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Search Results (193)

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Keywords = diabetes diagnosed in pregnancy

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16 pages, 786 KiB  
Review
The Role of Vitamin D Supplementation in Type 1, Type 2, and Gestational Diabetes: A Comprehensive Updated Narrative Review
by Asala Nasser, Dimitrios Papandreou, Sousana K. Papadopoulou and Leila Cheikh Ismail
Clin. Pract. 2025, 15(8), 148; https://doi.org/10.3390/clinpract15080148 - 7 Aug 2025
Abstract
Vitamin D has emerged as a modulatory factor in the pathogenesis and management of diabetes mellitus due to its influence on pancreatic β-cell function, immune regulation, and inflammatory pathways. This narrative review critically examines mechanistic and clinical evidence linking vitamin D status with [...] Read more.
Vitamin D has emerged as a modulatory factor in the pathogenesis and management of diabetes mellitus due to its influence on pancreatic β-cell function, immune regulation, and inflammatory pathways. This narrative review critically examines mechanistic and clinical evidence linking vitamin D status with type 1 diabetes (T1DM), type 2 diabetes (T2DM), and gestational diabetes (GDM). In T1DM, vitamin D’s immunomodulatory effects are thought to protect β-cells from autoimmune destruction; epidemiological studies associate vitamin D sufficiency with lower T1DM incidence and improved glycemic control, although causality remains under investigation. In T2DM, vitamin D deficiency is associated with worsened metabolic control and may contribute to disease development in at-risk individuals; however, it does not influence the initial onset of T2DM in patients who are already diagnosed. Intervention trials indicate that correcting the deficiency can modestly improve insulin sensitivity, β-cell function, and metabolic parameters. GDM has similarly been linked to hypovitaminosis D, with low maternal vitamin D levels associated with higher GDM risk and adverse perinatal outcomes; mechanistic insights suggest that adequate vitamin D supports glucose homeostasis in pregnancy, and emerging trials demonstrate improved insulin resistance with maternal vitamin D supplementation. Across these diabetes subtypes, maintaining sufficient vitamin D levels appears to confer metabolic benefits and may serve as an adjunct to current preventive and therapeutic strategies. However, definitive evidence from large-scale trials is required to establish optimal vitamin D supplementation protocols and confirm its efficacy in diabetes care. Full article
(This article belongs to the Special Issue The Effect of Dietary Compounds on Inflammation-Mediated Diseases)
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11 pages, 857 KiB  
Article
Placental Expression of Sirtuins in Women with Gestational Diabetes
by Michał Czerewaty, Łukasz Ustianowski, Kajetan Kiełbowski, Estera Bakinowska, Krzysztof Safranow, Maciej Tarnowski, Tomasz Sroczyński and Andrzej Pawlik
Genes 2025, 16(7), 844; https://doi.org/10.3390/genes16070844 - 20 Jul 2025
Viewed by 365
Abstract
Background/Objectives: Gestational diabetes mellitus (GDM) is a common metabolic disorder in pregnant women. It can lead to several complications, such as preterm delivery, macrosomia, or metabolic disorders in newborns. Studies have revealed morphological and transcriptional differences between the placentas of patients with GDM [...] Read more.
Background/Objectives: Gestational diabetes mellitus (GDM) is a common metabolic disorder in pregnant women. It can lead to several complications, such as preterm delivery, macrosomia, or metabolic disorders in newborns. Studies have revealed morphological and transcriptional differences between the placentas of patients with GDM and women with normal glucose tolerance. Sirtuins (SIRTs) are nicotinamide adenine dinucleotide-dependent deacetylases that interact with and regulate the activity of numerous proteins. However, little is known about their role in the pathogenesis of GDM. This study was performed to analyze the placental expression of SIRTs and investigate their correlations with clinical parameters. Methods: GDM was diagnosed based on the 75 g oral glucose tolerance test in accordance with the criteria developed by the International Association of Diabetes and Pregnancy Study Groups. Placental tissues were collected, and the expression of SIRT1,-3,-4 and a reference gene (β-2 microglobulin) was analyzed. Results: The placental expression of SIRT1 and SIRT3 was elevated in women with GDM. However, there was no significant difference in SIRT4 expression between women with GDM and those with normal glucose tolerance. Furthermore, we found no significant correlations between SIRT1, SIRT3, and SIRT4 expression and clinical parameters. Conclusions: The findings of this study demonstrate elevated expression of SIRT1 and SIRT3 in the placentas of women with GDM. Further studies are required to confirm our observations and demonstrate the precise role of these enzymes in GDM. Full article
(This article belongs to the Section Molecular Genetics and Genomics)
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21 pages, 511 KiB  
Systematic Review
Trimester-Specific Serum Lipid Profiles in Gestational Diabetes Mellitus: A Systematic Review, Meta-Analysis, and Meta-Regression
by Milos Milincic, Andja Cirkovic, Katarina Ivanovic, Stefan Dugalic and Miroslava Gojnic Dugalic
Medicina 2025, 61(7), 1290; https://doi.org/10.3390/medicina61071290 - 17 Jul 2025
Viewed by 321
Abstract
Background and Objectives: Gestational diabetes mellitus (GDM) is a major public health concern associated with adverse maternal and neonatal outcomes. It was found that even physiological pregnancy is followed by a significant shift in serum lipid profile, and even more pronounced in [...] Read more.
Background and Objectives: Gestational diabetes mellitus (GDM) is a major public health concern associated with adverse maternal and neonatal outcomes. It was found that even physiological pregnancy is followed by a significant shift in serum lipid profile, and even more pronounced in GDM pregnancies. We aimed to comprehensively assess lipid parameters among pregnant women with and without GDM. Materials and Methods: A systematic review, covering PubMed, WoS, and SCOPUS until 23 July 2024, with meta-analysis and meta-regression, was conducted, comprising studies measuring TG, TC, LDL-C, HDL-C, VLDL-C, and TG/HDL ratio in pregnant women diagnosed with GDM, and those with normal glucose tolerance. The overall effect size measure was the SMD. NOS and JADAD scales were used for quality assessment, I2 statistics for heterogeneity evaluation, and funnel plots for publication bias inspection. Results: A total of 457 studies were included in the qualitative analysis, and 74, 277, and 122 studies were included in the quantitative analysis for the 1st 2nd, and 3rd trimester, respectively. TG and TG/HDL levels were significantly elevated in all three trimesters (TG: SMD = 0.61, 0.57, and 0.48, p < 0.001 for all, and TG/HDL: SMD = 0.44, 0.66, and 0.49; p < 0.001 for all), while TC and LDL-C levels showed significant increases in the 1st and 2nd trimesters (TC: SMD = 0.38, 0.27, p < 0.001 for both, LDL-C: SMD = 0.33, 0.20, p < 0.001 for both), in pregnant women with GDM compared to those without the condition. Conclusions: GDM is associated with significant lipid abnormalities, particularly elevated TG and decreased HDL-C levels. These lipid changes are most pronounced in the first and second trimesters, highlighting the importance of early detection and management. Full article
(This article belongs to the Section Obstetrics and Gynecology)
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33 pages, 17821 KiB  
Systematic Review
Pregestational Diabetes Mellitus and Adverse Perinatal Outcomes: A Systematic Review and Meta-Analysis
by Dionysios Gazis, Antigoni Tranidou, Antonios Siargkas, Aikaterini Apostolopoulou, Georgia Koutsouki, Dimitrios G. Goulis, Christos Tsakalidis, Ioannis Tsakiridis and Themistoklis Dagklis
J. Clin. Med. 2025, 14(13), 4789; https://doi.org/10.3390/jcm14134789 - 7 Jul 2025
Viewed by 489
Abstract
Background/Objectives: As the incidence of diabetes mellitus (DM) is increasing rapidly worldwide, it is anticipated that an increasing number of women will enter pregnancy with pregestational diabetes mellitus (PGDM) in the future. Compelling evidence suggests that hyperglycemia in pregnancy is related to multiple [...] Read more.
Background/Objectives: As the incidence of diabetes mellitus (DM) is increasing rapidly worldwide, it is anticipated that an increasing number of women will enter pregnancy with pregestational diabetes mellitus (PGDM) in the future. Compelling evidence suggests that hyperglycemia in pregnancy is related to multiple adverse perinatal outcomes. This systematic review and meta-analysis aims to assess and quantify the association of PGDM with a range of adverse perinatal outcomes, providing a comprehensive understanding of its impact on pregnancy. Methods: The data sources of this systematic review and meta-analysis were Medline/PubMed, Scopus and Cochrane Library (January 1999 to August 2023), complemented by hand-searching for additional references. Observational studies reporting perinatal outcomes of pregnancies with PGDM diagnosed before pregnancy versus control pregnancies were eligible for inclusion. A systematic review and meta-analysis were conducted as per the PRISMA guidelines. Pooled estimate odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to determine the risk of adverse pregnancy outcomes between PGDM and control pregnancies. Results: The systematic search of the literature yielded 81 observational studies meeting inclusion criteria and in total, 137,237,640 pregnancies were included in the analysis. A total of 19 adverse perinatal outcomes were assessed, revealing a significant association with PGDM. In pregnancies with PGDM there was an increased risk of adverse perinatal outcomes, including gestational hypertension (OR 3.16, 95% CI 2.65–3.77), preeclampsia (OR 4.46, 95% CI 3.94–5.05), preterm delivery (OR 3.46, 95% CI 3.06–3.91), cesarean delivery (OR 3.12, 95% CI 2.81–3.47), induction of labor (OR 2.92, 95% CI 2.35–3.63), macrosomia (OR 2.23, 95% CI 1.76–2.83), LGA neonates (OR 3.95, 95% CI 3.47–4.49), low 5-min Apgar score (OR 2.49, 95% CI 2.07–2.99), shoulder dystocia (OR 3.05, 95% CI 2.07–4.50), birth trauma (OR 1.40, 95% CI 1.22–1.62), polyhydramnios (OR 5.06, 95% CI 4.33–5.91), oligohydramnios (OR 1.61, 95% CI 1.19–2.17), neonatal hyperbilirubinemia (OR 3.45, 95% CI 2.51–4.74), neonatal hypoglycemia (OR 19.19, 95% CI 2.78–132.61), neonatal intensive care unit (NICU) admission (OR 4.54, 95% CI 3.87–5.34), congenital malformations (OR 2.44, 95% CI 1.96–3.04), stillbirth (OR 2.87, 95% CI 2.27–3.63) and perinatal mortality (OR 2.94, 95% CI 2.18–3.98). Subgroup analyses indicated a higher risk of neonatal hypoglycemia, stillbirth and perinatal mortality in T1DM pregnancies compared with T2DM pregnancies. Conclusions: This study provides a robust synthesis of evidence underlying the strong association between PGDM and several adverse perinatal outcomes. Early detection, optimal glycemic control during the periconceptional and pregnancy periods, and proper antenatal care are critical to mitigate these risks. Full article
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16 pages, 1086 KiB  
Review
Fulminant and Slowly Progressive Type 1 Diabetes Associated with Pregnancy
by Eiji Kawasaki
Int. J. Mol. Sci. 2025, 26(13), 6499; https://doi.org/10.3390/ijms26136499 - 6 Jul 2025
Viewed by 543
Abstract
Type 1 diabetes is classified into three clinical subtypes: fulminant type 1 diabetes, acute-onset type 1 diabetes, and slowly progressive type 1 diabetes, also known as latent autoimmune diabetes in adults. Among these, the fulminant and slowly progressive forms may develop in association [...] Read more.
Type 1 diabetes is classified into three clinical subtypes: fulminant type 1 diabetes, acute-onset type 1 diabetes, and slowly progressive type 1 diabetes, also known as latent autoimmune diabetes in adults. Among these, the fulminant and slowly progressive forms may develop in association with pregnancy and are herein collectively referred to as “pregnancy-associated type 1 diabetes”. Fulminant type 1 diabetes can manifest suddenly during pregnancy, often accompanied by ketoacidosis, posing a significant risk to both the mother and the fetus. Early diagnosis and treatment are, therefore, critical. In pregnant women with no prior history of diabetes who present with marked hyperglycemia (≥288 mg/dL) but relatively low HbA1c levels (<8.7%), fulminant type 1 diabetes should be suspected, and insulin therapy should be initiated immediately. Conversely, women diagnosed with gestational diabetes who test positive for anti-islet autoantibodies are at high risk of developing slowly progressive type 1 diabetes postpartum. For these patients, regular monitoring of blood glucose levels, HbA1c, and endogenous insulin secretion is essential for early detection and management. Full article
(This article belongs to the Section Molecular Pathology, Diagnostics, and Therapeutics)
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15 pages, 527 KiB  
Article
Some Levels of Plasma Free Fatty Acids and Amino Acids in the Second Trimester Are Linked to Gestational Diabetes and Are Predictive of Persisting Impaired Glucose Tolerance After Delivery
by Vendula Bartáková, Anna Pleskačová, Lukáš Pácal, Monika Skrutková Langmajerová, Jindra Smutná, Katarína Chalásová, Veronika Eclerová, Zdeněk Glatz, Kateřina Kaňková and Josef Tomandl
J. Clin. Med. 2025, 14(13), 4744; https://doi.org/10.3390/jcm14134744 - 4 Jul 2025
Viewed by 310
Abstract
Background/Objectives: Gestational diabetes mellitus (GDM) represents an increased metabolic risk in future life for both mother and child. We hypothesize free fatty acids (FFAs) and amino acids (AAs) disturbances in plasma during second trimester might be indicating high risk of persisting glucose intolerance [...] Read more.
Background/Objectives: Gestational diabetes mellitus (GDM) represents an increased metabolic risk in future life for both mother and child. We hypothesize free fatty acids (FFAs) and amino acids (AAs) disturbances in plasma during second trimester might be indicating high risk of persisting glucose intolerance (PGI). The aim of study was to determine plasma FFAs and AAs during pregnancy in women with normal pregnancy and GDM and also in post-GDM women with PGI after delivery and to find potential association of altered FFAs and AAs profile with adverse peripartal outcomes and PGI after GDM. Material and Methods: A total of 54 pregnant women were included in the study. Of those 34 participants had GDM. PGI was diagnosed by oGTT up to one year after delivery. Plasma FFAs were determined using GC-FID and plasma AAs levels were determined using CE-MS method. Results: Decreased levels of tetradecanoic acid and several AAs were found in GDM group during pregnancy. Oleic and docosahexaenoic acid correlated positively while almost all AAs negatively correlated with oGTT values in the pregnancy (all p < 0.05, Spearman). Logistic regression model (using AAs, FFAs and BMI) identified higher citrulline and glutamate levels and lower tetradecenoic acid and choline as the best predictors for postpartum PGI. Some differences in AA levels were detected in women with macrosomic babies. Conclusions: Data support a possible link between GDM development and PGI after delivery and selected metabolite levels. The predictive potential of plasma FFAs and AAs levels on a diabetes risk in future life requires further validation. Full article
(This article belongs to the Special Issue Gestational Diabetes: Cutting-Edge Research and Clinical Practice)
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10 pages, 388 KiB  
Article
Evaluating the Predictive Value of HOMA-IR in Gestational Diabetes: A Case–Control Study from Romania
by Ait el Haj Iman, Cristina Onel, Gheorghe Furau, Cristian Furau, Roxana Furau, Mihai Lucan, Mircea Sandor, Liliana Sachelarie and Anca Huniadi
Diagnostics 2025, 15(13), 1704; https://doi.org/10.3390/diagnostics15131704 - 3 Jul 2025
Viewed by 526
Abstract
Background/Objectives: Gestational diabetes mellitus (GDM) is a common metabolic disorder during pregnancy, associated with increased risks for both maternal and fetal complications. Insulin resistance plays a central role in its pathophysiology. This study aimed to evaluate the predictive value of the Homeostatic Model [...] Read more.
Background/Objectives: Gestational diabetes mellitus (GDM) is a common metabolic disorder during pregnancy, associated with increased risks for both maternal and fetal complications. Insulin resistance plays a central role in its pathophysiology. This study aimed to evaluate the predictive value of the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) in diagnosing GDM and to explore its correlation with clinical and anthropometric parameters in a Romanian population. Methods: A retrospective case–control study was conducted on 320 pregnant women between 24 and 28 weeks of gestation. Based on ADA criteria, participants were divided into 160 with GDM and 160 controls, matched by age and gestational week. Fasting glucose, insulin, BMI, and blood pressure were assessed. HOMA-IR and HOMA-β were calculated. Statistical analyses included t-tests, Pearson correlation, and logistic regression. Results: HOMA-IR was significantly higher in the GDM group (2.9 vs. 1.8; p < 0.001). It correlated with fasting insulin (r = 0.85, p < 0.001), fasting glucose (r = 0.65, p < 0.001), BMI (r = 0.60, p < 0.001), and systolic blood pressure (r = 0.42, p < 0.001). Logistic regression identified HOMA-IR as an independent predictor of GDM (OR = 2.4, 95% CI: 1.6–3.5, p < 0.001), along with BMI (p = 0.01) and maternal age (p = 0.05). Conclusions: HOMA-IR is significantly associated with GDM and may enhance mid-gestational risk assessment when combined with clinical and anthropometric measures. Further studies are needed to validate its predictive accuracy in broader populations. Full article
(This article belongs to the Special Issue Insights into Perinatal Medicine and Fetal Medicine—2nd Edition)
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18 pages, 657 KiB  
Review
Pregnancy and Neonatal Outcomes in Maturity-Onset Diabetes of the Young: A Systematic Review
by Franciszek Ługowski, Julia Babińska, Katarzyna Makowska, Artur Ludwin and Paweł Jan Stanirowski
Int. J. Mol. Sci. 2025, 26(13), 6057; https://doi.org/10.3390/ijms26136057 - 24 Jun 2025
Viewed by 621
Abstract
Maturity-onset diabetes of the young (MODY)—a monogenic form of diabetes—accounts for approximately 1–2% of all diabetes cases, with GCK-MODY being the second most commonly diagnosed type. Although the inherited nature of the disease implies that the interplay between maternal glycemia and fetal genotype [...] Read more.
Maturity-onset diabetes of the young (MODY)—a monogenic form of diabetes—accounts for approximately 1–2% of all diabetes cases, with GCK-MODY being the second most commonly diagnosed type. Although the inherited nature of the disease implies that the interplay between maternal glycemia and fetal genotype directly influences neonatal outcomes, clinical guidelines for MODY-complicated pregnancies remain underdeveloped. A systematic literature search in the PubMed, Scopus, Web of Science, and Cochrane databases was conducted following the PRISMA guidelines. The study protocol has been logged in the PROSPERO registry with the identification number CRD42024609390. Data, such as MODY type, the gestational age at delivery, mode of delivery, insulin administration, mutational status of the fetus, fetal birthweight (FBW), occurrence of small-/large-for-gestational age fetus, shoulder dystocia, and neonatal hypoglycemia, were extracted and evaluated. Among 19 studies selected for the final analysis, 15 investigated perinatal outcomes in the GCK-MODY variant. Women diagnosed with GCK-MODY treated with insulin delivered approximately 1–2 weeks earlier than those managed with diet alone. FBW was significantly higher in GCK-negative as compared to GCK-positive offspring. Accordingly, fetal macrosomia was notably more common among unaffected neonates. In GCK-affected fetuses, insulin therapy was associated with a significantly lower FBW. Fetal genotype critically modifies perinatal outcomes in GCK-MODY pregnancies. In the absence of fetal genotyping, conservative management should be prioritized to mitigate the risks of fetal growth restriction and iatrogenic prematurity. As data regarding other types of MODY in pregnancy remain sparse, there is an urgent need for more research in this area. Full article
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12 pages, 223 KiB  
Article
Pre-Conception Physical Activity and the Risk of Gestational Diabetes Mellitus: Findings from the BORN 2020 Study
by Antigoni Tranidou, Antonios Siargkas, Ioannis Tsakiridis, Emmanuela Magriplis, Aikaterini Apostolopoulou, Georgia Koutsouki, Michail Chourdakis and Themistoklis Dagklis
Nutrients 2025, 17(11), 1832; https://doi.org/10.3390/nu17111832 - 28 May 2025
Viewed by 638
Abstract
Background/Objectives: Pre-conception health behaviors may influence the risk of gestational diabetes mellitus (GDM), but evidence on the joint effects of physical activity (PA) and dietary patterns remains limited. This study investigated the associations between pre-conception PA and GDM risk and explored their [...] Read more.
Background/Objectives: Pre-conception health behaviors may influence the risk of gestational diabetes mellitus (GDM), but evidence on the joint effects of physical activity (PA) and dietary patterns remains limited. This study investigated the associations between pre-conception PA and GDM risk and explored their interaction with adherence to a Mediterranean diet (MD). Methods: This analysis used data from the BORN2020 cohort, which included pregnant women in Greece (2020–2022). Pre-conception PA was assessed using the International Physical Activity Questionnaire-Short Form (IPAQ-SF), expressed as the metabolic equivalent of task (MET)-min/week and categorized into quartiles. Adherence to the MD was assessed via the Trichopoulou score and then grouped into tertiles. Multivariable logistic regression models were computed, accounting for sociodemographic and clinical covariates, including sedentary time and post-lunch nap frequency. Results: In total, 524 women were included and 13.9% (n = 73) were diagnosed with GDM. Women who developed GDM were significantly older (mean age 34.41 vs. 31.98 years, p < 0.0001), were more likely to be >35 years old (46.6% vs. 26.6%, p < 0.001), had higher pre-pregnancy BMI (median 24.6 vs. 22.7 kg/m2, p = 0.014), and were more likely to be obese (23.3% vs. 11.8%, p = 0.012). No significant association was observed between total pre-conception PA and GDM risk. Compared to the lowest PA quartile, women in the medium (aOR = 0.80, 95% CI: 0.45–1.40), high (aOR = 1.12, 95% CI: 0.52–2.39), and very high (aOR = 1.10, 95% CI: 0.50–2.38) PA quartiles showed no significant differences in GDM risk. PA, when modeled as a continuous variable, showed no significant trend (aOR = 0.99, 95% CI: 0.99–1.00; p-trend = 0.61). A joint analysis of PA and MD adherence also yielded no significant associations overall. However, in very small BMI-stratified subgroups, a low level of PA combined with very high MD adherence in normal-weight women was associated with increased GDM risk (aOR = 14.06, 95% CI: 1.55–165.54, p = 0.022), while in obese women, very high levels of PA and medium MD adherence showed a potentially protective effect (aOR = 0.006, 95% CI: 8.43 × 10−6–0.42, p = 0.048). These subgroup findings require cautious interpretation, due to the limited size of the sample set and wide confidence intervals. Conclusions: In this cohort, pre-conception PA, either alone or in combination with MD adherence, was not a reliable predictor of GDM. While our subgroup signals are hypothesis-generating, they do not yet support changes to clinical risk stratification. Future large-scale and interventional studies should investigate combined lifestyle interventions before conception to clarify the potential synergistic effects on GDM prevention. Full article
10 pages, 400 KiB  
Article
The Lack of a Glucose Peak During the Oral Glucose Tolerance Test in Pregnancy: What Does It Portend for Perinatal Outcomes?
by Anna Maria Marconi, Nikita Alfieri, Emanuele Garzia, Stefano Terzoni, Stefano Manodoro and Patrick M. Catalano
Nutrients 2025, 17(11), 1785; https://doi.org/10.3390/nu17111785 - 24 May 2025
Viewed by 535
Abstract
Background: An univocal definition for a lack of glucose peak during the oral glucose tolerance test in pregnancy (flat curve) has never been agreed upon. Thus, the aim of this study was to provide a definition for the flat 75 g oral [...] Read more.
Background: An univocal definition for a lack of glucose peak during the oral glucose tolerance test in pregnancy (flat curve) has never been agreed upon. Thus, the aim of this study was to provide a definition for the flat 75 g oral glucose tolerance test (OGTT) and to assess its clinical significance. Methods: A retrospective cohort study, where 8.810 pregnant singleton women were evaluated at the time of a 75 g OGTT between 240 and 286 weeks for the universal screening of gestational diabetes (GDM). The 75 g OGTT was considered flat when the difference between peak and fasting glucose concentrations was ≤30 mg/dL. A total of 953 (10.8%) women were diagnosed as having GDM, while 7.857 (89.2%) had normal glucose tolerance (NGT); 2791 women with normal glucose tolerance (35.5%) had a FLAT curve and 5066 (64.5%) had a concentration difference > 30 mg/dL (NGT). In all groups, we evaluated maternal characteristics and perinatal outcome. Results: Women with a FLAT curve were younger, taller, thinner, and their pre-pregnancy body mass index was lower than the other groups (all p < 0.001). The rate of obesity was also lower (p < 0.01). The vaginal delivery rate was higher than in NGT (80.4% vs. 77.8%; p < 0.01) and women with GDM (73.0%; p < 0.001) and that of primary cesarean lower than in NGT (11.9% vs. 14.8%; p < 0.001) and women with GDM (18.2%; p < 0.001). Between women with a FLAT and NGT OGTT curve, there was no significant difference for birthweight < 10th percentile (6.9% vs. 6.2%; p = 0.2), though the proportion of birthweight > 90th was lower (8% vs. 10%; p < 0.01). Conclusions: A 75 g flat OGTT as defined does not represent an abnormal maternal phenotype nor portend an adverse perinatal outcome. Full article
(This article belongs to the Section Nutrition in Women)
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19 pages, 9021 KiB  
Systematic Review
The Association of Placental Grading with Perinatal Outcomes: A Systematic Review and Meta-Analysis
by Antonios Siargkas, Christina Pachi, Meletios P. Nigdelis, Sofoklis Stavros, Ekaterini Domali, Apostolos Mamopoulos, Ioannis Tsakiridis and Themistoklis Dagklis
Diagnostics 2025, 15(10), 1264; https://doi.org/10.3390/diagnostics15101264 - 15 May 2025
Cited by 1 | Viewed by 802
Abstract
Objective: Premature placental calcification (PPC) has been implicated in adverse perinatal outcomes, yet its clinical significance remains controversial. This meta-analysis aimed to quantitatively synthesize current data on the association between PPC, defined as grade 3 placental calcification before 36+6 weeks of [...] Read more.
Objective: Premature placental calcification (PPC) has been implicated in adverse perinatal outcomes, yet its clinical significance remains controversial. This meta-analysis aimed to quantitatively synthesize current data on the association between PPC, defined as grade 3 placental calcification before 36+6 weeks of gestation and adverse perinatal outcomes. Data Sources: A systematic search was conducted in MEDLINE, Scopus and The Cochrane Library from inception until 11 March 2025, to identify eligible studies. Study Eligibility Criteria: Observational studies including singleton pregnancies with PPC diagnosed via ultrasonography between 28+0 and 36+6 weeks of gestation and comparing them with pregnancies with Grannum grade 0, 1, or 2 placentas were considered eligible. Methods: Study quality was assessed using the Newcastle−Ottawa Scale, and the risk of bias was evaluated with the Quality In Prognosis Studies tool. The primary outcomes were small-for-gestational-age (SGA) neonates and preeclampsia. Heterogeneity was assessed using Cochran’s Q test and the I2 statistic. Meta-analyses were conducted using a random-effects model, with outcomes reported as relative risk (RR) or mean difference (MD) with 95% confidence intervals (CIs). Results: In total, nine cohort studies were included. PPC was associated with an increased risk of SGA (RR, 1.99; 95% CI, 1.46−2.70), preeclampsia (RR, 5.27; 95% CI, 2.24−12.40), fetal growth restriction (RR, 2.31; 95% CI, 1.30−4.09), preterm delivery (RR, 2.11; 95% CI, 1.00−4.45), suspected fetal hypoxia (RR, 1.71; 95% CI, 1.13–2.56), low 5 min Apgar score (RR, 2.28; 95% CI, 1.50−3.44) and neonatal intensive care unit admission (RR, 1.80; 95% CI, 1.02−3.18). No significant associations were found with fetal or neonatal death (RR, 2.75; 95% CI, 0.87−8.71), cesarean delivery (RR, 1.26; 95% CI, 0.90−1.78), gestational diabetes mellitus (RR, 1.17; 95% CI, 0.81−1.70), neonatal resuscitation (RR, 1.04; 95% CI, 0.92−1.16), birthweight (MD, −187.46 g; 95% CI, −413.14 to +38.21), or gestational age at birth (MD, −0.62 weeks; 95% CI, −1.36 to +0.11). A sensitivity analysis excluding high-risk-of-bias studies yielded consistent results. Conclusions: PPC is associated with several adverse perinatal outcomes, including SGA and preeclampsia. While the clinical significance of placental grading has remained limited in recent years, this study has shown that PPC may serve as an early indicator of placental insufficiency, warranting enhanced fetal surveillance and risk assessment in affected pregnancies. Further research is needed to refine its prognostic utility and integration into obstetric practice. Full article
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10 pages, 912 KiB  
Article
Prenatal Diagnosis of Ductal Constriction in Normal Heart Anatomy—Are There Any Neonatal Consequences?
by Łucja Hanna Biały, Tomasz Talar, Ewa Gulczyńska, Iwona Strzelecka and Maria Respondek-Liberska
J. Clin. Med. 2025, 14(10), 3388; https://doi.org/10.3390/jcm14103388 - 13 May 2025
Cited by 1 | Viewed by 677
Abstract
Background/Objectives: The main goal of this study was to determine whether ductal constriction in the third trimester of a pregnancy during fetal echocardiography examination has an impact on the neonatal clinical condition during the first days after birth. Methods: A retrospective study [...] Read more.
Background/Objectives: The main goal of this study was to determine whether ductal constriction in the third trimester of a pregnancy during fetal echocardiography examination has an impact on the neonatal clinical condition during the first days after birth. Methods: A retrospective study was based on 348 newborns who were examined during their fetal life in the third trimester of a pregnancy in our fetal cardiology center. They were divided into two groups: the study group (n = 49): neonates with “normal heart anatomy” (NHA), assessed by fetal echocardiography (ECHO) examination and prenatally diagnosed ductal constriction (NHA-DC); and the control group (n = 299): NHA neonates without DC (NHA-NDC). Results: Prenatally, DC was associated with other functional abnormalities, such as myocardial hypertrophy, cardiomegaly, tricuspid regurgitation, pericardial effusion and abnormal flow through foramen ovale. Neonates with prenatally diagnosed DC in 43% of cases presented with elevated neonatal bilirubin levels requiring phototherapy treatment (p < 0.006). In the study group 27% of neonates showed signs of breathing difficulties in the first hours of life (p < 0.001). Neonates with a prenatal diagnosis of DC were hospitalized longer than neonates with a normal heart study (NHS) (p < 0.001). Conclusions: Neonates with a prenatal diagnosis of ductal constriction are prone to having transient respiratory problems (up to 27%) and mild neonatal hyperbilirubinemia (in presented series up to 43%). Gestational diabetes can be associated with ductal constriction. Full article
(This article belongs to the Section Obstetrics & Gynecology)
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12 pages, 217 KiB  
Article
Do Gynecologists-Obstetricians Know How to Manage Pregnancies in Women After Bariatric Surgery?
by Joanna Dzedzej, Maria Szewczyk, Jan Pietruszka, Mateusz Ficygowski, Agnieszka Majewska, Wojciech Migal, Jan Dębski, Maciej Walędziak and Anna Różańska-Walędziak
Healthcare 2025, 13(10), 1107; https://doi.org/10.3390/healthcare13101107 - 9 May 2025
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Abstract
Introduction and aim of the study: The majority of bariatric procedures are performed in women of reproductive age, which has resulted in a growing number of pregnancies following bariatric surgery. The purpose of the study was to analyze whether obstetricians-gynecologists taking care [...] Read more.
Introduction and aim of the study: The majority of bariatric procedures are performed in women of reproductive age, which has resulted in a growing number of pregnancies following bariatric surgery. The purpose of the study was to analyze whether obstetricians-gynecologists taking care of pregnancies after bariatric surgery possess sufficient knowledge about it. Materials and method: The study was conducted in the form of a multiple choice, anonymous survey, conducted among 123 certified specialists in obstetrics and gynecology and 37 residents training in obstetrics and gynecology. The questions were related to supplementation of vitamins and micronutrients, the appropriate time interval between bariatric surgery and pregnancy, dietary recommendations, diagnosing gestational diabetes mellitus, and risks for the fetus following bariatric surgery. Results: The majority of participants did not know the correct answers, with only one participant who answered correctly all the questions provided. There was a correlation between giving correct answers to the question about dietary recommendations and the question about risks existing during a pregnancy after bariatric surgery. Only 30% of participants knew how gestational diabetes mellitus should be diagnosed in pregnancies after bariatric surgery. Conclusions: To enhance safety for women and their children, it is of utmost importance to implement additional training and educational programs for obstetricians-gynecologists about optimum care for pregnancies after bariatric surgery. Full article
8 pages, 272 KiB  
Article
Gestational Hydronephrosis: A Retrospective Analysis of the Clinical Outcomes of Ureteral Stent Placement Versus Conservative Treatment
by Dursun Baba, Engin Yurtçu, Burak Ayvacık, Yusuf Salih Küçük, Arda Taşkın Taşkıran, Mehmet Ali Özel, Ahmet Yıldırım Balık, Ekrem Başaran and Betül Keyif
Medicina 2025, 61(5), 845; https://doi.org/10.3390/medicina61050845 - 4 May 2025
Viewed by 601
Abstract
Background and Objectives: Gestational hydronephrosis (GH) is a physiological condition commonly observed during pregnancy, resulting from hormonal effects and mechanical compression of the ureters by the enlarging uterus. Although often asymptomatic, GH can cause urinary stasis, recurrent infections, and renal function impairment in [...] Read more.
Background and Objectives: Gestational hydronephrosis (GH) is a physiological condition commonly observed during pregnancy, resulting from hormonal effects and mechanical compression of the ureters by the enlarging uterus. Although often asymptomatic, GH can cause urinary stasis, recurrent infections, and renal function impairment in symptomatic cases. The optimal management of such cases remains controversial, especially regarding the role of ureteral stent placement. This study aimed to compare clinical outcomes—including renal function, inflammatory markers, and obstetric parameters—in pregnant women with symptomatic GH who underwent ureteral stent placement versus those managed conservatively. Materials and Methods: We conducted a retrospective cohort study at Düzce University Hospital between 2020 and 2024, including 40 pregnant women diagnosed with symptomatic GH. The patients were divided into the following two groups: those who received a ureteral stent (n = 20) and those who were managed with conservative treatment (n = 20). Conservative management included hydration therapy, acetaminophen-based analgesia, and close clinical monitoring. The parameters assessed included serum creatinine, estimated glomerular filtration rate (GFR), inflammatory markers (C-reactive protein, erythrocyte sedimentation rate, and white blood cell count), urinary findings, obstetric outcomes, and postpartum complications. Statistical significance was set at p < 0.05. Results: Gestational age at diagnosis was significantly higher in the stent group (29.1 ± 3.2 weeks) than in the non-stent group (27.1 ± 3.5 weeks; p = 0.045), possibly reflecting increased mechanical compression in later pregnancy. Renal function parameters (serum creatinine and GFR), inflammatory markers (CRP, ESR, and WBC count), and obstetric outcomes (birth weight, Apgar scores) showed no significant differences between groups (p > 0.05). Interestingly, gestational diabetes mellitus (GDM) was more prevalent in the non-stent group (20% vs. 5%; p = 0.042), although no significant differences were found in fasting glucose levels. Conclusions: Ureteral stent placement in symptomatic GH does not appear to significantly improve renal function or obstetric outcomes. However, it may provide symptom relief in select patients with persistent or severe discomfort. Given the limitations of retrospective data and a small sample size, further prospective studies with larger cohorts and quality-of-life assessments are warranted to optimize management strategies and enhance patient-centered care. Full article
(This article belongs to the Section Urology & Nephrology)
13 pages, 784 KiB  
Article
Pilot Study of Growth Factors in Colostrum: How Delivery Mode and Maternal Health Impact IGF-1, EGF, NGF, and TGF-β Levels in Polish Women
by Paweł Paśko, Jadwiga Kryczyk-Kozioł, Paweł Zagrodzki, Ewelina Prochownik, Martyna Ziomek, Ryszard Lauterbach, Hubert Huras, Magdalena Staśkiewicz and Justyna Dobrowolska-Iwanek
Nutrients 2025, 17(8), 1386; https://doi.org/10.3390/nu17081386 - 20 Apr 2025
Viewed by 771
Abstract
Background: Breast milk is the most important nutrition for newborns. Growth factors such as insulin-like growth factor 1 (IGF-1), epidermal growth factor (EGF), transforming growth factor-β (TGF-β), and nerve growth factor (NGF) are among its components that play pivotal roles in neonatal development, [...] Read more.
Background: Breast milk is the most important nutrition for newborns. Growth factors such as insulin-like growth factor 1 (IGF-1), epidermal growth factor (EGF), transforming growth factor-β (TGF-β), and nerve growth factor (NGF) are among its components that play pivotal roles in neonatal development, immune system priming, and gastrointestinal maturation. This study examined the effects of gestational diabetes mellitus (GDM), maternal hypothyroidism, and method of delivery on the concentrations of these factors in colostrum collected at three distinct postpartum time points. Methods: A group of 39 women was included, 20 of whom gave birth vaginally, whereas caesarean section was performed in 19 patients. A total of 18 volunteers were diagnosed with GDM, and 17 suffered from hypothyroidism. Colostrum samples were collected from the volunteers in the first 3 days after birth under hospital conditions. Growth factors like IGF-1, EGF, NGF, and TGF-β were measured in the samples using commercial immunoenzymatic assays. Results: No significant differences were observed in the values of these parameters between the groups of women (with GDM or hypothyroidism and healthy, as well as giving birth naturally and by caesarean section). In addition, the growth factors exhibited good stability within the first few postpartum days (CVs for all studied parameters: in the range of 0.7–5.0%). Conclusions: The pregnancy disorders that were properly controlled and treated by specialists appeared not to affect the levels of the analyzed growth factors—just like the type of delivery and the day of colostrum collection. Full article
(This article belongs to the Special Issue Breastmilk for Healthy Development)
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