| 1. |
- Bryman, Inger, et al.
(författare)
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Pregnancy rate and outcome in Swedish women with Turner syndrome
- 2011
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Ingår i: Fertility and Sterility. - : Elsevier BV. - 1556-5653 .- 0015-0282. ; 95:8, s. 2507-2510
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Tidskriftsartikel (refereegranskat)abstract
- Pregnancies occurred in 57 (12%) of 482 Swedish women with Turner syndrome with a liveborn rate of 54% in 124 pregnancies. Spontaneous pregnancies occurred in 40%, mainly in women with 45,X/46,XX mosaicism, and oocyte donation in 53% where miscarriages were less frequent, odds ratio 0.43 (95% confidence interval 0.17-1.04). (Fertil Steril (R) 2011; 95: 2507-10. (c) 2011 by American Society for Reproductive Medicine.)
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| 2. |
- Bryman, Inger, et al.
(författare)
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Pregnancy Rate and Outcome in Swedish Women With Turner Syndrome EDITORIAL COMMENT
- 2011
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Ingår i: Obstetrical and Gynecological Survey. - 0029-7828 .- 1533-9866. ; 66:12, s. 756-757
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The rate of spontaneous pregnancies in women with Turner syndrome (TS) is low (2% to 5%). Oocyte donation is an option for these women and enables many to become pregnant. Some investigators question the use of pregnancy induction in TS because of the high risk for aortic dissection or other serious cardiac events. A cardiac evaluation is recommended before pregnancy is planned in TS. Among patients with TS who use their own oocytes to become pregnant, 45% suffered a miscarriage. The aim of this study was to assess pregnancy rate and outcome in a population of Swedish women with spontaneous pregnancies or who were induced using donated oocytes. Cytogenetic karyotype also was examined; mosaicism was defined as the presence of more than 5% 46, XX cells. The study subjects were 482 women with TS who had participated in a voluntary screening program conducted at Swedish Turner Centers. Among the 482 women with TS, 57 (12%) had pregnancies, including spontaneous pregnancies. The live-born rate was 67 of 124 (54%). The patient's own oocytes were used in 27 (47%) of the pregnancies and oocyte donation in 30 (53%) of pregnancies. Spontaneous pregnancies occurred in 23 of 57 women (40%) with TS. Most pregnancies using the patient's own oocytes occurred in those with 45, X/46, XX mosaic karyotype. The miscarriage rate was 26% after oocyte donation and 45% with the use of the patient's own oocytes. Five liveborns (7%) had birth defects or a serious illness; 4 of these were born after spontaneous pregnancies. Only 1 live-born had coarctation of the aorta.
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| 3. |
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| 4. |
- Anderberg, Eva, et al.
(författare)
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Prevalence of impaired glucose tolerance and diabetes after gestational diabetes mellitus comparing different cut-off criteria for abnormal glucose tolerance during pregnancy.
- 2011
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 90, s. 1252-1258
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To determine the prevalence of diabetes and impaired glucose tolerance after gestational diabetes mellitus in relation to different categories of glucose tolerance during pregnancy. Design. Prospective study. Setting. Four delivery departments and three hospitals in southern Sweden took part in recruitment and follow-up. Population. Women undergoing a 75 g oral glucose tolerance test during pregnancy delivering in 2003-2005. Methods. At first follow-up, 1-2 years after delivery, 29% of eligible women with abnormal glucose tolerance during pregnancy had an oral glucose tolerance test; 160 with gestational diabetes, 309 with gestational impaired glucose tolerance, in addition to 167 control women. Cut-off levels defining gestational diabetes and impaired glucose tolerance were 2-hour capillary blood glucose levels 9.0 and 7.8 mmol/l or plasma glucose 10.0 and 8.6 mmol/l, respectively. Main outcome measures. Frequency of abnormal test results at follow-up. Results: Diabetes was diagnosed in 11% and impaired glucose tolerance in 24% of women with gestational diabetes vs. 4% and 23% in those with gestational impaired glucose tolerance. Combining women with abnormal test results during pregnancy revealed diabetes or impaired glucose tolerance in 29% as compared to 10% among controls; the odds ratio (95% confidence interval) for having abnormal test results was 3.3 (1.8-5.9) in a multivariate logistic regression analysis. Conclusions: Lowering the cut-off level for gestational diabetes to also include the category of impaired glucose tolerance would identify a high percentage of women with diabetes and impaired glucose tolerance postpartum, they constitute target groups for intervention and/or diabetes prevention.
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| 5. |
- Anderberg, Eva, et al.
(författare)
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The impact of gestational diabetes mellitus on pregnancy outcome comparing different cut-off criteria for abnormal glucose tolerance.
- 2010
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 89:12, s. 1532-1537
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Objective. To examine pregnancy outcomes in relation to different categories of glucose tolerance during pregnancy. Design. Prospective observational cohort study. Setting. Patient recruitment and data collection were performed in four delivery departments in southern Sweden. Population. Women delivering during 2003-2005; 306 with gestational diabetes mellitus, 744 with gestational impaired glucose tolerance and 329 randomly selected controls. Methods. All women were offered a 75 g oral glucose tolerance test during pregnancy. On the basis of their capillary 2-hour plasma glucose concentrations, three groups were identified: gestational diabetes mellitus (>10.0 mmol/l), gestational impaired glucose tolerance (8.6-9.9 mmol/l) and controls (<8.6 mmol/l). Data for the groups were compared using a population-based database. Main outcome measures. Maternal and fetal outcomes. Results. For the gestational diabetes mellitus group, adjusted odds ratios (95% confidence intervals) for hypertensive disorders during pregnancy and induction of labor and emergency cesarean section were 2.7 (1.3-5.8), 3.1 (1.8-5.2) and 2.5 (1.5-4.4), respectively; and for Apgar score <7 at 5 minutes, need for neonatal intensive care >1 day and large-for-gestational age infant were 9.6 (1.2-78.0), 5.2 (2.8-9.6) and 2.5 (1.3-5.1), respectively. The increases in odds ratios for the gestational impaired glucose tolerance group were less pronounced but still significant for hypertension during pregnancy, induction of labor, large-for-gestational age infant and use of neonatal intensive care >1 day, with odds ratios (95% confidence interval) 2.0 (1.0-4.1), 1.8 (1.1-3.0), 2.1 (1.1-3.9) and 2.1 (1.1-3.8), respectively. Conclusions. These data indicate that even limited degrees of maternal hyperglycemia may affect the outcome of pregnancy.
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| 6. |
- Anderberg, Eva, et al.
(författare)
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Use of healthcare resources after gestational diabetes mellitus: A longitudinal case-control analysis.
- 2012
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 40:4, s. 385-390
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To analyse whether gestational diabetes mellitus (GDM) was associated with increases in healthcare utilisation after delivery. METHODS: A longitudinal case-control registry-based study of 579 women with GDM delivered in 1995-2001. Two controls for each case were selected from the Swedish National Board of Health and Welfare, matched for year of birth, year of delivery, and municipality of residence. Data regarding healthcare utilisation was provided by the Patients' Administrative System in Skåne County, Sweden, covering the period from the years of delivery up to year 2009. RESULTS: Women with previous GDM had higher mean number of contacts and total cost in the years after delivery as compared to controls, also when excluding utilisation related to subsequent pregnancies and childbirth. By year 2009, 31% of women with prior GDM were diagnosed with diabetes, compared to 1% of controls. Women diagnosed with diabetes were more likely to use health care (odds ratio 14.22, 95% confidence interval 5.87-34.45) controlling for age and time since delivery, whereas cases not diagnosed with diabetes did not differ from controls. The average annual cost of healthcare utilisation was 101% higher (p<0.001) for women with diabetes 10 years after delivery compared to controls. CONCLUSIONS: GDM was associated with higher healthcare utilisation postpartum for women who had a diabetes diagnosis. The results call for implementation of structured programmes to follow up women with GDM postpartum for early detection of diabetes and effective management, which may have the potential for improved health and savings in healthcare costs.
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| 7. |
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| 8. |
- Berntorp, Kerstin, et al.
(författare)
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Initiation of biphasic insulin aspart 30/70 in subjects with type 2 diabetes mellitus in a largely primary care-based setting in Sweden.
- 2011
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Ingår i: Primary Care Diabetes. - : Elsevier BV. - 1878-0210 .- 1751-9918. ; 5, s. 89-94
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: Despite a wealth of clinical trial data supporting use of the premixed insulin analogue, biphasic insulin aspart 30 (BIAsp 30) in the treatment of type 2 diabetes mellitus (T2DM), there is limited documentation of its use in primary care-based clinical practice. METHODS: An observational study investigating the safety and efficacy of BIAsp 30 in routine clinical practice was conducted. Patients were followed up 3 and 6 months after initiating insulin treatment. Safety and efficacy measures were documented. RESULTS: During the course of the study, 1154 patients were included (age range 20-95years), of whom 89% completed the 6-month follow-up period. Mean HbA(1c) at baseline was 8.8% (73mmol/mol), and had improved to 7.2% (55mmol/mol) after 6 months of treatment. The rate of total hypoglycaemia at completion of the study was 4.1 events per patient year. Major hypoglycaemic events were rare (two in total). CONCLUSIONS: BIAsp 30 was initiated safely and effectively in insulin-naïve patients with T2DM. The safety and efficacy profile observed in clinical trials was confirmed in this largely primary care-based setting in Sweden.
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| 9. |
- Claesson, Rickard, et al.
(författare)
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The potential impact of new diagnostic criteria on the frequency of gestational diabetes mellitus in Sweden.
- 2013
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 92:10, s. 1223-1226
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Tidskriftsartikel (refereegranskat)abstract
- The International Association of Diabetes and Pregnancy Study Groups (IADPSG) has suggested new diagnostic criteria for gestational diabetes mellitus. Many centers in Europe still use the World Health Organization (WHO) criteria. In southern Sweden we use the 2-h threshold of the European Association for the Study of Diabetes criteria based on universal screening with a 75-g oral glucose tolerance test. We have retrospectively scrutinized oral glucose tolerance tests in a subset of 174 women included in a previous study, diagnosed with gestational diabetes mellitus 1996-1999. A complete repeat oral glucose tolerance test was performed directly after diagnosis in 120 women. When applying the current Swedish criteria, and the IADPSG and the WHO criteria to the material, gestational diabetes mellitus was confirmed in 67% (80/120), 84% (101/120), and 80% (96/120), respectively. Hence, 26% (101/80) more women were identified by the IADPSG criteria and 20% (96/80) more women by the WHO criteria, compared with the criteria presently in use.
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| 10. |
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