Maternal serum atrial natriuretic peptide (ANP) and brain-type natriuretic peptide (BNP) levels in gestational diabetes mellitus

Objective: The aim of the study is to evaluate maternal serum atrial natriuretic peptide (ANP) and brain-type natriuretic peptide (BNP) levels in patients with getational diabetes mellitus compared with a control group.

Methods: We have measured maternal serum ANP and BNP levels in 35 otherwise healthy and 45 gestational diabetic women between gestational week 24 and 28 referred to our unit in a cross-sectional study. Independent samples t-test or the Mann–Whitney U-test was used for comparison of two groups where appropriate.

Results: Mean maternal serum homeostasis model assessment of insulin resistance (HOMA-IR), HbA1c, fasting glucose and insulin levels in gestational diabetes mellitus (GDM) group were significantly higher than the control group (p?<?0.01). Mean maternal serum ANP and BNP levels of women with GDM were significantly lower than the control group (12.9?±?9.9 versus 34.8?±?16.9?pg/ml, p?<?0.001; 416.6?±?209.7 versus 629.7?±?162.2?mg/dl, p?<?0.001, respectively). Maternal serum ANP and BNP levels were negatively correlated with insulin levels, HbA1c and HOMA-IR values (p?<?0.05).

Conclusions: Maternal serum ANP and BNP levels are significantly lower in patients with GDM. These biomarkers might be valuable in clinical setting for identifying high-risk women for developing diabetes during pregnancy.     

Neopterin and hsCRP are not correlated in gestational diabetes mellitus

Objective: To determine serum neopterin and high sensitive C-reactive protein (hsCRP) levels in patients with and without gestational diabetes mellitus (GDM).

Methods: Neopterin and hsCRP levels were quantified in 28 women with GDM and 20 pregnant women with normal glucose tolerance (NGT). Postpartum neopterin and hsCRP levels were measured in a follow-up study.

Results: Neopterin levels were significantly higher in women with GDM than in women with NGT (15.89?±?8.19?nmol/L versus 10.4?±?3.8?nmol/L, p?p?p?=?0.9, respectively). In contrast, hsCRP levels decreased after delivery in patients with GDM (5.74?±?3.91 versus 3.78?±?2.78, p?r?=?0.3, p?=?0.02) and fasting glucose (r?=?0.4, p?=?0.004), postprandial glucose (r?=?0.3, p?=?0.01), HbA1c (r?=?0.3, p?=?0.02), whereas hsCRP levels were correlated with pre-pregnancy (r?=?0.3, p?=?0.04) and pregnancy body mass index (r?=?0.4, p?=?0.008). No correlation between serum neopterin and hsCRP levels was found (p?=?0.9).

Conclusion: Neopterin levels increased in patients with GDM; hence, it may be related to inflammation. However, the lack of correlation between neopterin and hsCRP suggests the role of different attitudes of these two parameters in the course of pregnancy and GDM.     

Weight gain in gestational diabetes: the effect of treatment modality

Objective: To evaluate treatment effectiveness (diet alone, insulin or glyburide) on maternal weight gain in gestational diabetes (GDM).

Methods: GDM patients were treated with diet alone, insulin or glyburide. Weight gain was stratified into: prior to GDM diagnosis, from diagnosis to delivery and total pregnancy weight gain. Good glycemic control was defined as mean blood glucose ≤105?mg/dl and obesity as Body Mass Index (BMI)?≥?30?kg/m², overweight BMI 25–29?kg/m² and normal <?25?kg/m².

Results: Total weight gain was similar in all the treatment groups. Two-thirds of weight gain occurred prior to diagnosis (diet 85%, insulin 67% and glyburide 78%). Post-diagnosis, patients on diet alone gained less weight than those on insulin or glyburide (p?<?0.001); insulin-treated patients showed greater weight gain than glyburide-treated patients (p?<?0.001). Patients on diet with good glycemic control showed less weight gain after diagnosis than patients on insulin or glyburide (2.8?±?13, 6.6?±?10, 5.2?±?7.9 lbs, respectively, p?<?0.02). Poorly-controlled patients, regardless of treatment, had similar patterns of weight gain throughout pregnancy.

Conclusion: Patterns of maternal weight gain in GDM pregnancies are associated with treatment modality and level of glycemic control.     

Relationship between advanced glycation end products and gestational diabetes mellitus

Objective: To investigate the levels of and dynamic changes of advanced glycation end products (AGEs) in maternal plasma during pregnancy and explore the association between these levels and gestational diabetes mellitus (GDM).

Methods: This study recruited 90 GDM women and 90 healthy pregnant controls. The women received prenatal care and were hospitalized for delivery in Peking University First Hospital in China between October 2015 and April 2016. The patients were recruited and provided blood samples during gestational weeks 24–29. The levels of AGEs, TNF-α, hs-CRP, plasma glucose, and FINS and lipid profiles were measured, and HOMA-IR was calculated. New blood samples were collected and AGE was measured again in the two groups at 33–41 weeks of gestation to identify its dynamic changes.

Results: The levels of AGEs were significantly higher in the GDM group than in the NGT group at both 24–29 weeks (473.65?±?105.32 versus 324.36?±?57.86?ng/L; p?p?p?p?=?.003), TNF-α (p?=?.005), and hs-CRP (p?p?=?.001). In the NGT group, there was no significant change in the concentration of AGEs between the two gestational periods (p?=?.388).

Conclusions: Plasma levels of AGEs are associated with GDM. During pregnancy, the changes observed in the levels of AGEs were different between GDM and normal pregnancies.     

Glyburide in gestational diabetes – prediction of treatment failure

Objective.?To identify factors predicting failure of glyburide treatment in women with gestational diabetes mellitus (GDM).

Methods.?A retrospective study of all women with GDM that were treated with glyburide in a single tertiary referral center. Patients were switched from glyburide to insulin if they failed to achieve glycemic goals, and were then classified as glyburide failure.

Results.?Overall, 124 women with GDM treated with glyburide were included in the study, of which 31 (25%) failed to achieve glycemic control. Women in the failure group were characterized by a higher weight gain during pregnancy, higher rates of GDM on previous pregnancies, and a glucose challenge test (GCT) result. On multivariate logistic regression analysis, a GCT value of >200?mg/dl (OR=7.1, 95% CI 2.8–27.6) and weight gain ≥12?kg (OR=3.9, 95% CI 1.2–13.0) were the only significant and independent predictors of glyburide failure. Most women who were successfully treated with glyburide required a daily dose of 5?mg or less and the time required to achieve glycemic control in these cases was 12.4±4.9 days (range 5–24 days). Of the women who failed to achieve glycemic control with gluburide, 26/31 were switched to insulin, of them only 12 (46%) achieved desired level of glycemic control.

Conclusion.?Most women with GDM achieved desired level of glycemic control under glyburide treatment.     

Role of antioxidants in gestational diabetes mellitus and relation to fetal outcome: a randomized controlled trial

Objective: To examine the effect of antioxidant administration on the oxidative parameters in both blood and placental tissue and its relation to fetal outcome in women with GDM.

Patients and methods: Two-hundred pregnant women with gestational diabetes mellitus (GDM) were randomized into 2 groups, Group1 received 1 gram L-ascorbic acid per day and Group2 received placebo.

Results: The use of antioxidants significantly lower the needed insulin dose for blood sugar control (25.6?±?20.3 versus 40.5?±?23.7, respectively). In placental tissue homogenates, glutathione (GSH) was 49.6?±?5.9 versus 62.34?±?4.99, malondialdahyde (MDA) was 165.7?±?9.2 versus 264.15 ±?12, superoxide dismutase (SOD) was 0.3?±?0.3 versus 0.054?±?0.16 while catalase (CAT) was 14.06?±?2.4 versus 15.52?±?3.97 and glutathione peroxidase (GPx) was 14?±?4.1 versus 26.3?±?4.26 in antioxidant group compared to the control group (p?<?0.001). In maternal blood, GSH was 1.5?±?0.3 versus 0.74?±?0.088, CAT was 380.7?±?11 versus 325.44?±?21.8, GPx was 52.3?±?8.7 versus 75.82?±?6.84 and SOD was 188?±?15.3 versus 98.56?±?11.05 in antioxidant group compared to control group (p <?0.001). In neonatal blood, the level of MDA and SOD showed a statistically significant difference between antioxidants and control groups (4?±?0.7 versus 6.6 7 ±0.66 and1 8 8?±?15.3 versus 98.5?±?11.05, respectively) (p?<?0.001). The neonatal blood sugar after 1 and 2?hours of delivery was more stable in antioxidant group (56.7?±?10.9 versus 39.7?±?11.1 and 58.5?±?10.8 versus 41.7?±?13.1, respectively) (p <0.05). The neonates NICU admission was lower in antioxidant group (5 versus 11) (p <0.05).

Conclusion: The use of antioxidants markedly reverses the oxidative stresses in women with GDM with marked improvement on neonatal outcome.     

Homeostatic indices of insulin resistance among gestational diabetics in anticipating pregnancy complications

Abstract

Objective: This was to determine HOMA-IR score as well as to assess its association in fetal and maternal outcomes among pregnant women with diabetes risks.

Methods: A prospective cohort study of pregnant women with diabetes risks was done. GDM was diagnosed using modified glucose tolerance test. Serum insulin was taken and measured by an electrochemiluminescence immunoassay method. Plasma glucose was measured by enzymatic reference method with hexokinase. HOMA-IR score was calculated for each patient. Maternal and fetal outcomes were analyzed.

Results: From 279 women recruited, 22.6% had GDM with higher HOMA-IR score (4.07?±?2.44 versus 2.08?±?1.12; p?=?0.001) and fasting insulin (16.76?±?8.63?µIU/L versus 10.15?±?5.07?µIU/L; p?=?0.001). Area under ROC curve for HOMA-IR score was 0.79 (95% confidence interval, 0.74–0.84) with optimum cut-off value of 2.92 (sensitivity?=?63.5%; specificity?=?89.8%), higher than recommended by IDF (2.38). This point showed significant association with neonatal hypoglycemia (p?=?0.02) and Cesarean section (p?=?0.04) in GDM mothers.

Conclusions: HOMA-IR score and insulin resistance levels were higher in GDM women in our population. With the cut-off HOMA-IR value of 2.92, neonatal hypoglycemia and Cesarean section were significant complications in GDM mothers. This can be used in anticipation of maternal and fetal morbidities.     

Obstetric outcomes and placental findings in gestational diabetes patients according to maternal prepregnancy weight and weight gain

Objective: We assessed clinical outcomes and placental pathology among pregnancies complicated with gestational diabetes mellitus (GDM) according to their pregestational body mass index (BMI) and weight gain during pregnancy.

Study design: Pregnancy outcome and placental pathological reports of all GDM deliveries, during 2009–2015, were reviewed. We compared women with pregestational BMI?>?30 and or gestational weight gain >20?kg (high-BMI group), and women with pregestational BMI?Results: Out of the 429 women with GDM, 221 (51.5%) were in the high-BMI group and 208 (48.3%) were in the normal BMI group. As compared to the normal BMI group, the high-BMI group displayed a higher rate of GDMA2 41.6 versus 30.2%, p?=?.01, higher birth weight, 3475?±?508?g versus 3242?±?503?g, p?p?p?=?.07, respectively. By logistic regression analysis, past CD and high BMI were independently associated with CD, while GDM type and birth weight were nonsignificant. Pathological reports were available for 143 of these patients. Placental weight was increased among the high-BMI group, but did not retain significance after adjustment for birth weight, and GDM type. No differences were demonstrated in other placental histological findings.

Conclusions: GDM pregnancies accompanied by increased weight gain or elevated pregestational BMI are associated with adverse obstetric outcomes, despite similar placental findings. Patient should be advised accordingly, as gestational weight gain may determine delivery mode.     

Higher levels of thyrotropin in pregnancy and adverse pregnancy outcomes

Objective: To determine the frequency of subclinical hypothyroidism in women with pathological pregnancies and the association between elevated thyroid-stimulating hormone (TSH) and pregnancy outcome.

Subjects and methods: A cross-sectional prospective study investigated value of TSH and free thyroxine (FT4) in (1) pregnant women with hypertension (HTA) (N?=?62) or preeclampsia (PE) (N?=?50), (2) women with gestational diabetes mellitus (GDM) (N?=?92) in pregnancy, and (3) women with normal pregnancies (control) (N?=?201). The level of statistical significance was set at p?Results: Of the total 404 respondents, the highest incidence of subclinical hypothyroidism was in the group with preeclampsia 22%, followed HTA group 9.6%; GDM group 10.9% and in the control group 9% (p?p?3?mIU/L (p?=?.003). There were no differences in the average TSH value between GDM (1.93?±?1.03?mIU/L) and control group (p?=?.962).

Conclusions: Early detection and optimal treatment of thyroid dysfunction before and in the first trimester of pregnancy reduces the risk of adverse pregnancy outcomes.     

Elevated mean platelet volume is associated with gestational diabetes mellitus

The mean platelet volume (MPV) is an indicator of the average size and activity of platelets. Elevated MPV values are associated with larger and more active platelets and perceived as a new independent cardiovascular risk factor. The aim of this study was to determine the MPV in women with gestational diabetes mellitus (GDM) and to determine the correlation of MPV with metabolic parameters in GDM. We retrospectively analyzed 30 women with GDM and 38 body mass index-matched women with healthy pregnancies as controls. MPV and platelet counts were recorded in the third trimester and at postpartum 6–12 months for GDM group and in the third trimester for control group. Third-trimester MPV was significantly higher in GDM group compared to control group (8.8?±?1.0 versus 8.1?±?0.7?fl, p?=?0.002). In women with GDM, there was a significant decrease in MPV in the postpartum period (8.8?±?1.0 versus 8.1?±?0.8?fl, p?r?=?0.346, p?=?0.007 and r?=?0.346, p?=?0.02, respectively). Our results indicate that MPV is increased in GDM. Monitoring MPV, which is widely available in clinical practice, may potentially identify women who will develop gestational diabetes during pregnancy.     

Maternal serum ADAMTS-9 levels in gestational diabetes: a pilot study

Objective: Gestational diabetes mellitus (GDM) is characterized with insulin resistance which is diagnosed during pregnancy. Although pregnancy is a diabetogenic state, not all women develop GDM. Genetic factors together with enviromental factors cause the maladaptation of maternal pancreas to this diabetogenic state and GDM develops. ADAMTS-9 is a recently recognized molecule whose genetic variants have risk of GDM. Decreased levels have already been shown in fetal membranes. Maternal serum levels of this protein have not been studied yet. We hypothesized that the alteration of ADAMTS-9 expression should cause changes in maternal serum levels which further could help to identify the disease and develop new treatment strategies.

Materials and methods: This prospective case–control study is consisted of 27 pregnancies with GDM and 30 healthy singleton pregnancies matched for matenal age, gestational week, and maternal weight. GDM diagnosis was made with 2-h 75?g oral glucose tolerance test. ADAMTS-9 levels were compared between groups.

Results: ADAMTS levels were 3.62?±?0.33?ng/dL (range: 3.04–4.23) in GDM group and 4.65?±?1.70?ng/dL (range: 3.07–8.21) in control group (p?Conclusion: ADAMTS-9 levels were significantly lower in GDM pregnancies. This may help to understand the mechanism of GDM pathogenesis. In future, target treatments with ADAMTS proteins may help to improve the severity of diabetes pathogenesis.     

Omega-3 fatty acid supplementation affects pregnancy outcomes in gestational diabetes: a randomized,double-blind,placebo-controlled trial

Objective: This study was designed to assess the effects of omega-3 fatty acid supplementation on inflammatory factors, biomarkers of oxidative stress, and pregnancy outcomes among pregnant women with gestational diabetes (GDM).

Methods: This randomized, double-blind, placebo-controlled clinical trial was performed among 56 women with GDM. Subjects were randomly selected to receive either 1000?mg omega-3 fatty acid supplements (containing 180?mg eicosapentaenoic acid and 120?mg docosahexanoic acid) (n?=?27) or a placebo (n?=?27) for 6 weeks. Fasting blood samples were taken at study baseline and after 6 weeks of intervention to quantify biochemical variables. Newborn’s weight, height, head circumference, Apgar score, and hyperbilirubinemia were determined.

Results: At the end of the 6 weeks, taking omega-3 fatty acid significantly decreased serum high-sensitivity C-reactive protein (hs-CRP) (change from baseline: ?245.1?±?1570.5 versus?+?913.9?±?2329.4?ng/mL, p?=?0.03) and plasma malondialdehyde (MDA) concentrations (?0.4?±?1.3 versus?+?0.6±2.3, p?=?0.04) compared with the placebo. Supplementation with omega-3 had a low incidence of hyperbilirubinemiain newborns (7.7% versus 33.3%, p?=?0.02) and decreased newborns’ hospitalization rate (7.7% versus 33.3%, p?=?0.02).

Conclusions: Taken together, omega-3 fatty acid supplementation in GDM women had beneficial effects on maternal serum hs-CRP, plasma MDA levels, incidence of newborn’s hyperbilirubinemia, and hospitalization.     

Obstetric outcome of second trimester antenatal bleeding

Objective: To evaluate the clinical significance of vaginal bleeding in pregnant women between 14th and 22th gestational weeks.

Methods: This retrospective case–control study was conducted between September 2010 and December 2013. Two-hundred nineteen pregnant women with vaginal bleeding between 14th and 22th gestational weeks were compared with 325 pregnant women without vaginal bleeding for their maternal and early neonatal outcomes.

Results: Mean gestational age and birth weight of study group were significantly different from those of the control group respectively (37.9?±?2.8 versus 38.9?±?1.4 and 3071?±?710 versus 3349?±?446 for groups p?<?0.001). Vaginal bleeding between 14th and 22th gestational weeks had increased risk of having preterm birth (PB) and preterm premature rupture of membranes (PPROM) (OR: 10.8, 95% CI: [4.5–26.1]; OR: 12.0, 95% CI: [3.5–40.6], respectively). Gestational diabetes mellitus (GDM) and polyhydramnios ratio in the study group was significantly higher than the control respectively (4.1% versus 1.2%, p?=?0.031; 1.9% versus 0%, p?=?0.025).

Conclusion: Pregnant women with vaginal bleeding was a significantly risk factor for PB, PPROM, GDM, and polyhydramnios. Consequently, these pregnancies should be closely followed up for maternal and fetus complications.     

Gestational diabetes and pregnancy outcome – do we have right diagnostic criteria?

Abstract

Objective: To determine thresholds of maternal glycemia at which specific adverse pregnancy outcomes occur in high-risk population.

Methods: A total of 1002 pregnant women with risk factors for gestational diabetes mellitus (GDM) underwent an originally modified glucose tolerance test (OGTT) with 75?g of glucose. Information on OGTT results and pregnancy outcomes were collected from database and medical records.

Results: Large for gestational age (LGA) newborn, infant’s stay in the neonatal intensive care unit (NICU) >24?h, neonatal hyperbilirubinemia and cesarean section due to cephalopelvic disproportion were identified as specific GDM adverse outcomes. In the study group of participants with one or more specific GDM adverse outcomes, mean glycemic values during the modified OGTT (4.2?±?1.0?mmol/L at 0?min, 6.8?±?1.7?mmol/L at 30?min, 7.9?±?2.1?mmol/L at 60?min, 7.7?±?2.3?mmol/L at 90?min and 7.5?±?2.3?mmol/L at 120?min) according to Student’s t-test for independent samples were significantly higher than mean glycemic values in the control group of participants without specific adverse outcomes (p?<?0.001, p?=?0.02, p?<?0.001, p?<?0.001, p?<?0.001).

Conclusion: This study provides additional data that support the acceptance of the newly recommended outcome-based GDM diagnostic criteria.     

The impact of unicornuate uterus on perinatal outcomes after IVF/ICSI cycles: a matched retrospective cohort study

Objective: To evaluate the impact of unicornuate uterus on perinatal outcomes after in vitro fertilization and/or intracytoplasmic sperm injection (IVF/ICSI) cycles.

Methods: We performed a retrospective cohort study including 160 women with unicornuate uterus and 1:1 matched controls with normally shaped uterus. They received IVF/ICSI treatment during January 2009 and December 2011. The perinatal outcomes were followed up till December 2014.

Results: There were no significant differences in pregnancy rate, clinical pregnancy rate or live birth rate (53.6 versus 52.7, 41.4 versus 43.5, 33.8% versus 31.8%) between unicornuate uterus group and controls. Their biochemical pregnancy rate (22.8 versus 17.5%) and miscarriage rate (16.0 versus 18.8%) were similar. No significant differences were identified in preterm birth rate (18.3 versus 11.8%), birthweight (3.24?±?0.60 versus 3.33?±?0.54?kg) or birth length (50.47?±?2.33 versus 50.06?±?2.40?cm) among the singletons. However, lower gestational age (35.56?±?2.68 versus 36.71?±?1.73, p?=?.019), higher preterm birth rate (55.0 versus 34.4%, p?=?.038), lower birthweight (2.33?±?0.58 versus 2.69?±?0.38?kg, p?=?.001), lower birth length (45.33?±?2.46 versus 48.88?±?2.06?cm, p?=?.000), as well as higher rate of very low birthweight (13.2% versus 0, p?=?.007) were found for the twins from unicornuate uterus group.

Conclusions: The results indicated unimpaired pregnancy and perinatal outcomes for women with unicornuate uterus conceiving one fetus. However, close attention should be paid to twin pregnancy in unicornuate uterus owing to increased risks of prematurity and low birthweight. Selected single embryo transfer is recommended for women with unicornuate uterus undergoing IVF/ICSI cycles.     

Neonatal respiratory morbidity in late-preterm births in pregnancies with and without gestational diabetes mellitus

Objective: To evaluate neonatal respiratory morbidity in infants born late-preterm to mothers with or without gestational diabetes mellitus (GDM).

Methods: Analysis of a population-based cohort of all live-born singletons, born at 34 0/7 to 36 6/7 weeks to mothers with and without GDM, focusing on transient tachypnea of the newborn (TTN) and respiratory distress syndrome (RDS).

Results: The study group comprised 363 (4.7%) singletons born to mothers with GDM and the controls were 7400 born to mothers without GDM. Mothers with GDM were older (31.4?±?5.1 versus 29.5?±?5.1 years, p?p?Conclusion: GDM, per se, is not a major contributor to RDS in late pre-term infants. Rather, the combination of prematurity and cesarean birth act independently to increase the risk of respiratory morbidity.     

Investigation of maternal and cord blood erythropoietin and copeptin levels in low-risk term deliveries complicated by meconium-stained amniotic fluid

Objective: To compare maternal, cord blood erythropoietin (EPO), and copeptin levels in low-risk term deliveries which are complicated by meconium-stained amniotic fluid (MSAF) to those with clear amniotic fluid. Also, to evaluate the relations between these markers and cord blood pH values.

Methods: Low-risk term pregnant women with MSAF at an active phase of labor were defined as the study group (n?=?39). Pregnant women with clear amniotic fluid were selected for the control group (n?=?41). The two groups were matched for age, body mass index and gestational age. Maternal, cord blood EPO and copeptin levels with cord blood pH values were also measured.

Results: Maternal, cord blood EPO, and copeptin levels of study and control groups were 42.6?±?9.0 versus 40.7?±?9.2, 134.2 (20.5–834.6) versus 38.4 (10.3–114.2), 4.9 (0.1–31.1) versus 4.0 (3.1–28.4), and 4.7 (2.6–25.5) versus 3.6 (2.0–23.2), respectively. The differences were statistically significant for cord blood EPO, maternal and cord blood copeptin levels (p?p?=?0.004, p?p?p?p?=?0.005, and p?=?0.009, respectively).

Conclusion: We suggest that higher cord blood EPO and maternal and cord blood copeptin levels may be an indicator of fetal acidosis in low-risk term deliveries complicated by MSAF.     

The effects of probiotic supplementation on biomarkers of inflammation,oxidative stress and pregnancy outcomes in gestational diabetes

Objective: This study was designed to evaluate the effects of probiotic supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes among subjects with gestational diabetes (GDM).

Methods: This randomized, double-blind, placebo-controlled clinical trial was done among 60 subjects with GDM who were not on oral hypoglycemic agents. Patients were randomly allocated to intake either probiotic capsule containing Lactobacillus acidophilus, Lactobacillus casei and Bifidobacterium bifidum (2?×?10⁹ CFU/g each) (n?=?30) or placebo (n?=?30) for six?weeks.

Results: Compared with the placebo, probiotic supplementation resulted in significant decreases in fasting plasma glucose (FPG) (?5.3?±?6.7 vs.?+0.03?±?9.0?mg/dL, p?=?.01), serum high-sensitivity C-reactive protein (hs-CRP) (?2.2?±?2.7 vs.?+0.5?±?2.4?μg/mL, p?p?=?.03) and MDA/TAC ratio (?0.0003?±?0.0008 vs.?+0.0009?±?0.002, p?=?.004), and a significant increase in total antioxidant capacity (TAC) levels (+65.4?±?103.3 vs. ?37.2?±?143.7?mmol/L, p?=?.002). Probiotic supplementation did not affect pregnancy outcomes.

Conclusions: Overall, probiotic supplementation among women with GDM for six?weeks had beneficial effects on FPG, serum hs-CRP, plasma TAC, MDA and oxidative stress index, but did not affect pregnancy outcomes.     

Intrauterine hematomas in the second and third trimesters associated with adverse pregnancy outcomes: a retrospective study

Objective: To carry out a retrospective study of the clinical features of patients with intrauterine hematoma in the second and third trimesters, and discuss the risk factors for poor pregnancy outcomes.

Methods: A total of 398 patients who underwent routine examination in our hospital from January 2011 to December 2015 were classified into normal pregnancy (NP) group (N?=?265) and adverse pregnancy (AP) group (N?=?133), according to their pregnancy outcomes. Maternal clinical demographics, gestational age, location of hematoma, volume of hematoma, and accompanying contraction and vaginal bleeding were recorded.

Results: The average age of pregnant women in the NP and AP groups was 28.25?±?4.06 and 29.5?±?5.06 years, respectively (p?=?0.007). Gestational age at first detection of hematoma was 15.11?±?5.13 weeks in the NP group compared with 21.22?±?8.25 weeks in the AP group (p?p?Conclusion: Intrauterine hematoma in the second and third trimesters is a sign of pathological pregnancy, resulting in adverse outcomes. Maternal age, gestational age at first diagnosis, location of hematoma and accompanying contraction are risk factors for poor pregnancy outcomes.     

Ethnicity is an independent predictor of IVF-ICSI outcome: a study of 5,549 cycles in Spain and India

Aim: To determine the role of ethnicity on IVF/ICSI outcomes between Indian and white Caucasian women.

Settings and design: Retrospective cohort study.

Materials and methods: White Caucasian and Indian women undergoing IVF/ICSI treatment cycles. Total 5549 self, non-donor, fresh IVF cycles conducted from January 2014 to March 2015, out of which, 4227 were white Caucasian and 1322 were Indian. Data were collected on baseline characteristics, IVF cycle parameters and outcomes. Ongoing pregnancy rate (OPR) was measured as main outcome.

Results: Indian women differed significantly from white Caucasian women in baseline characteristics like age (30.6?±?0.2 versus 37.6?±?0.1 years; p?2; p?p?p?p?p?p?Conclusions: OPR was significantly lower among Indian ethnic group following IVF/ICSI suggest that ethnicity, like age, is a major and an independent predictor of IVF outcome.