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Background: Sugar-sweetened beverage (SSB) is known to increase risks for many health problems in the general population, but its association with gestational diabetes mellitus (GDM) is rarely discussed. Consumption amount of SSB could be subjected to recall biases and estimation errors, whereas psychological dependence using a standardized assessment tool would provide more persistent and objective measurements. Therefore, we hypothesize that desire of SSB may play a role in developing GDM. Methods: This prospective cohort study recruited 183 pregnant women, who answered self-describing questionnaires designed to depict SSB use behaviors. The desire to drink SSBs was assessed using the modified Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for substance use disorder (SUD), with questions specific for SSB use. All participants received a 75-gram oral glucose tolerance test during 24th–28th weeks of gestation to screen for GDM. Results: Age, body mass index, and SSB-related SUD DSM-5 items were significant predictive factors of GDM, with odds ratios of 1.112 (95% confidence interval 1.018–1.214), 1.208 (95% confidence interval 1.079–1.353), and 1.338 (95% confidence interval 1.077–1.664), respectively. SUD DSM-5 scores positively correlate with education level (p = 0.046), frequency of dining out (p = 0.028), sedentary lifestyle (p = 0.001), and negatively with water intake amount (p = 0.033). Conclusions: The current study is the first to find a positive association between SSB intake pattern and GDM risk. Specifically, every SSB-related DSM point scored increases GDM risk by 33%, which did not necessarily reflect on the reported SSB consumption amount. To offer useful and specific behavioral advices, decreasing frequencies of dining out, increasing exercises and encouraging plain water intake might be helpful. more...

Background: Cervical insufficiency, or cervical incompetence, describes the condition in which the cervix dilates without painful uterine contractions in the second trimester of pregnancy. It often leads to loss of pregnancy or preterm delivery. Recommendations for the prophylactic placement of cervical sutures are well established, however rescue cervical cerclage for a prolapsing amniotic bag is more controversial due to higher technical demands, higher risk of iatrogenic rupture of membranes, and questionable long-term neonatal prognosis. This study aimed to answer two important questions: (1) Should rescue cerclage be performed for those with an evidently protruding amniotic bag? (2) Who would benefit the most from rescue cerclage? Materials: Eighteen pregnant women with cervical incompetence with a clinically evident prolapsing amniotic bag from January 2016 to February 2020 were included. Four received conservative treatment, i.e., without cerclage, and the other 14 patients opted to receive emergency rescue cervical cerclage. Results: We classified the patients into futile (n = 7) and successful (n = 7) cerclage groups at post-operative day 21. Pregnancy and neonatal outcomes were obviously better in the success group, however no significant pre-operative predictive factors for success could be identified. The results of the women who did not receive cerclage and those with futile cerclage were comparable. Rescue cerclage was especially beneficial for those at 22 weeks to 26 weeks of gestation. Conclusions: The maternal and fetal outcomes of the patients with futile rescue cerclage were comparable to those who did not receive cerclage. Therefore, rescue cerclage for advanced cervical insufficiency could be considered, especially for those at 22 weeks to 26 weeks of gestation. more...