Pregnancy

About: Pregnancy is a research topic. Over the lifetime, 163969 publications have been published within this topic receiving 4013502 citations. The topic is also known as: pregnancy & gestation.

Pregnancy outcomes among women with polycystic ovary syndrome treated with metformin

Abstract: BACKGROUND: We sought to determine whether metformin, which had facilitated conception in 72 oligoamenorrhoeic women with polycystic ovary syndrome (PCOS), would safely reduce the rate of first trimester spontaneous abortion (SAB) and increase the number of live births without teratogenicity. METHODS: Seventytwo oligoamenorrheic women with PCOS conceived on metformin (2.55 g/day). They were prospectively assessed in an outpatient clinical research centre. Outcome measures included number of first trimester SAB, live births, normal ongoing pregnancies ≥13 weeks, gestational diabetes (GD), congenital defects (CD), birthweight and height, as well as weight, height, and motor and social development during the first 6 months of life. RESULTS: Of the 84 fetuses, to date there have been 63 normal live births without CD (75%), 14 first trimester SAB (17%), and seven ongoing pregnancies ≥13 weeks with normal sonograms without CD (8%). Previously, without metformin, 40 of the 72 women had 100 pregnancies (100 fetuses) with 34 (34%) live births and 62 (62%) first trimester SAB. In current pregnancies on metformin in these 40 women (46 pregnancies, 47 fetuses), there have been 33 live births (70%), two pregnancies ongoing ≥13 weeks (4%), and 12 SAB (26%) (P < 0.0001). There was no maternal lactic acidosis, and no maternal or neonatal hypoglycaemia. Fasting entry serum insulin was a significant explanatory variable for total (previous and current) first trimester SAB, odds ratio 1.32 (for each 5 µU/ml rise in insulin), 95% CI 1.09– 1.60 (P 0.005). On metformin, GD developed in 4% of pregnancies versus 26% of previous pregnancies without metformin, P 0.025. There have been no major CD in the 63 live births or CD by sonography in the seven fetuses ≤13 weeks. In the 63 live births, neither weight nor height differed from the normal neonatal population. At 6 month follow-up, height was greater (P 0.008) and weight did not differ from the normal paediatric population; motor and social development were normal. CONCLUSIONS: Metformin therapy during pregnancy in women with PCOS was safely associated with reduction in SAB and in GD, was not teratogenic, and did not adversely affect birthweight or height, or height, weight, and motor and social development at 3 and 6 months of life.

Maternal and Neonatal Morbidity and Mortality Among Pregnant Women With and Without COVID-19 Infection: The INTERCOVID Multinational Cohort Study

Abstract: José Villar, MD; Shabina Ariff, MD; Robert B. Gunier, PhD; Ramachandran Thiruvengadam, MD; Stephen Rauch, MPH; Alexey Kholin, MD; Paola Roggero, PhD; Federico Prefumo, PhD; Marynéa Silva do Vale, MD; Jorge Arturo Cardona-Perez, MD; Nerea Maiz, PhD; Irene Cetin, MD; Valeria Savasi, PhD; Philippe Deruelle, PhD; Sarah Rae Easter, MD; Joanna Sichitiu, MD; Constanza P. Soto Conti, MD; Ernawati Ernawati, PhD; Mohak Mhatre, MD; Jagjit Singh Teji, MD; Becky Liu, MBBS; Carola Capelli, MD; Manuela Oberto, MD; Laura Salazar, MD; Michael G. Gravett, MD; Paolo Ivo Cavoretto, PhD; Vincent Bizor Nachinab, MD; Hadiza Galadanci, MSc; Daniel Oros, PhD; Adejumoke Idowu Ayede, MD; Loïc Sentilhes, PhD; Babagana Bako, MD; Mónica Savorani, MD; Hellas Cena, PhD; Perla K. García-May, MD; Saturday Etuk, MD; Roberto Casale, MD; Sherief Abd-Elsalam, PhD; Satoru Ikenoue, PhD; Muhammad Baffah Aminu, MD; Carmen Vecciarelli, MD; Eduardo A. Duro, MD; Mustapha Ado Usman, MBBS; Yetunde John-Akinola, PhD; Ricardo Nieto, MD; Enrico Ferrazi, MD; Zulfiqar A. Bhutta, PhD; Ana Langer, MD; Stephen H. Kennedy, MD; Aris T. Papageorghiou, MD

Maternal lipids as strong determinants of fetal environment and growth in pregnancies with gestational diabetes mellitus.

Abstract: RESEARCH DESIGN AND METHODS — In 150 pregnancies, serum triglycerides (TGs), cholesterol, free fatty acids (FFAs), glycerol, insulin, and glucose were determined in maternal serum and cord blood during the 3rd trimester. Maternal glucose values came from oral glucose tolerance testing and glucose profiles. Measurements of fetal abdominal circumference (AC) were performed simultaneously with maternal blood sampling and birth weight, and BMI and neonatal fat mass were obtained following delivery. RESULTS — Maternal TGs and FFAs correlated with fetal AC size (at 28 weeks: triglycerides, P 0.001; FFAs, P 0.02), and at delivery they correlated with all neonatal anthropometric measures (FFA: birth weight, P 0.002; BMI, P 0.001; fat mass, P 0.01). After adjustment for confounding variables, maternal FFAs and TGs at delivery remained the only parameters independently related to newborns large for gestational age (LGA) (P 0.008 and P 0.04, respectively). Maternal FFA levels were higher in mothers with LGA newborns than in those with appropriate for gestational age (AGA) newborns (362.8 101.7 vs. 252.4 10.1, P 0.002). Maternal levels of TGs, FFAs, and glycerol at delivery correlated with those in cord blood (P 0.003, P 0.004, and P 0.005, respectively). Fetal triglyceride and cholesterol levels were negatively correlated with newborn birth weight (P 0.001), BMI (P 0.004), and fat mass (P 0.001). TGs were significantly higher in small for gestational age (SGA) newborns compared with AGA or LGA newborns, while insulin-to-glucose ratio and FFAs were the highest in LGA newborns. CONCLUSIONS — In well-controlled GDM pregnancies, maternal lipids are strong predictors for fetal lipids and fetal growth. Infants with abnormal growth seem to be exposed to a distinct intrauterine environment compared with those with appropriate growth. Diabetes Care 31:1858–1863, 2008