The incidence of obstructive sleep apnea (OSA) is higher in pregnancy than in non-pregnancy,and obesity is a major risk factor.OSA in pregnancy can lead to multiple organ dysfunction and is associated with hypertensive disorders in pregnancy,gestational diabetes mellitus,premature birth,and fetal growth restriction. Therefore,early screening and diagnosis are essential for the prevention and treatment of OSA in pregnancy.
Diabetes, Gestational ; Female ; Humans ; Obesity ; Pregnancy ; Pregnancy Complications/epidemiology* ; Premature Birth ; Risk Factors ; Sleep Apnea, Obstructive/therapy*

Objective To explore the performance of mobile health platform for standardized management of pregnant women with gestational diabetes mellitus(GDM). Methods A randomized controlled trial was conducted,in which 295 women with GDM were randomized into two groups(traditional management group and mobile health management group)by a computer-generated sequence.The traditional management group accepted standardized GDM management,and the mobile health management group was supplemented by mobile health management based on the standardized management.The glycemic control rate and the incidences of low birth weight,macrosomia,preterm birth,premature rupture of membranes,postpartum hemorrhage after cesarean section,neonatal asphyxia,malformation,and admission to the neonatal intensive care unit were compared between the two groups. Results The glycemic control rate in mobile health management group was significantly higher than that in the traditional management group [(67.22±22.76)%
Cesarean Section ; Diabetes, Gestational/therapy* ; Female ; Fetal Macrosomia ; Humans ; Infant, Newborn ; Pregnancy ; Pregnancy Outcome ; Premature Birth ; Telemedicine

Objective To evaluate the effects of vitamin D supplementation on serum lipid profiles and neonatal prognosis in gestational diabetes mellitus(GDM)patients.Methods The electronic databases including PubMed,Web of Science,Embase,CNKI,and Wanfang Data were searched from inception to February 1,2020.All randomized controlled trials that compared vitamin D supplementation with placebo or without supplementation for GDM women were included.Paper selection,data extraction,meta-analysis and sensitivity analysis were conducted independently by two authors.Risk of bias was assessed using the Cochrane Risk of Bias Tool.The data were analyzed in RevMan 5.3 software and Stata 12.0.Results Totally 17 randomized controlled trials involving 1432 patients(704 in the intervention group and 728 in the control group)were included in the meta-analysis.The results showed that vitamin D supplementation significantly reduced serum total cholesterol [MD=-6.11,95% CI=(-7.17,-5.04)],low-density lipoprotein cholesterol [MD=-10.80,95% CI=(-14.72,-6.89)],and triglyceride [MD=-8.11,95% CI=(-10.09,-6.13)],while significantly increased serum 25-hydroxyvitamin D3 level [MD=45.45,95% CI=(41.98,48.92)] and high-density lipoprotein cholesterol [MD=2.77,95% CI=(1.59,3.96)].In addition,vitamin D supplementation significantly reduced the incidence rate of hyperbilirubinemia [RR=0.49,95% CI=(0.35,0.68)],premature birth [RR=0.44,95% CI=(0.27,0.72)],and neonatal hospitalization [RR=0.44,95% CI=(0.29,0.67)].Conclusions Vitamin D supplementation may regulate the serum lipid profiles in patients with GDM and reduce the incidence of adverse neonatal outcomes.More high-quality RCTs are needed to confirm the findings in our study.
Diabetes, Gestational/drug therapy* ; Dietary Supplements ; Female ; Humans ; Infant, Newborn ; Pregnancy ; Premature Birth ; Randomized Controlled Trials as Topic ; Vitamin D ; Vitamins

Gestational diabetes mellitus(GDM)can cause blood glucose disorders in pregnant women and result in adverse maternal-neonatal outcomes.Vitamin D(VD)can improve glucose tolerance and insulin sensitivity,and thus theoretically,VD supplementation during pregnancy could improve glycemic control as well as maternal-neonatal outcomes in GDM patients.Although studies have shown that VD deficiency is associated with poor maternal-neonatal outcomes in GDM patients,no solid conclusion has been drawn with regard to the effects of VD supplementation on these patients.Therefore,here we summarized the research progress of the effects of VD supplementation on glycemic control and adverse maternal-neonatal outcomes in GDM patients,in an effort to guide the clinical VD supplementation during pregnancy.
Blood Glucose ; Diabetes, Gestational/drug therapy* ; Dietary Supplements ; Female ; Glycemic Control ; Humans ; Infant, Newborn ; Pregnancy ; Pregnancy Outcome ; Vitamin D

gestational diabetes mellitus (GDM) has been increasing worldwide, as has the economic cost associated with this condition. GDM threatens the health of the mother and child, and thus proper monitoring and management are essential. Mobile healthcare services have been applied to manage some diseases, particularly chronic diseases. We aimed to evaluate the utility of a mobile application in nutritional intervention by observing cases of a mobile application in a series of patients with GDM. We provided a mobile-based intervention to GDM patients and collected biochemical and nutritional information. The mobile-based nutritional intervention was effective in controlling carbohydrate intake and improving blood glucose level for patients with GDM.]]>
Blood Glucose ; Child ; Chronic Disease ; Delivery of Health Care ; Diabetes, Gestational ; Diet Therapy ; Diet, Food, and Nutrition ; Female ; Humans ; Mobile Applications ; Mothers ; Pregnancy ; Prevalence

BACKGROUND: An early identification of the risk groups might be beneficial in reducing morbidities in patients with gestational diabetes mellitus (GDM). Therefore, this study aimed to assess the biochemical predictors of glycemic conditions, in addition to fasting indices of glucose disposal, to predict the development of GDM in later stage and the need of glucose-lowering medication.METHODS: A total of 574 pregnant females (103 with GDM and 471 with normal glucose tolerance [NGT]) were included. A metabolic characterization was performed before 15+6 weeks of gestation by assessing fasting plasma glucose (FPG), fasting insulin (FI), fasting C-peptide (FCP), and glycosylated hemoglobin (HbA1c). Thereafter, the patients were followed-up until the delivery.RESULTS: Females with NGT had lower levels of FPG, FI, FCP, or HbA1c at the early stage of pregnancy, and therefore, showed an improved insulin action as compared to that in females who developed GDM. Higher fasting levels of FPG and FCP were associated with a higher risk of developing GDM. Moreover, the predictive accuracy of this metabolic profiling was also good to distinguish the patients who required glucose-lowering medications. Indices of glucose disposal based on C-peptide improved the predictive accuracy compared to that based on insulin. A modified quantitative insulin sensitivity check index (QUICKIc) showed the best differentiation in terms of predicting GDM (area under the receiver operating characteristics curve [ROC-AUC], 72.1%) or need for pharmacotherapy (ROC-AUC, 83.7%).CONCLUSION: Fasting measurements of glucose and C-peptide as well as the surrogate indices of glycemic condition could be used for stratifying pregnant females with higher risk of GDM at the beginning of pregnancy.
Blood Glucose ; C-Peptide ; Diabetes, Gestational ; Drug Therapy ; Fasting ; Female ; Glucose Metabolism Disorders ; Glucose ; Hemoglobin A, Glycosylated ; Humans ; Insulin ; Insulin Resistance ; Metabolic Diseases ; Metabolism ; Pregnancy ; ROC Curve

OBJECTIVES: The aim of this study was to examine self-management status, nutritional knowledge, barrier factors in dietary management and needs of nutritional management program for women with Gestational Diabetes Mellitus (GDM). METHODS: A total of 100 women with GDM were recruited from secondary and tertiary hospitals in Seoul. The questionnaire composed of general characteristics, status of self-management, dietary habits, nutrition knowledge, barrier factors in dietary management, needs for nutrition information contents and nutritional management programs. Data were collected by a self-administered questionnaire. All data were statistically analyzed using student's t-test and chi-square test using SAS 9.3. RESULTS: About 35% of the subjects reported that they practiced medical nutrition and exercise therapy for GDM control. The main sources of nutrition information were ‘internet (50.0%)’ and ‘expert advice (45.0%)’. More than 70% of the subjects experienced nutrition education. The mean score of nutrition knowledge was 7.5 point out of 10, and only about half of the subjects were reported to be correctly aware of some questions such as ‘the cause of ketosis’, ‘the goal of nutrition management for GDM’, ‘the importance of sugar restriction on breakfast’. The major obstructive factors in dietary management were ‘eating more than planned when dining out’, ‘finding the appropriate menu when dining out’. The preferred nutrition information contents in developing management program were ‘nutritional information of food’, ‘recommended food by major nutrients’, ‘the relationship between blood glucose and food’, ‘tips on menu selection at eating out’. The subjects reported that they need management program such as ‘example of menu by calorie prescription’, ‘recommended weight gain guide’, ‘meal recording and dietary assessment’, ‘expert recommendation’, ‘sharing know-how’. CONCLUSIONS: Based on the results of this study, it is necessary to develop a program that provide personalized information by identifying the individual characteristics of the subjects and expert feedback function through various information and nutrition information contents that can be used in real life.
Blood Glucose ; Diabetes, Gestational* ; Eating ; Education ; Exercise Therapy ; Female ; Food Habits ; Humans ; Needs Assessment ; Nutritional Status ; Pregnancy ; Self Care ; Seoul ; Tertiary Care Centers ; Weight Gain

Gestational diabetes mellitus (GDM) is commonly defined a frequent metabolic condition associated with pregnancy that leads to substantial maternal and perinatal complications. Medical nutrition therapy (MNT) is the cornerstone treatment on patients with GDM, and accordingly, it has a significant impact in women and newborns. The main purpose of MNT in GDM is carbohydrates because they are the major nutrient affecting postprandial euglycemia. Recent epidemiological studies suggest that low-carbohydrate intake is related to beneficial effects on maternal and newborn outcomes. Current evidence consistently supports the advantages of using the glycemic index for additional benefit. Therefore in this context, we will discuss from summarize studies involving carbohydrate in GDM. In addition, this article describes the efficacy of low glycemic index diet for the management of GDM.
Carbohydrates* ; Diabetes, Gestational* ; Diet ; Epidemiologic Studies ; Female ; Glycemic Index ; Humans ; Infant, Newborn ; Nutrition Therapy ; Pregnancy

Gestational diabetes mellitus (GDM) is one of the most common medical complications during pregnancy. Both mother and baby are at increased risk of adverse pregnancy outcomes, as well as long-term metabolic effects such as diabetes. Diagnosing and treating GDM can reduce perinatal complications. The International Association of Diabetes and Pregnancy Study Groups (IADPSG) has proposed a new screening strategy for overt diabetes at the first prenatal visit and diagnostic criteria for GDM based on perinatal outcomes. However, controversies still exist and there is no international consensus about these issues. Regarding the management of GDM, individualized medical nutrition therapy is the cornerstone of treatment. If maternal glucose levels and/or fetal growth patterns show a sufficiently high risk of perinatal complications, insulin can be used to intensify treatment, and regimens should be tailored to meet glycemic targets. Postpartum screening for early detection of glucose intolerance and implementation of diabetes prevention programs are important for women with a history of GDM.
Consensus ; Diabetes, Gestational* ; Diagnosis* ; Female ; Fetal Development ; Glucose ; Glucose Intolerance ; Humans ; Insulin ; Mass Screening ; Mothers ; Nutrition Therapy ; Postpartum Period ; Pregnancy ; Pregnancy Outcome

OBJECTIVE: Psychotropic drugs use in pregnant mothers with psychiatric disorders raises issues of safety not only with the mothers but also with fetal development and the postpartum prognosis of the neonate. Several studies have reported on the harmful effects of antenatal exposure to psychotropic drugs. However, debatable disregard of the psychiatric disorder itself and issues of necessary and useful pharmacotherapy clouds the results. Hence, the purpose of this study was to retrospectively examine the association between prenatal psychotropic exposure and clinically evident fetal adverse effects. METHODS: From January 1994 to December 2011, a retrospective chart review of patients diagnosed with a major psychiatric disorder from the department of psychiatry and who also had a history of giving birth at the department of obstetrics and gynecology at Ajou University Hospital was conducted. Participants were divided into two groups: those taking psychotropic drugs during pregnancy were designated to the case group and the control group consisted of those not on psychotropics during pregnancy. Psychotropics included antidepressants, antipsychotics and benzodiazepines used in clinical dosages. Then the two groups were compared on factors such as gestational age, the offspring's birth weight, bitemporal diameter, and Apgar scores. After then, we analyzed relatively risk potential to the preterm labor in such variables (old age pregnancy, gestational diabetes, gestational hypertension and exposure psychotropics in pregnancy). T-test and logistic regression analysis of the data was performed. RESULTS: Demographic and clinical characteristics did not differ significantly between the groups. Also, there was no significant difference in gestational age, birth weight, bitemporal diameter and Apgar scores between the exposure and non-exposure groups. There was no significant relationship between psychotropic exposure during pregnancy, old age pregnancy, gestational diabetes and preterm labor. However, the relationship between gestational hypertension and preterm labor was significant. CONCLUSION: Psychotropic drugs are considered as significant clinical treatment options to control symptoms of psychiatric disorders during pregnancy. In the clinical setting there was no statistically significant relationship between psychotropic exposure and gestational age on fetal development. However the retrospective nature of the study limits the interpretation of the data and constant close monitoring of pregnant patients in the clinical setting is advised.
Antidepressive Agents ; Antipsychotic Agents ; Benzodiazepines ; Birth Weight ; Diabetes, Gestational ; Drug Therapy ; Female ; Fetal Development ; Fetus* ; Gestational Age ; Gynecology ; Humans ; Hypertension, Pregnancy-Induced ; Infant, Newborn ; Logistic Models ; Mothers ; Obstetric Labor, Premature* ; Obstetrics ; Parturition ; Postpartum Period ; Pregnancy ; Prognosis ; Psychotropic Drugs ; Retrospective Studies