetal adaptation to the chronic stress. Objectives: Evaluating the association between UCB acidosis with maternal factors and adverse neonatal outcomes in term pregnancies with gestational diabetes mellitus. Methods: This prospective cohort evaluated 673 pregnant women who had term pregnancies and were admitted for elective cesarean delivery. A total of 80 women had gestational diabetes. After delivery, a blood sample was obtained from the umbilical artery for arterial blood gas analysis. The neonates were then followed. Results: Term pregnancies with gestational diabetes had significantly higher UCB acidosis rates compared to the healthy controls (26.2% vs. 6%, P < 0.001). In mothers with gestational diabetes, UCB acidosis was independently associated with higher maternal body mass index (P = 0.04) and HbA1C levels (P = 0.01). In the term neonates born to gestational diabetes mothers, after adjustment for gestational age, birth weight and pre-delivery blood glucose, UCB acidosis remained significantly associated with macrosomia (47.6% vs. 23.7%, P = 0.04), neonatal hypoglycemia (76.1% vs. 25.4%, P = 0.002), and moderate-severe jaundice (71.4% vs. 27.1%, p0.01). Conclusions: In our study term, pregnancies with gestational diabetes had a higher rate of UCB acidosis, which was associated with poor maternal glycemic and weight control during the last gestational trimester. UCB acidosis in these pregnancies seems to be independently associated with adverse neonatal outcomes.

An observational study of clinical profile of infants born to pregestational and gestational diabetic mothers

Background: Diabetes has now become a global pandemic because of sedentary lifestyle, urbanization, and increasing incidence of obesity and the prevalence is on the rise in developing nations like India. The objective of this study was to study the clinical profile and complications of neonates born to established diabetic mothers and gestational diabetic mothers on insulin.Methods: Over a period of one year, all consecutive live born neonates born to diabetic mothers, both gestational and pregestational (known/established diabetic), on insulin were included in the study.Results: The incidence of hypoglycemia in IPGDM was 2-fold higher (55%) than 25% in IGDM (25%) which was statistically significant (p = 0.009). Congenital anomalies were seen more in IPGDM (41.9%) compared to 18.2% in IGDM which was statistically significant (p=0.02).Conclusions: Congenital anomalies mostly involving cardiovascular, renal system were seen significantly more in newborns born to mothers with established diabetes compared to infants of gestational diabetic mothers. Hypoglycemia was the most common complication followed by hypocalcemia and hyperbilirubinemia.