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- Berg, Marie, 1955, et al.
(author)
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Early random capillary glucose level screening and multidisciplinary antenatal teamwork to improve outcome in gestational diabetes mellitus
- 2007
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In: Acta Obstet Gynecol Scand. ; 86:3, s. 283-90
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Journal article (peer-reviewed)abstract
- BACKGROUND: This study describes maternal and neonatal characteristics and delivery outcome in women with gestational diabetes mellitus [GDM], compared to a control group. METHODS: A retrospective observational study of 719 women with GDM was undertaken in a Swedish urban district. All other parturients at the same hospital served as the control group. GDM was diagnosed using random capillary glucose levels at fixed intervals, beginning early in pregnancy. An oral glucose tolerance test was performed at glucose levels>or=7.0 mmol/l (127.8 mg/dl). Data was analysed according to glucose levels at diagnosis, ie, mild or severe GDM. RESULTS: GDM was diagnosed in 2.28% of the women who were older and had higher Body Mass Index [BMI]. A high proportion was of non-Nordic origin (44.5%); they had severe GDM more often (49.1%) than the Nordic group (33.1%). The GDM-mild group had less complications and abnormalities, compared to the GDM-severe group, although both groups differed from the control group in this respect. Delivery was spontaneous in 70.2% of GDM-mild, 65.7% of GDM-severe and 81.0% of the control group. LGA (+2 SD) was found in 4.8, 10.5 and 3.2%, respectively. CONCLUSION: Early non-fasting random universal screening and multidisciplinary antenatal teamwork intervention seems to be favourable, with low rates of excessive fetal growth, instrumental vaginal delivery and caesarean section.
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| 2. |
- Thordstein, Magnus, et al.
(author)
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Visual evoked potentials in disproportionately growth-retarded human neonates
- 2004
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In: Pediatric Neurology. - : Elsevier BV. - 0887-8994 .- 1873-5150. ; 30:4, s. 262-70
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Journal article (peer-reviewed)abstract
- To study brain function in the neonatal period, disproportionately growth-retarded (n = 33) and appropriately grown (n = 21) infants were examined using Doppler flow velocities prenatally and visual evoked potentials postnatally. Visual evoked potentials recordings were made at gestation of 40 and 46 weeks. The group of growth-retarded infants had significantly prolonged latencies to both of the two major peaks (designated P and N), most pronounced for the P peak. This result was observed at both ages investigated and corresponds to a developmental delay of 3 weeks. For individuals, the increase in P latency correlated to prenatal flow indices and to neonatal anthropometric parameters indicative of growth retardation. We conclude that in utero growth retardation affects brain development as assessed by visual evoked potentials in the neonatal period. This developmental delay may be produced by intracerebral factors during the process of growth retardation, and these alterations may have a prognostic value.
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| 3. |
- Welin, Anna-Karin, 1965, et al.
(author)
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Melatonin reduces inflammation and cell death in white matter in the mid-gestation fetal sheep following umbilical cord occlusion.
- 2007
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In: Pediatric research. - : Springer Science and Business Media LLC. - 0031-3998 .- 1530-0447. ; 61:2, s. 153-8
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Journal article (peer-reviewed)abstract
- The premature infant is at increased risk of cerebral white matter injury. Melatonin is neuroprotective in adult models of focal cerebral ischemia and attenuates ibotenate-induced white matter cysts in neonatal mice. Clinically, melatonin has been used to treat sleep disorders in children without major side effects. The aim of this study was to investigate the protective and anti-inflammatory effects of melatonin in the immature brain following intrauterine asphyxia. Fetal sheep at 90 d of gestation were subjected to umbilical cord occlusion. Melatonin (20 mg/kg, n = 9) or vehicle (n = 10) was administered IV to the fetus, starting 10 min after the start of reperfusion and continued for 6 h. Melatonin treatment resulted in a slower recovery of fetal blood pressure following umbilical cord occlusion, but without changes in fetal heart rate, acid base status or mortality. The production of 8-isoprostanes following umbilical cord occlusion was attenuated and there was a reduction in the number of activated microglia cells and TUNEL-positive cells in melatonin treated fetuses, suggesting a protective effect of melatonin. In conclusion, this study shows that melatonin attenuates cell death in the fetal brain in association with a reduced inflammatory response in the blood and the brain following intrauterine asphyxia in mid-gestation fetal sheep.
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