Search

Objective: To assess the effectiveness of a complex digital health intervention, in pregnant women with obesity, by means of an app for advice eating habits and a virtual midwife's support, regarding their eating habits, and also to analyze the global satisfaction with digital intervention. Methods: A parallel randomized clinical trial with two arms 1:1 with intervention group (IG) and control group (CG) was conducted. 150 pregnant women with pre-pregnancy obesity were included. Both groups received usual prenatal care. The intervention, in the IG, was delivered with smartband and an app providing advice about eating habits and with a virtual midwife to support women. The validated «Questionnaire of eating habits for patients with overweight and obesity» was administrated and measured using a 1-to-5-point Likert scale. Statistical tests were two-sided and evaluated at an a level of 0.05. Analyzes were performed with SPSS v. 25 and SAS v. 9.4. Results: 110 (73.3% of the total) women were analyzed. In the IG, the mean score for eating habits was higher than in the CG (3.49 ± 0.36 versus 3.35 ± 0.41; p=0.056), but no statistically significant differences were observed. In the IG, the mean score for the intake of the type of food was higher than in the CG (3.49 ± 0.78 versus 3.18 ± 0.71; p=0.019). The mean of global satisfaction was 4.76 ± 0.6 points. Conclusions: The use of a complex digital intervention was effective in improving the intake of the type of food compared to pregnant women who only received usual prenatal care. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate pregnancy complications and obstetric and perinatal outcomes in women with twin pregnancy and GDM. Study Design: An observational multicentre retrospective study was performed and 534 pregnant woman and 1068 twins infants allocated into two groups, 257 with GDM and 277 controls, were studied. Main Outcome Measures: Pregnant women characteristics, hypertensive complications, preterm delivery rate, mode of delivery and birthweight were analysed. Results: Pregnant women with GDM were older ( p < 0.001) and had higher body mass index ( p < 0.001) than controls. GDM was associated with higher risk of prematurity in twin pregnancy (odds ratio 1.64, 95% confidence interval [1.14-2.32], p = 0.005). This association was based on the association with other pregnancy complications. Birthweight Z-scores were significantly higher in the GDM group ( p = 0.02). The rate of macrosomia was higher in the GDM group ( p = 0.002) and small for gestational age (SGA) babies were significantly less frequent ( p = 0.03). GDM was an independent predictor of macrosomia ( p = 0.006). Conclusion: The presence of GDM in twin pregnancy was associated with a higher risk of hypertensive complications, prematurity and macrosomia, but significantly reduces the risk of SGA infants. Prematurity was related to the presence of other associated pregnancy complications. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the impact of a prepregnancy care (PPC) programme, beyond HbA1c, on hypoglycaemia awareness and glycaemic variability (GV).Methods: Prospective pilot study. We selected women with Type 1 diabetes who initiated a PPC programme with normal hypoglycaemia awareness (n = 24). Hypoglycaemia awareness, hypoglycaemic events and GV derived from masked-continuous glucose monitoring were evaluated in the first visit and within 2 weeks after pregnancy confirmation.Results: The duration was 16.5 ± 13.0 months. HbA1c significantly decreased (-0.8 ± 0.7; p < 0.001). The Clarke score increased (0[0-1] vs. 1[0-2] points, p = 0.164), 2 out of 24 were reclassified as having impaired awareness of hypoglycaemia and 2 presented severe hypoglycaemia. GV decreased: standard deviation (p = 0.008), coefficient of variation (p = 0.021), mean amplitude of glycaemic excursions (p = 0.007), average daily risk range (p < 0.001), J-index (p = 0.010), high blood glucose index (HBGI) (p = 0.004), continuous overall net glycaemic action (CONGA) (p = 0.018), mean of daily differences (p = 0.045) and glycaemic risk assessment diabetes equation (p = 0.012). Final HbA1c was associated with baseline J-index, CONGA and HBGI (β = 0.535, β = 0.466, β = 0.534, respectively; p < 0.05).Conclusions: A PPC programme improved HbA1c as well as GV with no significant impact on hypoglycaemia awareness. Moreover, GV could help to identify women less likely to achieve glycaemic targets. Larger studies are needed to confirm these results. [ABSTRACT FROM AUTHOR]

Objective: To identify the prevalence of pre-pregnancy overweight/obesity in pregnant women and its relationship with socio-demographic factors and to describe the maternal and perinatal outcomes in a Barcelona hospital (Spain)., Method: A descriptive cross-association study, with retrospective data collection, was performed Barcelona Hospital. The data of 5447 pregnant women who delivered at >=23 weeks of gestation were included. Body Mass Index (BMI) data were categorised into World Health Organization classifications. p values <.05 (two-tailed) were considered significant. Logistic regression models were performed., Results: The prevalence of pre-pregnancy obesity was 8.4% and 18.9% for overweight. Gestational diabetes was more frequent in pre-pregnancy overweight/obesity (OR 1.92: 95% CI 1.54-2.40 and OR 3.34: 95% CI 2.57-4.33), as were preeclampsia (OR 2.08: 95% CI 1.55-2.79 and OR 3.35: 95% CI 2.38-4.71), induction of labour (OR 1.19: 95% CI 1.02-1.38 and OR 1.94: 95% CI 1.57-2.10), caesarean section (OR 1.41: 95% CI 1.21-1.65 and OR 2.68: 95% CI 2.18-3.29), prematurity (OR 1.28: 95% CI 1-1.65 and OR 1.79: 95% CI 1.32-2.44) and macrosomia (OR 1.87: 95% CI 1.43-2.46 and OR 2.03: 95% CI 1.40-2.93)., Conclusions: One in four pregnant women had pre-pregnancy overweight or obesity. This study shows the relationship between pre-pregnancy overweight or obesity with adverse maternal and perinatal outcomes., (Copyright © 2021 Elsevier España, S.L.U. All rights reserved.)

Background and Objective: Pregnancy in women with type 1 diabetes (T1D) involves greater risks as compared to non-diabetic women, but less information is available about blood glucose and weight control after delivery. Our aim was to evaluate the postpartum metabolic profile (blood glucose and weight control) of women with T1D and the factors related to those metabolic outcomes., Methods: A retrospective, observational study of 36 women with T1D during pregnancy and for up to one year after delivery., Results: Fifty percent of patients attended a preconceptional planning program (PPP), and 44.4% of women were treated with continuous subcutaneous insulin infusion. Mean preconceptional HbA1c and body mass index (BMI) were 7.2±1.2% and 23.8±5.0 respectively. In the total cohort, blood glucose control significantly worsened one year after delivery (HbA1c: 7.2±1.2 vs 7.6±1.2%, P<0.001). Lower preconceptional HbA1c values were found in patients who attended PPP (6.6±0.5 vs. 7.8±1.4%; P=0.02), and were maintained for one year after delivery. No differences were found in body mass index (BMI) from the pregestational period to one year after delivery in any of two groups (No PPP 22.5±4.6 vs 23.2±4.8, P=0.078; PPP 25.4±3.4 vs 25.5±3.4 kg/m(2), P=0.947). Preconceptional HbA1c was shown to be the most important determinant of metabolic control (β=0.962, p<0.001) and weight one year after delivery (β=0.524, p=0.025) and weight gain during pregnancy (β=0.633, p=0.004)., Conclusions: Pregnant women with T1D return to prepregnancy body weight one year after delivery, especially those with lower HbA1c levels and BMI before pregnancy. However, blood glucose control deteriorates after delivery, suggesting the need for changes in clinical practice after delivery., (Copyright © 2014 SEEN. Published by Elsevier España, S.L.U. All rights reserved.)