Author: "Jeannet Lauenborg" - Searchworks@Jio Institute Digital Library Search Results

54 results on '"Jeannet Lauenborg"'

1. Danish Diabetes Birth Registry 2: a study protocol of a national prospective cohort study to monitor outcomes of pregnancies of women with pre-existing diabetes

Author: Peter Damm, Per G Ovesen, Dorte M Jensen, Christina Vinter, Lene Ringholm, Elisabeth R Mathiesen, Jens Fuglsang, Sine Knorr, Ulla Kampmann, Tine D Clausen, Henrik Støvring, Allan Kofoed-Enevoldsen, Jori Aalders, Martin Overgaard, Ulla Bjerre-Christensen, Lise Lotte T Andersen, Jeannet Lauenborg, Trine T Christensen, and Anne Sørensen
Subjects: Medicine
Abstract: Introduction Despite technological developments and intensified care, pregnancies in women with pre-existing diabetes are still considered high-risk pregnancies. The rate of adverse outcomes in pregnancies affected by diabetes in Denmark is currently unknown, and there is a limited understanding of mechanisms contributing to this elevated risk. To address these gaps, the Danish Diabetes Birth Registry 2 (DDBR2) was established. The aims of this registry are to evaluate maternal and fetal-neonatal outcomes based on 5 years cohort data, and to identify pathophysiology and risk factors associated with short-term and long-term outcomes of pregnancies in women with pre-existing diabetes.Methods and analysis The DDBR2 registry is a nationwide 5-year prospective cohort with an inclusion period from February 2023 to February 2028 of pregnancies in women with all types of pre-existing diabetes and includes registry, clinical and questionnaire data and biological samples of mother–partner–child trios. Eligible families (parents age ≥18 years and sufficient proficiency in Danish or English) can participate by either (1) basic level data obtained from medical records (mother and child) and questionnaires (partner) or (2) basic level data and additional data which includes questionnaires (mother and partner) and blood samples (all). The primary maternal outcome is Hemoglobin A1c (HbA1c) levels at the end of pregnancy and the primary offspring endpoint is the birth weight SD score. The DDBR2 registry will be complemented by genetic, epigenetic and metabolomic data as well as a biobank for future research, and the cohort will be followed through data from national databases to illuminate possible mechanisms that link maternal diabetes and other parental factors to a possible increased risk of adverse long-term child outcomes.Ethics and dissemination Approval from the Ethical Committee is obtained (S-20220039). Findings will be sought published in international scientific journals and shared among the participating hospitals and policymakers.Trial registration number NCT05678543.
Published: 2024
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2. The prevention of adverse pregnancy outcomes by periodontal treatment during pregnancy (PROBE) intervention study—A controlled intervention study: Protocol paper

Author: Karoline Winckler, Kathrine Hansen Bukkehave, Lise Tarnow, Peter Bindslev Iversen, Christian Damgaard, Sisse Bolm Ditlev, Allan Kofoed-Enevoldsen, Heidi Marianne Fischer, Signe Camilla Hjuler Dueholm, Jeannet Lauenborg, Cæcilie Trier, and Berit Lilienthal Heitmann
Subjects: Medicine, Science
Published: 2024

3. Gestational diabetes and the human salivary microbiota: a longitudinal study during pregnancy and postpartum

Author: Mie K. W. Crusell, Lærke R. Brink, Trine Nielsen, Kristine H. Allin, Torben Hansen, Peter Damm, Jeannet Lauenborg, Tue H. Hansen, and Oluf Pedersen
Subjects: Salivary microbiota, Gestational diabetes mellitus, Gestational hyperglycaemia, Pregnancy, Glycaemic traits, Bacterial species, Gynecology and obstetrics, RG1-991
Abstract: Abstract Background An aberrant composition of the salivary microbiota has been found in individuals with type 2 diabetes, and in pregnant women salivary microbiota composition has been associated with preeclampsia and pre-term birth. Pregnant women, who develop gestational diabetes (GDM), have a high risk of developing type 2 diabetes after pregnancy. In the present study we assessed whether GDM is linked to variation in the oral microbial community by examining the diversity and composition of the salivary microbiota. Method In this observational study the salivary microbiota of pregnant women with GDM (n = 50) and normal glucose regulation (n = 160) in third trimester and 9 months postpartum was assessed by 16S rRNA gene amplicon sequencing of the V1-V3 region. GDM was diagnosed in accordance with the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria. Cross-sectional difference in alpha diversity was assessed using Student’s t-test and longitudinal changes were assessed by mixed linear regression. Cross-sectional and longitudinal difference in beta diversity was assessed by permutational multivariate analyses of variance. Differentially abundant genera and OTUs were identified by negative binomial regression. Results In the third trimester, two species-level operational taxonomic units (OTUs), while eight OTUs postpartum were differentially abundant in women with GDM compared with normoglycaemic women. OTU richness, Shannon diversity and Pielou evenness decreased from late pregnancy to 9 months after delivery regardless of glycaemic status. Conclusion GDM is associated with a minor aberration of the salivary microbiota during late pregnancy and postpartum. For unknown reasons richness of the salivary microbiota decreased from late pregnancy to postpartum, which might be explained by the physiological changes of the immune system during human pregnancy.
Published: 2020
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4. Comparative Studies of the Gut Microbiota in the Offspring of Mothers With and Without Gestational Diabetes

Author: Mie Korslund Wiinblad Crusell, Tue Haldor Hansen, Trine Nielsen, Kristine Højgaard Allin, Malte C. Rühlemann, Peter Damm, Henrik Vestergaard, Christina Rørbye, Niklas Rye Jørgensen, Ole Bjarne Christiansen, Femke-Anouska Heinsen, Andre Franke, Torben Hansen, Jeannet Lauenborg, and Oluf Pedersen
Subjects: gut microbiota, infancy, gestational diabetes, maternal glycaemic traits, bacterial genera, Microbiology, QR1-502
Abstract: Background: Offspring of mothers with gestational diabetes mellitus (GDM) have increased risk of developing metabolic disorders as they grow up. Microbial colonization of the newborn gut and environmental exposures affecting the configuration of the gut microbiota during infancy have been linked to increased risk of developing disease during childhood and adulthood. In a convenience sample, we examined whether the intestinal tract of children born to mothers with GDM is differentially colonized in early life compared to offspring of mothers with normal gestational glucose regulation. Secondly, we examined whether any such difference persists during infancy, thus potentially conferring increased risk of developing metabolic disease later in life.Methods: Fecal samples were collected from children of mothers with (n = 43) and without GDM (n = 82) during the first week of life and again at an average age of 9 months. The gut microbiota was characterized by 16S rRNA gene amplicon sequencing (V1–V2). Differences in diversity and composition according to maternal GDM status were assessed, addressing potential confounding by mode of delivery, perinatal antibiotics treatment, feeding and infant sex.Results: Children of mothers with GDM were featured by a differential composition of the gut microbiota, both during the first week of life and at 9 months, at higher taxonomic and OTU levels. Sixteen and 15 OTUs were differentially abundant after correction for multiple testing during the first week of life and at 9 months, respectively. Two OTUs remained differentially abundant after adjustment for potential confounders both during the first week of life and at 9 months. Richness (OTU) was decreased in neonates born to mothers with GDM; however, at 9 months no difference in richness was observed. There was no difference in Shannon's diversity or Pielou's evenness at any timepoint. Longitudinally, we detected differential changes in the gut microbiota composition from birth to infancy according to GDM status.Conclusion: Differences in glycaemic regulation in late pregnancy is linked with relatively modest variation in the gut microbiota composition of the offspring during the first week of life and 9 months after birth.
Published: 2020
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5. Newborn body composition after maternal bariatric surgery.

Author: Emma Malchau Carlsen, Kristina Martha Renault, Bertha Kanijo Møller, Kirsten Nørgaard, Jens-Erik Beck Jensen, Jeannet Lauenborg, Dina Cortes, and Ole Pryds
Subjects: Medicine, Science
Abstract: INTRODUCTION:In pregnancy after Roux-en-Y gastric bypass (RYGB), there is increased risk of low birthweight in the offspring. The present study examined how offspring body composition was affected by RYGB. MATERIAL AND METHODS:Mother-newborn dyads, where the mothers had undergone RYGB were included. Main outcome measure was neonatal body composition. Neonatal body composition was assessed by dual-energy X-ray absorptiometry scanning (DXA) within 48 hours after birth. In a statistical model offspring born after RYGB were compared with a reference material of offspring and analyses were made to estimate the effect of maternal pre-pregnancy body mass index (BMI), gestational weight gain, parity, gestational age at birth and newborn sex on newborn body composition. Analyses were made to estimate the impact of maternal weight loss before pregnancy and of other effects of bariatric surgery respectively. The study was performed at a university hospital between October 2012 and December 2013. RESULTS:We included 25 mother-newborn dyads where the mothers had undergone RYGB and compared them to a reference material of 311 mother-newborn dyads with comparable pre-pregnancy BMI. Offspring born by mothers after RYGB had lower birthweight (335g, p
Published: 2020
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6. Gestational diabetes is associated with change in the gut microbiota composition in third trimester of pregnancy and postpartum

Author: Mie Korslund Wiinblad Crusell, Tue Haldor Hansen, Trine Nielsen, Kristine Højgaard Allin, Malte C. Rühlemann, Peter Damm, Henrik Vestergaard, Christina Rørbye, Niklas Rye Jørgensen, Ole Bjarne Christiansen, Femke-Anouska Heinsen, Andre Franke, Torben Hansen, Jeannet Lauenborg, and Oluf Pedersen
Subjects: Gut microbiota, Gestational diabetes, Pregnancy, Bacterial species, Body mass index, Glycaemic traits, Microbial ecology, QR100-130
Abstract: Abstract Background Imbalances of gut microbiota composition are linked to a range of metabolic perturbations. In the present study, we examined the gut microbiota of women with gestational diabetes mellitus (GDM) and normoglycaemic pregnant women in late pregnancy and about 8 months postpartum. Methods Gut microbiota profiles of women with GDM (n = 50) and healthy (n = 157) pregnant women in the third trimester and 8 months postpartum were assessed by 16S rRNA gene amplicon sequencing of the V1-V2 region. Insulin and glucose homeostasis were evaluated by a 75 g 2-h oral glucose tolerance test during and after pregnancy. Results Gut microbiota of women with GDM was aberrant at multiple levels, including phylum and genus levels, compared with normoglycaemic pregnant women. Actinobacteria at phylum level and Collinsella, Rothia and Desulfovibrio at genus level had a higher abundance in the GDM cohort. Difference in abundance of 17 species-level operational taxonomic units (OTUs) during pregnancy was associated with GDM. After adjustment for pre-pregnancy body mass index (BMI), 5 of the 17 OTUs showed differential abundance in the GDM cohort compared with the normoglycaemic pregnant women with enrichment of species annotated to Faecalibacterium and Anaerotruncus and depletion of species annotated to Clostridium (sensu stricto) and to Veillonella. OTUs assigned to Akkermansia were associated with lower insulin sensitivity while Christensenella OTUs were associated with higher fasting plasma glucose concentration. OTU richness and Shannon index decreased from late pregnancy to postpartum regardless of metabolic status. About 8 months after delivery, the microbiota of women with previous GDM was still characterised by an aberrant composition. Thirteen OTUs were differentially abundant in women with previous GDM compared with women with previous normoglycaemic pregnancy. Conclusion GDM diagnosed in the third trimester of pregnancy is associated with a disrupted gut microbiota composition compared with normoglycaemic pregnant women, and 8 months after pregnancy, differences in the gut microbiota signatures are still detectable. The gut microbiota composition of women with GDM, both during and after pregnancy, resembles the aberrant microbiota composition reported in non-pregnant individuals with type 2 diabetes and associated intermediary metabolic traits.
Published: 2018
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7. Long-Term Follow-Up on Morbidity Among Women With a History of Gestational Diabetes Mellitus: A Systematic Review

Author: Lana R Flachs Madsen, Stine Gerdøe-Kristensen, Jeannet Lauenborg, Peter Damm, Ulrik S Kesmodel, and Elsebeth Lynge
Subjects: Endocrinology, Diabetes and Metabolism, Clinical Biochemistry, morbidity, Biochemistry, DISEASE, Endocrinology, cardiovascular disease, Pregnancy, ARTERY RISK DEVELOPMENT, BREAST-CANCER, cancer, Humans, POPULATION, MORTALITY, Biochemistry (medical), ASSOCIATION, SUBSEQUENT, PREVALENCE, Diabetes, Gestational, Diabetes Mellitus, Type 2, Cardiovascular Diseases, long-term risk, HEART-FAILURE, Female, gestational diabetes, Morbidity, Follow-Up Studies
Abstract: Background Gestational diabetes mellitus (GDM) complicates up to 10% of pregnancies and is a well-known risk factor for type 2 diabetes mellitus (T2DM) and cardiovascular disease. Little is known about possible long-term risks of other diseases. Background The aim was to review the literature for evidence of associations with morbidity other than T2DM and cardiovascular disease and with long-term mortality. Methods A systematic review based on searches in Medline, Embase, and Cochrane Library until March 31, 2021, using a broad range of keywords. We extracted study characteristics and results on associations between GDM and disease occurrence at least 10 years postpartum, excluding studies on women with diabetes prior to pregnancy or only diabetes prior to outcome. The results are reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Newcastle-Ottawa Scale was used to assess risk of bias. Results We screened 3084 titles, 81 articles were assessed full-text, and 15 included in the review. The strongest evidence for an association was for kidney diseases, particularly in Black women. We found indication of an association with liver disease, possibly restricted to women with T2DM postpartum. The association between GDM and breast cancer had been studied extensively, but in most cases based on self-reported diagnosis and with conflicting results. Only sparse and inconsistent results were found for other cancers. No study on thyroid diseases was found, and no study reported on short-term or long-term mortality in women with a history of GDM. Conclusion Given the frequency of GDM, there is a need for better evidence on possible long-term health consequences, in particular, studies based on comprehensive records of diagnosis of GDM and long-term health outcomes.
Published: 2022

8. A flexible silicone patch for treatment of hemorrhoids after birth: a pilot study of HEMOCIN® Patch

Author: M Zara Siddiqi, Jeannet Lauenborg, Caroline B. Madsen, and Johan Tolstrup
Subjects: medicine.medical_specialty, Pregnancy, Medical treatment, business.industry, Gastroenterology, Treatment options, Intervention group, medicine.disease, Surgery, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Hemorrhoids, Silicone, chemistry, 030220 oncology & carcinogenesis, Intervention (counseling), medicine, 030211 gastroenterology & hepatology, business
Abstract: To test a non-pharmacological silicone patch for treatment of symptomatic hemorrhoids with focus on usability, safety, and self-reported short-term effect. Puerperal women in a Danish maternity ward were cluster randomized to treatment with the HEMOCIN® patch (intervention) or no systematic treatment (control group). On inclusion and after 2 weeks, they completed a questionnaire regarding history and hemorrhoid symptoms scored from 0 to 10. Women in the intervention group also reported on the usability of the patch and any side effects. We included 31 women in the intervention group and 33 in the control group. Twenty-eight (90.3%) women in the intervention group and 27 (81.8%) women in the control group responded to follow-up. Except from a difference in the severity of swelling at inclusion, there were no differences between the two groups for any symptoms, neither at inclusion, nor at follow-up, or in the change of symptoms during the two weeks (p > 0.05). Twenty-three women (85.2%) in the control group used medical treatment vs. one woman in the intervention group. The patch was used on an average of 9.3 days, 15.5 h/day and for 7.1 h before changing the patch. No severe side effects were reported. This pilot study finds that the HEMOCIN® patch is a safe and feasible treatment option for hemorrhoids. However, we did not detect any significant effect on hemorrhoid symptoms. The patch could be an option for people who seek non-pharmacological treatment for symptomatic hemorrhoids or need long-term treatment without steroid side effects.
Published: 2021

9. Screening for Gestational Diabetes Mellitus and Care of Diabetes Mellitus in Pregnancy

Author: Jeannet Lauenborg and Peter J. Hornnes
Subjects: Gestational diabetes, medicine.medical_specialty, Pregnancy, Obstetrics, business.industry, Diabetes mellitus, medicine, medicine.disease, business
Published: 2021

10. Validity of bladder volume measurement by ultrasound in women postpartum

Author: Niels Klarskov, Jeannet Lauenborg, and Josefine Tangen Jensen
Subjects: medicine.medical_specialty, Vaginal birth, Urology, media_common.quotation_subject, Urinary Bladder, 030232 urology & nephrology, urologic and male genital diseases, Urination, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Humans, Medicine, Prospective Studies, Ultrasonography, media_common, 030219 obstetrics & reproductive medicine, business.industry, Urinary retention, Vaginal delivery, Postpartum Period, Ultrasound, Obstetrics and Gynecology, Predictive value, Bladder volume, Female, Radiology, medicine.symptom, Urinary Catheterization, business, Volume (compression)
Abstract: Vaginal birth increases the risk of urinary retention and overdistention of the bladder. To avoid unnecessary discomfort by catheterization, it is preferable to use ultrasound for diagnosis of these conditions. The aim of this study was to determine the validity of transabdominal ultrasound and a portable ultrasound system, Biocon-700, to measure bladder volume in women postpartum. Fifty women were included in this method comparison study. Within 48 h of giving birth, their bladder volume was measured in randomized order with both transabdominal ultrasound and Biocon-700. After urination, participants were scanned with Biocon-700 to measure residual bladder volume, and finally the bladder was emptied by catheterization. The total bladder volume was calculated as the voided volume plus the catheterized volume. Biocon-700 measured 43.4 ml ± 117.4 ml (mean ± SD) lower than the total bladder volume, while volumes measured by transabdominal ultrasound were 117.8 ml ± 110.0 ml (mean ± SD) lower. Linear regression showed significant proportional bias in both methods. The Biocon-700 could detect a residual bladder volume > 150 ml with a positive predictive value of 66.7% and a negative predictive value of 100%. Neither transabdominal ultrasound nor the portable ultrasound system, Biocon-700, can be used to measure bladder volume precisely after vaginal delivery. However, both ultrasound methods can be used as screening tools to prevent overdistention of the bladder, and Biocon-700 can furthermore be used to screen women for a residual bladder volume > 150 ml.
Published: 2019

11. Changing incidence of obstetric anal sphincter injuries—A result of formal prevention programs?

Author: Hanna Jangö, Jeannet Lauenborg, Jens Langhoff-Roos, Anette Kjaerbye-Thygesen, and Hanne Brix Westergaard
Subjects: medicine.medical_specialty, 030219 obstetrics & reproductive medicine, Vaginal delivery, business.industry, Incidence (epidemiology), Prevalence, Psychological intervention, Obstetrics and Gynecology, Retrospective cohort study, General Medicine, Odds ratio, 03 medical and health sciences, 0302 clinical medicine, Emergency medicine, medicine, 030212 general & internal medicine, Risk assessment, business, Cohort study
Abstract: Introduction Obstetric anal sphincter injuries (OASIS) are serious complications to vaginal delivery causing anal incontinence in 50% of the women in the long term. In Norway, the incidence of OASIS has been significantly reduced from 4%-5% to 1%-2% after implementation of prevention programs focusing on perineal protection. The aim of our study was to evaluate whether implementation of formal prevention programs was associated with a reduced incidence of OASIS over time. Material and methods We performed a historical cohort study, evaluating incidence, change of incidence and risk factors of OASIS during the years 2011-2015 at the four delivery departments in the Capital Region of Denmark. Two of the four departments implemented formal prevention programs in 2012-2013. We performed trend tests and uni- and multivariable analyses, adjusting for important risk factors and calculating interactions between risk factors. Results There were 75 173 vaginal deliveries during the study period; of those, 2670 (3.6%) were complicated by OASIS. The incidence of OASIS decreased during the study period from 4.3% (n = 636) in 2011 to 2.6% (n = 399) in 2015. There was a significant decrease in the incidence of OASIS at both the departments with formal prevention programs and those without. After adjustment for other important risk factors of OASIS, we found no significant difference in the risk reduction between departments with and without formal prevention programs. Conclusions We found that the general focus on prevention of OASIS in Denmark was associated with a significant decrease in the incidence of OASIS, but implementation of formal prevention programs did not lead to a further reduction. It is possible that more rigorous interventions at the hospitals with formal prevention programs could have resulted in a significant difference in incidence of OASIS.
Published: 2019

12. The increasing role of a retained placenta in postpartum blood loss: a cohort study

Author: Jens Svare, Jeannet Lauenborg, Hellen McKinnon Edwards, Jens Langhoff-Roos, and Anne Juul Wikkelsø
Subjects: Adult, medicine.medical_specialty, Multivariate analysis, Cohort Studies, Young Adult, Blood loss, Pregnancy, Risk Factors, Retained placenta, Bayesian multivariate linear regression, Humans, Medicine, Young adult, reproductive and urinary physiology, Retrospective Studies, business.industry, Obstetrics, Postpartum Hemorrhage, Obstetrics and Gynecology, Retrospective cohort study, General Medicine, medicine.disease, embryonic structures, Female, business, Labor Stage, Third, Placenta, Retained, Cohort study
Abstract: To describe the association between quantity of blood loss, duration of the third stage of labour, retained placenta and other risk factors, and to describe the role of a retained placenta depending on the cutoff used to define postpartum haemorrhage.Cohort study of all vaginal deliveries at two Danish maternity units between 1 January 2009 and 31 December 2013 (n = 43,357), univariate and multivariate linear regression statistical analyses.A retained placenta was shown to be a strong predictor of quantity of blood loss and duration of the third stage of labour a weak predictor of quantity of blood loss. The predictive power of the third stage of labour was further reduced in the multivariate analysis when including retained placenta in the model. There was an increase in the role of a retained placenta depending on the cutoff used to define postpartum haemorrhage, increasing from 12% in cases of blood loss ≥ 500 ml to 53% in cases of blood loss ≥ 2000 ml CONCLUSION: The predictive power of duration of the third stage of labour in regard to postpartum blood loss was diminished by the influence of a retained placenta. A retained placenta was, furthermore, present in the majority of most severe cases.
Published: 2019

13. A flexible silicone patch for treatment of hemorrhoids after birth: a pilot study of HEMOCIN® Patch

Author: Caroline, Madsen, Johan, Tolstrup, M Zara, Siddiqi, and Jeannet, Lauenborg
Subjects: Pregnancy, Surveys and Questionnaires, Silicones, Humans, Female, Pilot Projects, Hemorrhoids
Abstract: To test a non-pharmacological silicone patch for treatment of symptomatic hemorrhoids with focus on usability, safety, and self-reported short-term effect.Puerperal women in a Danish maternity ward were cluster randomized to treatment with the HEMOCIN® patch (intervention) or no systematic treatment (control group). On inclusion and after 2 weeks, they completed a questionnaire regarding history and hemorrhoid symptoms scored from 0 to 10. Women in the intervention group also reported on the usability of the patch and any side effects.We included 31 women in the intervention group and 33 in the control group. Twenty-eight (90.3%) women in the intervention group and 27 (81.8%) women in the control group responded to follow-up. Except from a difference in the severity of swelling at inclusion, there were no differences between the two groups for any symptoms, neither at inclusion, nor at follow-up, or in the change of symptoms during the two weeks (p0.05). Twenty-three women (85.2%) in the control group used medical treatment vs. one woman in the intervention group. The patch was used on an average of 9.3 days, 15.5 h/day and for 7.1 h before changing the patch. No severe side effects were reported.This pilot study finds that the HEMOCIN® patch is a safe and feasible treatment option for hemorrhoids. However, we did not detect any significant effect on hemorrhoid symptoms. The patch could be an option for people who seek non-pharmacological treatment for symptomatic hemorrhoids or need long-term treatment without steroid side effects.
Published: 2020

14. [Post-partum hypoglycaemia in a child to a father with HNF4A diabetes]

Author: Bo Schneider Vohra, Thomsen, Jeannet, Lauenborg, and Marie, Søgaard
Subjects: Blood Glucose, Diabetes Mellitus, Type 2, Hepatocyte Nuclear Factor 4, Mutation, Postpartum Period, Infant, Newborn, Humans, Female, Child, Hypoglycemia
Abstract: Untreated hypoglycaemia in newborns may result in permanent cognitive damage, why early diagnosis and treatment is important. This case report describes a newborn girl, who developed hypoglycaemia, when she was two hours old despite early feeding. The father of the child had maturity-onset diabetes of the young Type 1, which is caused by an autosomal dominant inherited mutation in the HNF4A gene. Due to this, early blood glucose measurements were performed. The child was treated with extra feeding and recovered without any consequences. A later gene test showed, that the child was carrier of the mutation.
Published: 2020

15. Gestational diabetes and the human salivary microbiota: a longitudinal study during pregnancy and postpartum

Author: Trine Nielsen, Lærke R. Brink, Kristine H. Allin, Mie Crusell, Tue H. Hansen, Oluf Pedersen, Peter Damm, Torben Hansen, and Jeannet Lauenborg
Subjects: medicine.medical_specialty, Longitudinal study, Multivariate analysis, Reproductive medicine, Physiology, Type 2 diabetes, Gestational hyperglycaemia, Salivary microbiota, Gestational diabetes mellitus, lcsh:Gynecology and obstetrics, Preeclampsia, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Diabetes mellitus, medicine, lcsh:RG1-991, 030304 developmental biology, 0303 health sciences, Glycaemic traits, business.industry, Obstetrics and Gynecology, 030206 dentistry, medicine.disease, Gestational diabetes, business, Research Article, Bacterial species
Abstract: Background An aberrant composition of the salivary microbiota has been found in individuals with type 2 diabetes, and in pregnant women salivary microbiota composition has been associated with preeclampsia and pre-term birth. Pregnant women, who develop gestational diabetes (GDM), have a high risk of developing type 2 diabetes after pregnancy. In the present study we assessed whether GDM is linked to variation in the oral microbial community by examining the diversity and composition of the salivary microbiota. Method In this observational study the salivary microbiota of pregnant women with GDM (n = 50) and normal glucose regulation (n = 160) in third trimester and 9 months postpartum was assessed by 16S rRNA gene amplicon sequencing of the V1-V3 region. GDM was diagnosed in accordance with the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria. Cross-sectional difference in alpha diversity was assessed using Student’s t-test and longitudinal changes were assessed by mixed linear regression. Cross-sectional and longitudinal difference in beta diversity was assessed by permutational multivariate analyses of variance. Differentially abundant genera and OTUs were identified by negative binomial regression. Results In the third trimester, two species-level operational taxonomic units (OTUs), while eight OTUs postpartum were differentially abundant in women with GDM compared with normoglycaemic women. OTU richness, Shannon diversity and Pielou evenness decreased from late pregnancy to 9 months after delivery regardless of glycaemic status. Conclusion GDM is associated with a minor aberration of the salivary microbiota during late pregnancy and postpartum. For unknown reasons richness of the salivary microbiota decreased from late pregnancy to postpartum, which might be explained by the physiological changes of the immune system during human pregnancy.
Published: 2020

16. Undervægt blandt prægravide kvinder er en overset risikofaktor

Author: Sarah Marie Bjørnholt, Lea Bo Sønderlund Ankerstjerne, Elisabeth Thal Rønneberg, Jens Fuglsang, Camilla Viola Palm, Anne Ostenfeld, Ellen Aagaard Nøhr, Kristina Martha Renault, Sara Johanna Bergenheim, Susanne Lund Kristensen, and Jeannet Lauenborg
Abstract: Underweight, defined as BMI ≤ 18.5 kg/m2, is found in 4.2% of pregnancies in Denmark. Pre-pregnancy underweight is more often seen in relation to psychiatric disorders, e.g. anorexia nervosa, and diet restrictions and associates with adverse pregnancy outcomes, such as antepartum haemorrhage requiring blood transfusion, preterm birth, small for gestational age infants, and impaired ability to breastfeed. In this review, we recommend identification of possible underlying medical or psychiatric disorders, focus on sufficient gestational weight gain, and relevant vitamin and mineral substitution.
Published: 2020

17. Maternal Long-Term Outcomes after a Pregnancy Complicated by Gestational Diabetes Mellitus

Author: Jeannet Lauenborg, Mie Crusell, Peter Damm, and Elisabeth R. Mathiesen
Subjects: Gestational diabetes, Pregnancy, medicine.medical_specialty, business.industry, Obstetrics, medicine, Long term outcomes, medicine.disease, business
Published: 2019

18. Gestational diabetes is associated with change in the gut microbiota composition in third trimester of pregnancy and postpartum

Author: Henrik Vestergaard, Tue H. Hansen, Ole Bjarne Christiansen, Oluf Pedersen, Trine Nielsen, Peter Damm, Malte C. Rühlemann, Mie Crusell, Niklas Rye Jørgensen, Christina Rørbye, Andre Franke, Kristine H. Allin, Jeannet Lauenborg, Femke-Anouska Heinsen, and Torben Hansen
Subjects: 0301 basic medicine, Blood Glucose, Physiology, Type 2 diabetes, Gut flora, 0302 clinical medicine, Pregnancy, RNA, Ribosomal, 16S, Surveys and Questionnaires, Glucose homeostasis, Gestational diabetes, Body mass index, Glycaemic traits, Postpartum Period, Actinobacteria, lcsh:QR100-130, Desulfovibrio, Female, Microbiology (medical), Adult, food.ingredient, Pregnancy Trimester, Third, 030209 endocrinology & metabolism, Gut microbiota, Biology, Gestational hyperglycaemia, digestive system, Microbiology, lcsh:Microbial ecology, 03 medical and health sciences, food, medicine, Humans, Faecalibacterium, Clostridium, Christensenella, Research, Akkermansia, medicine.disease, biology.organism_classification, Gastrointestinal Microbiome, Gastrointestinal Tract, Diabetes, Gestational, 030104 developmental biology, Glucose, Dysbiosis, Bacterial species
Abstract: Background Imbalances of gut microbiota composition are linked to a range of metabolic perturbations. In the present study, we examined the gut microbiota of women with gestational diabetes mellitus (GDM) and normoglycaemic pregnant women in late pregnancy and about 8 months postpartum. Methods Gut microbiota profiles of women with GDM (n = 50) and healthy (n = 157) pregnant women in the third trimester and 8 months postpartum were assessed by 16S rRNA gene amplicon sequencing of the V1-V2 region. Insulin and glucose homeostasis were evaluated by a 75 g 2-h oral glucose tolerance test during and after pregnancy. Results Gut microbiota of women with GDM was aberrant at multiple levels, including phylum and genus levels, compared with normoglycaemic pregnant women. Actinobacteria at phylum level and Collinsella, Rothia and Desulfovibrio at genus level had a higher abundance in the GDM cohort. Difference in abundance of 17 species-level operational taxonomic units (OTUs) during pregnancy was associated with GDM. After adjustment for pre-pregnancy body mass index (BMI), 5 of the 17 OTUs showed differential abundance in the GDM cohort compared with the normoglycaemic pregnant women with enrichment of species annotated to Faecalibacterium and Anaerotruncus and depletion of species annotated to Clostridium (sensu stricto) and to Veillonella. OTUs assigned to Akkermansia were associated with lower insulin sensitivity while Christensenella OTUs were associated with higher fasting plasma glucose concentration. OTU richness and Shannon index decreased from late pregnancy to postpartum regardless of metabolic status. About 8 months after delivery, the microbiota of women with previous GDM was still characterised by an aberrant composition. Thirteen OTUs were differentially abundant in women with previous GDM compared with women with previous normoglycaemic pregnancy. Conclusion GDM diagnosed in the third trimester of pregnancy is associated with a disrupted gut microbiota composition compared with normoglycaemic pregnant women, and 8 months after pregnancy, differences in the gut microbiota signatures are still detectable. The gut microbiota composition of women with GDM, both during and after pregnancy, resembles the aberrant microbiota composition reported in non-pregnant individuals with type 2 diabetes and associated intermediary metabolic traits. Electronic supplementary material The online version of this article (10.1186/s40168-018-0472-x) contains supplementary material, which is available to authorized users.
Published: 2018

19. The incidence of obstetric anal sphincter injury depends on both correct diagnosis and preventive strategies

Author: Anette Kjaerbye-Thygesen, Hanna Jangö, Jens Langhoff-Roos, Hanne Brix Westergaard, and Jeannet Lauenborg
Subjects: Pregnancy, medicine.medical_specialty, Obstetrics, business.industry, Incidence, Incidence (epidemiology), MEDLINE, Anal Canal, Obstetrics and Gynecology, General Medicine, Anal canal, medicine.disease, Obstetric Labor Complications, Obstetric labor complication, medicine.anatomical_structure, medicine, Humans, Fecal incontinence, Female, medicine.symptom, Anal sphincter, business, Fecal Incontinence
Published: 2019

20. [Pregnancy underweight - an overlooked risk factor]

Author: Sarah Marie, Bjørnholt, Lea, Ankerstjerne, Elisabeth Thal, Rønneberg, Jens, Fuglsang, Camilla Viola Buskbjerg, Palm, Anne, Ostenfeld, Ellen Aagaard, Nøhr, Kristina Martha, Renault, Sara Johanna, Bergenheim, Susanne Lund, Kristensen, and Jeannet, Lauenborg
Subjects: Pregnancy Complications, Thinness, Pregnancy, Risk Factors, Denmark, Infant, Newborn, Pregnancy Outcome, Humans, Female, Body Mass Index, Retrospective Studies
Abstract: Underweight, defined as BMI ≤ 18.5 kg/m2, is found in 4.2% of pregnancies in Denmark. Pre-pregnancy underweight is more often seen in relation to psychiatric disorders, e.g. anorexia nervosa, and diet restrictions and associates with adverse pregnancy outcomes, such as antepartum haemorrhage requiring blood transfusion, preterm birth, small for gestational age infants, and impaired ability to breastfeed. In this review, we recommend identification of possible underlying medical or psychiatric disorders, focus on sufficient gestational weight gain, and relevant vitamin and mineral substitution.
Published: 2019

21. Continuous focus on preventive strategies and follow up is important for a change

Author: Anette Kjaerbye-Thygesen, Hanne Brix Westergaard, Jens Langhoff-Roos, Hanna Jangö, and Jeannet Lauenborg
Subjects: Focus (computing), Medical education, business.industry, Risk Factors, Incidence, Obstetrics and Gynecology, Medicine, Anal Canal, General Medicine, Longitudinal Studies, business, Follow-Up Studies
Published: 2019

22. Gestational diabetes mellitus and long-term consequences for mother and offspring: a view from Denmark

Author: Azadeh Houshmand-Oeregaard, Louise Kelstrup, Jeannet Lauenborg, Elisabeth R. Mathiesen, Tine D. Clausen, and Peter Damm
Subjects: medicine.medical_specialty, Fetus, Pregnancy, endocrine system diseases, Offspring, Obstetrics, business.industry, Endocrinology, Diabetes and Metabolism, nutritional and metabolic diseases, 030209 endocrinology & metabolism, Type 2 diabetes, medicine.disease, Obesity, Gestational diabetes, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Internal medicine, Diabetes mellitus, Internal Medicine, medicine, 030212 general & internal medicine, Metabolic syndrome, business
Abstract: Gestational diabetes mellitus (GDM) is defined as glucose intolerance of varying severity and is present in about 2-6% of all pregnancies in Europe, making it one of the most common pregnancy disorders. Aside from the short-term maternal, fetal and neonatal consequences associated with GDM, there are long-term consequences for both mother and child. Although maternal glucose tolerance often normalises shortly after pregnancy, women with GDM have a substantially increased risk of developing type 2 diabetes later in life. Studies have reported that women are more than seven times as likely to develop diabetes after GDM, and that approximately 50% of mothers with GDM will develop diabetes within 10 years, making GDM one of the strongest predictors of type 2 diabetes. In women with previous GDM, development of type 2 diabetes can be prevented or delayed by lifestyle intervention and/or medical treatment. Systematic follow-up programmes would be ideal to prevent progression of GDM to diabetes, but such programmes are unfortunately lacking in the routine clinical set-up in most countries. Studies have found that the risks of obesity, the metabolic syndrome, type 2 diabetes and impaired insulin sensitivity and secretion in offspring of mothers with GDM are two- to eightfold those in offspring of mothers without GDM. The underlying pathogenic mechanisms behind the abnormal metabolic risk profile in offspring are unknown, but epigenetic changes induced by exposure to maternal hyperglycaemia during fetal life are implicated. Animal studies indicate that treatment can prevent long-term metabolic complications in offspring, but this remains to be confirmed in humans. Thus, diabetes begets diabetes and it is likely that GDM plays a significant role in the global diabetes epidemic. This review summarises a presentation given at the 'Gestational diabetes: what's up?' symposium at the 2015 annual meeting of the EASD. It is accompanied by two other reviews on topics from this symposium (by Marja Vaarasmaki, DOI: 10.1007/s00125-016-3976-6 , and by Cuilin Zhang and colleagues, DOI: 10.1007/s00125-016-3979-3 ) and an overview by the Session Chair, Kerstin Berntorp (DOI: 10.1007/s00125-016-3975-7 ).
Published: 2016

23. A Time Interval of More Than 18 Months Between a Pregnancy and a Roux-en-Y Gastric Bypass Increases the Risk of Iron Deficiency and Anaemia in Pregnancy

Author: Mie Crusell, Lisbeth Nilas, Jeannet Lauenborg, and Jens Svare
Subjects: Adult, Gestational hypertension, medicine.medical_specialty, Time Factors, Anemia, Endocrinology, Diabetes and Metabolism, Birth weight, Gastric Bypass, Intrauterine growth restriction, 030209 endocrinology & metabolism, Prenatal care, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, medicine, Humans, Obesity, Retrospective Studies, 030219 obstetrics & reproductive medicine, Nutrition and Dietetics, Anemia, Iron-Deficiency, Obstetrics, business.industry, Pregnancy Outcome, Prenatal Care, Iron deficiency, medicine.disease, Nutrition Disorders, Pregnancy Complications, Cross-Sectional Studies, Ferritins, Female, Surgery, business, Body mass index
Abstract: The aim of the study is to explore the impact of time between Roux-en-Y gastric bypass (RYGB) and pregnancy on obstetrical outcome and nutritional derangements. In a retrospective cross-sectional study of pregnant women admitted for antenatal care at two tertiary hospitals, we examined 153 women with RYGB and a singleton pregnancy of at least 24 weeks. The women were stratified according to a pregnancy
Published: 2016

24. Ponderal index at birth associates with later risk of gestational diabetes mellitus

Author: Torben Hansen, Charlotte Glümer, Peter Damm, Oluf Pedersen, Allan Vaag, Jeannet Lauenborg, and Mie Crusell
Subjects: Adult, Blood Glucose, medicine.medical_specialty, endocrine system diseases, Birth weight, Population, 030209 endocrinology & metabolism, 03 medical and health sciences, 0302 clinical medicine, Insulin resistance, Pregnancy, Risk Factors, Journal Article, Odds Ratio, Medicine, Birth Weight, Humans, Insulin, 030212 general & internal medicine, education, education.field_of_study, business.industry, Obstetrics, nutritional and metabolic diseases, Obstetrics and Gynecology, Type 2 Diabetes Mellitus, General Medicine, Odds ratio, medicine.disease, female genital diseases and pregnancy complications, Gestational diabetes, Low birth weight, Diabetes, Gestational, Glucose, Diabetes Mellitus, Type 2, Cohort, Female, medicine.symptom, business, Follow-Up Studies
Abstract: PURPOSE: Low birth weight (BW) and low ponderal index (PI) are associated with increased risk of type 2 diabetes mellitus. This study has two purposes: first to investigate the influence of PI on the risk of gestational diabetes mellitus (GDM); second, to study the association between glucose metabolism and BW in women with previous GDM.METHODS: GDM cohort: 185 women with GDM in 1978-1996, attending a follow-up study in 2000-2002. Control cohort: 1137 women from a population-based diabetes screening study (Inter99) in a neighbouring county in 1999-2001. BW and birth length were collected from the original midwifery records. BW and PI were stratified into tertiles for analysis.RESULTS: PI in the lower tertiles was associated with an increased risk of GDM [odds ratio 1.59 (95% confidence interval 1.07-2.36, p = 0.021)]. Among women with previous GDM, the area under the curve (AUC) for plasma levels of glucose and insulin during an OGTT was highest for the lower tertiles of BW (for AUCglucose p = 0.048, for AUCinsulin p = 0.047 adjusted for age and BMI).CONCLUSIONS: Lower PI is associated with increased risk of GDM. In women with previous GDM, lower BW is associated with a more severe impairment of glucose metabolism one to two decades after the pregnancy complicated by GDM.
Published: 2017

25. High Prevalence of Diabetes-Predisposing Variants in MODY Genes Among Danish Women With Gestational Diabetes Mellitus

Author: Jun Wang, Ivan Brandslund, Peter Damm, Torben Hansen, Mette Hollensted, Niels Grarup, Jeannet Lauenborg, Shi Quan, Anette P. Gjesing, Ehm A. Andersson, Oluf Pedersen, Gao Rui, Christian Theil Have, and Jihua Sun
Subjects: 0301 basic medicine, medicine.medical_specialty, endocrine system, Diabetes, Pancreatic and Gastrointestinal Hormones, Endocrinology, Diabetes and Metabolism, Context (language use), 03 medical and health sciences, Internal medicine, Diabetes mellitus, medicine, Journal Article, genes, Research Articles, Pregnancy, business.industry, genetic screening, Anthropometry, medicine.disease, HNF1B, 3. Good health, HNF1A, Gestational diabetes, 030104 developmental biology, monogenic diabetes, MODY, gestational diabetes, business, Biomedical sciences
Abstract: Context: Gestational diabetes mellitus (GDM), defined as any degree of glucose intolerance with first recognition during pregnancy, is a heterogeneous form of diabetes characterized by various degrees of β-cell dysfunction. Objectives: We aimed to estimate the prevalence of possibly pathogenic variants in the maturity-onset diabetes of the young genes GCK, HNF1A, HNF4A, HNF1B, and INS among women with GDM. Furthermore, we examined the glucose tolerance status in variant carriers vs noncarriers at follow-up. Design, Setting, and Patients: We sequenced the coding regions and intron/exon boundaries of GCK, HNF1A, HNF4A, HNF1B, and INS using targeted region capture and next-generation sequencing in 354 Danish women with diet-treated GDM. Glucose tolerance was examined at follow-up 10 years after the index pregnancy. Main Outcome Measures: The prevalence of possibly pathogenic variants in GCK, HNF1A, HNF4A, HNF1B, and INS was estimated, and differences in anthropometric traits, high-sensitivity C-Reactive Protein (CRP), and glucose metabolism were measured. Results: At baseline, 17 possibly disease-causing variants were found in 21 women, revealing a combined GCK, HNF1A, HNF4A, HNF1B, and INS variant prevalence of 5.9% (95% confidence interval: 3.5% to 8.4%). At follow-up, 15 out of 135 women with diabetes (11%) were carriers of variants in GCK, HNF1A, HNF4A, HNF1B, or INS. Conclusions: Almost 6% of Danish women with diet-treated GDM have possibly pathogenic variants in GCK, HNF1A, HNF4A, HNF1B, or INS. These women are at high risk of developing diabetes after pregnancy. Thus screening for variants in GCK, HNF1A, HNF4A, HNF1B, and INS should be considered among women with GDM., Almost 6% out of 354 Danish women with diet-treated gestational diabetes mellitus carried possibly pathogenic diabetes-predisposing variants in the MODY genes GCK, HNF1A, HNF4A, HNF1B, and INS.
Published: 2017

26. The Impact of Upper Abdominal Pain During Pregnancy Following a Gastric Bypass

Author: Jeannet Lauenborg, Liselotte Petersen, Jens Svare, and Lisbeth Nilas
Subjects: Adult, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Gastric bypass, Gastric Bypass, Intrauterine growth restriction, 030209 endocrinology & metabolism, Gestational Age, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Pregnancy, medicine, Birth Weight, Humans, Mesentery, 030212 general & internal medicine, Nutrition and Dietetics, business.industry, Infant, Newborn, Pregnancy Outcome, nutritional and metabolic diseases, medicine.disease, Surgery, Abdominal Pain, Hernia, Abdominal, Obesity, Morbid, Pregnancy Complications, Upper abdominal pain, Female, business
Abstract: The aim of the present study was to describe the risk of internal herniation (IH) and the obstetric outcome in pregnant women with Roux-en-Y gastric bypass (RYGB) and episodes of upper abdominal pain.The cohort included 133 women with RYGB: 94 with 113 pregnancies, from the local area referred for routine antenatal care (local cohort) and 39 with 40 pregnancies referred from other hospitals for specialist consultation due to RYGB. RYGB was mainly performed without closure of the mesenteric defects. Data collected from medical records were episodes of upper abdominal pain, pregestational and gestational abdominal surgery and pregnancy outcome. The risk of upper abdominal pain was estimated in the local cohort. Surgical intervention, IH and obstetric outcome according to pain were evaluated for 139 pregnancies with delivery of a singleton after 24 weeks of gestation (birth cohort).Upper abdominal pain complicated 42/113 (37.2 %) pregnancies in the local cohort and 11 women (9.7 %) had IH. In the birth cohort, upper abdominal pain complicated 64/139 (46.0 %) pregnancies; surgery was performed in 30/64 (46.9 %), and IH diagnosed in 21/64 (32.8 %). The median gestational age at onset of pain was 25 + 3 weeks. Women reporting abdominal pain had a higher risk of preterm birth (n = 14/64 vs. 1/75, p 0.005), lower median gestational length (269 vs. 278 days, p 0.005) and lower median birth weight (3018 vs. 3281 g, p = 0.002) compared to women without abdominal pain.Upper abdominal pain during pregnancy is frequent among women with Roux-en-Y gastric bypass, is often due to IH and is associated with adverse pregnancy outcome.
Published: 2016

27. [Complications in pregnant women with polycystic ovary syndrome]

Author: Johan, Tolstrup, Fjóla, Jónsdóttir, Charlotte Mumm, Ring, Marianne, Andersen, Jimmi, Elers, Katrine, Hedengran, Anne Marie, Holm, and Jeannet, Lauenborg
Subjects: Pregnancy Complications, Pre-Eclampsia, Pregnancy, Risk Factors, Infant, Newborn, Humans, Premature Birth, Female, Hypertension, Pregnancy-Induced, Weight Gain, Polycystic Ovary Syndrome
Abstract: Pregnant women with polycystic ovary syndrome (PCOS) are at increased risk of pregnancy-related disorders such as gestational diabetes (GDM), gestational hypertension and preeclampsia in the 2nd and 3rd trimester. In addition, the risk of preterm birth, children who are small and large for gestational age, caesarean section and poorer neonatal outcome seem to be elevated, however with less clear evidence. Except for the screening for GDM, there is no evidence of a benefit of increased surveillance during pregnancy for women with PCOS.
Published: 2016

28. [Metformin and the obstetric patient]

Author: Katrine Dahl, Pedersen, Nathalie Søderhamn, Bülow, Kasper, Aaboe, Julie, Galsgaard, Helle Sand, Odgaard, Elisabeth Reinhardt, Mathiesen, and Jeannet, Lauenborg
Subjects: Diabetes, Gestational, Breast Feeding, Pregnancy, Pregnancy Trimester, Second, Pregnancy Trimester, Third, Prenatal Exposure Delayed Effects, Humans, Hypoglycemic Agents, Female, Metformin, Polycystic Ovary Syndrome
Abstract: Polycystic ovary syndrome (PCOS) is associated with insulin resistance, infertility, obesity and gestational complications. Metformin is widely used in fertility treatment of women with PCOS, due to a suggested positive effect of continued metformin treatment beyond the first trimester on pregnancy complications. Larger randomized trials have failed to confirm this. Metformin treatment has not been found to be superior to insulin treatment in women with gestational diabetes and may be associated with long-term consequences in the children in the form of overweight and disturbed glucose metabolism.
Published: 2015

29. The influence of parental history of diabetes and offspring birthweight on offspring glucose metabolism in adulthood

Author: Peter Damm, Søren A. Urhammer, Hans Eiberg, Jeannet Lauenborg, Torben Hansen, Oluf Pedersen, Mie K W Jørgensen, and Atheline Major-Pedersen
Subjects: Glucose tolerance test, education.field_of_study, medicine.medical_specialty, Pregnancy, medicine.diagnostic_test, Offspring, business.industry, Birth weight, Population, Obstetrics and Gynecology, General Medicine, Type 2 diabetes, medicine.disease, Insulin resistance, Endocrinology, Internal medicine, Diabetes mellitus, medicine, education, business
Abstract: Background. Links are well established between both family history of diabetes and reduced birthweight and increased risk of diabetes in adulthood. Objectives. 1) To investigate the influence of parental history of type 2 diabetes (T2DM) on offspring birthweight and adult offspring glucose tolerance status in non-diabetic offspring of patients with T2DM and 2) to study the associations of birthweight with measures of pancreatic beta-cell function and insulin sensitivity. Design. Family cohort study. Population. Offspring of patients with verified T2DM diagnosed after age 40 years with a spouse without known diabetes. Methods. Oral glucose tolerance tests and frequently sampled intravenous glucose tolerance tests (FSIGT) in nondiabetic offspring. Birthweight and length obtained from birth records. Results. Among 122 offspring with maternal history of T2DM, 14.8% had diabetes compared to 8.0% in 137 offspring with paternal history of diabetes, p=0.09. Offspring with maternal history of T2DM had a mean birthweight 196g higher than offspring with paternal T2DM (3 651±640g (mean±SD) vs. 3 456±472g (p=0.01)). Nondiabetic offspring with birthweights in the lowest tertile had significantly higher plasma glucose levels after an oral glucose tolerance test (OGTT) [Area under the curveglucOGTT, mean (95%CI), 1 795 (1 725‐1 866) vs. 1 683 (1 613‐1 753) mmol/L/min, p=0.02], and lower insulin sensitivity index calculated from a frequentlysampledintravenousglucosetolerancetest‐Si9.60[10 ‐5 (min ∗ pmol/L) ‐1 ] (8.23‐10.97)vs.11.79(10.41‐13.18),p=0.02‐inadulthoodcomparedtooffspring with birthweights in the upper tertile. Conclusions. Offspring with a family history of maternal T2DM have higher birthweights than those with paternal T2DM. Low birthweight associates with elevated plasma glucose levels after an oral glucose load and decreased insulin sensitivity in adulthood. Abbreviations: AIR, acute serum insulin responses; AUC, area under the curve; BMI, body mass index; FSIGT, frequently sampled intravenous glucose tolerance test;OGTT,oralglucosetolerancetest;Sg,glucoseeffectiveness;Si,insulinsensitivity index; T2DM, type 2 diabetes
Published: 2011

30. High Prevalence of Type 2 Diabetes and Pre-Diabetes in Adult Offspring of Women With Gestational Diabetes Mellitus or Type 1 Diabetes

Author: Tine D. Clausen, Dorte Møller Jensen, Peter Damm, Torben Hansen, Oluf Pedersen, Jeannet Lauenborg, and Elisabeth R. Mathiesen
Subjects: Advanced and Specialized Nursing, medicine.medical_specialty, Type 1 diabetes, Glucose tolerance test, medicine.diagnostic_test, business.industry, Offspring, Endocrinology, Diabetes and Metabolism, Physiology, Type 2 diabetes, medicine.disease, Impaired fasting glucose, Gestational diabetes, Impaired glucose tolerance, Endocrinology, Internal medicine, Diabetes mellitus, Internal Medicine, medicine, business
Abstract: OBJECTIVE—The role of intrauterine hyperglycemia and future risk of type 2 diabetes in human offspring is debated. We studied glucose tolerance in adult offspring of women with either gestational diabetes mellitus (GDM) or type 1 diabetes, taking the impact of both intrauterine hyperglycemia and genetic predisposition to type 2 diabetes into account. RESEARCH DESIGN AND METHODS—The glucose tolerance status following a 2-h 75-g oral glucose tolerance test (OGTT) was evaluated in 597 subjects, primarily Caucasians, aged 18–27 years. They were subdivided into four groups according to maternal glucose metabolism during pregnancy and genetic predisposition to type 2 diabetes: 1) offspring of women with diet-treated GDM (O-GDM), 2) offspring of genetically predisposed women with a normal OGTT (O-NoGDM), 3) offspring of women with type 1 diabetes (O-type 1), and 4) offspring of women from the background population (O-BP). RESULTS—The prevalence of type 2 diabetes and pre-diabetes (impaired glucose tolerance or impaired fasting glucose) in the four groups was 21, 12, 11, and 4%, respectively. In multiple logistic regression analysis, the adjusted odds ratios (ORs) for type 2 diabetes/pre-diabetes were 7.76 (95% CI 2.58–23.39) in O-GDM and 4.02 (1.31–12.33) in O-type 1 compared with O-BP. In O-type 1, the risk of type 2 diabetes/pre-diabetes was significantly associated with elevated maternal blood glucose in late pregnancy: OR 1.41 (1.04–1.91) per mmol/l. CONCLUSIONS—A hyperglycemic intrauterine environment appears to be involved in the pathogenesis of type 2 diabetes/pre-diabetes in adult offspring of primarily Caucasian women with either diet-treated GDM or type 1 diabetes during pregnancy.
Published: 2008

31. Pre-emptive treatment with fibrinogen concentrate for postpartum haemorrhage: randomized controlled trial

Author: Kim Ekelund, Volker Classen, Birgit Bødker, Jens Svare, Benedicte Utke Ramsing, Louise Pedersen, A. Afshari, L. Fuhrmann, Christian Viggo Nielsen, Lone Fuhrmann, H.F. Sharif, J. Svare, A.U. Mitchell, Jens Lunde, Marina K. Christensen, A. Troelstrup, Marianne S. Flindt, Christine Andersen, Lars Hyldborg Lundstrøm, Casper Okkels, Erik L. Secher, H.M. Edwards, Iben Darfeld, Marie Søgaard, Anna Engskov, Ane Troelstrup, Anja U. Mitchell, G. Hanke, Anne Wikkelsø, Rasmus Berthelsen, Peter Jensen-Gadegaard, K. Ekelund, Karen Elisabeth Linnet, Heidi F Sharif, A.J. Wikkelsø, Maria Petersen, A.M. Møller, L.M. Pedersen, Jakob Stensballe, Gabriele Hanke, Ann Merete Møller, Kristian J. Andersen, J. Lauenborg, M. H. Madsen, J. Langhoff-Roos, J. Stensballe, Jens Langhoff-Roos, B. Bødker, C. B. Wulff, Rasmus Winkel, Pernille Opstrup, Mette Andersson, Mathias Johansen, Birgit Lassen, Arash Afshari, Marie Winther-Olsen, E.L. Secher, Hellen Mc Kinnon Edwards, M.G. Madsen, Michelé Lefort Sønderskov, Sine Hougaard, Lars Møller Pedersen, Jeannet Lauenborg, Line Stendall, Charlotte Albrechtsen, C. Albrechtsen, Mette G. Madsen, and Marianne Berntsen
Subjects: Blood transfusion, medicine.medical_treatment, Placebo, Fibrinogen, law.invention, Randomized controlled trial, Double-Blind Method, law, Pregnancy, medicine, Humans, Hemostasis, business.industry, Postpartum Hemorrhage, Liter, medicine.disease, Anesthesiology and Pain Medicine, Treatment Outcome, Anesthesia, Maternal death, Female, business, Erythrocyte Transfusion, Postpartum period, medicine.drug
Abstract: Background. In early postpartum haemorrhage (PPH), a low concentration of fibrinogen is associated with excessive subsequent bleeding and blood transfusion. We hypothesized that pre-emptive treatment with fibrinogen concentrate reduces the need for red blood cell (RBC) transfusion in patients with PPH. Methods. In this investigator-initiated, multicentre, double-blinded, parallel randomized controlled trial, we assigned subjects with severe PPH to a single dose of fibrinogen concentrate or placebo (saline). A dose of 2 g or equivalent was given to all subjects independent of body weight and the fibrinogen concentration at inclusion. The primary outcome was RBC transfusion up to 6 weeks postpartum. Secondary outcomes were total blood loss, total amount of blood transfused, occurrence of rebleeding, haemoglobin ,58 g litre 21 , RBC transfusion within 4 h, 24 h, and 7 days, and as a composite outcome of ‘severe PPH’, defined as a decrease in haemoglobin of .40 g litre 21 , transfusion of at least 4 units of RBCs, haemostatic intervention (angiographic embolization, surgical arterial ligation, or hysterectomy), or maternal death. Results. Of the 249 randomized subjects, 123 of 124 in the fibrinogen group and 121 of 125 in the placebo group were included in the intention-to-treat analysis. At inclusion the subjects had severe PPH, with a mean blood loss of 1459 (SD 476) ml and a mean fibrinogen concentration of 4.5 (SD 1.2) g litre 21 . The intervention group received a mean dose of 26 mg kg 21 fibrinogen concentrate, thereby significantly increasing fibrinogen concentration compared with placebo by 0.40 g litre 21 (95% confidence interval, 0.15 –0.65; P¼0.002). Postpartum blood transfusion occurred in 25 (20%) of the fibrinogen group and 26 (22%) of the placebo group (relative risk, 0.95; 95% confidence interval, 0.58 –1.54; P¼0.88). We found no difference in any predefined secondary outcomes, per-protocol analyses, or adjusted analyses. No thromboembolic events were detected. Conclusions. We found no evidence for the use of 2 g fibrinogen concentrate as pre-emptive treatment for severe PPH in patients with normofibrinogenaemia. Clinical trial registration. ClinicalTrials.gov: http://clinicaltrials.gov/show/NCT01359878. Published protocol: http://www.trialsjournal.com/content/pdf/1745-6215-13-110.pdf.
Published: 2015

32. A Novel −192c/g Mutation in the Proximal P2 Promoter of the Hepatocyte Nuclear Factor-4α Gene (HNF4A) Associates With Late-Onset Diabetes

Author: Jan Lebl, Sara P. Hansen, Stepanka Pruhova, Torben Hansen, Oluf Pedersen, Anders Albrechtsen, A. Johansen, Jorge Ferrer, Torben Jørgensen, Knut Borch-Johnsen, Jeannet Lauenborg, Marcelin Parrizas, Jakob Ek, Peter Damm, Trine Welløv Boesgaard, Knud Bonnet Yderstræde, Carine Nicot, Maria Lajer, and Sylvia F. Boj
Subjects: Adult, Blood Glucose, Male, medicine.medical_specialty, Genotype, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Electrophoretic Mobility Shift Assay, Single-nucleotide polymorphism, Type 2 diabetes, Biology, Polymorphism, Single Nucleotide, Body Mass Index, Exon, Sex Factors, Internal medicine, Diabetes mellitus, Internal Medicine, medicine, Humans, Promoter Regions, Genetic, Aged, Binding Sites, Insulin, Age Factors, Middle Aged, medicine.disease, Pedigree, Gestational diabetes, Hepatocyte nuclear factors, Endocrinology, Diabetes Mellitus, Type 2, Haplotypes, Hepatocyte Nuclear Factor 4, Mutation, Female, TCF7L2, Protein Binding
Abstract: Recently, it has been shown that mutations in the P2 promoter of the hepatocyte nuclear factor (HNF)-4α gene (HNF4A) cause maturity-onset diabetes of the young (MODY), while single nucleotide polymorphisms in this locus are associated with type 2 diabetes. In this study, we examined 1,189 bp of the P2 promoter and the associated exon 1D of HNF4A for variations associated with diabetes in 114 patients with type 2 diabetes, 72 MODYX probands, and 85 women with previous gestational diabetes mellitus. A −192c/g mutation was found in five patients. We screened 1,587 diabetic subjects and 4,812 glucose-tolerant subjects for the −192c/g mutation and identified 5 diabetic and 1 glucose-tolerant mutation carriers (P = 0.004). Examination of the families showed that carriers of the −192c/g mutation had a significantly impaired glucose-stimulated insulin release and lower levels of serum total cholesterol compared with matched control subjects. Furthermore, the mutation disrupted the binding of an unidentified sequence-specific DNA binding complex present in human islet extracts. Also, two novel linked polymorphisms in the P2 promoter at positions −1107g/t and −858c/t were identified. These variants were not significantly associated with type 2 diabetes or any pre-diabetic traits. In conclusion, a rare, novel mutation that disrupts a protein binding site in the pancreatic HNF4A promoter associates with late-onset diabetes.
Published: 2006

33. The Prevalence of the Metabolic Syndrome in a Danish Population of Women with Previous Gestational Diabetes Mellitus Is Three-Fold Higher than in the General Population

Author: Torben Jørgensen, Oluf Pedersen, Peter J. Hornnes, Knut Borch-Johnsen, Torben Hansen, Peter Damm, Jeannet Lauenborg, Charlotte Glümer, and Elisabeth R. Mathiesen
Subjects: Adult, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Clinical Biochemistry, Population, Biochemistry, Endocrinology, Insulin resistance, Pregnancy, Internal medicine, Diabetes mellitus, Prevalence, medicine, Humans, education, National Cholesterol Education Program, Metabolic Syndrome, education.field_of_study, business.industry, Biochemistry (medical), Middle Aged, medicine.disease, Obesity, Gestational diabetes, Diabetes, Gestational, Female, Metabolic syndrome, business
Abstract: Context: Diabetes and obesity, components of the metabolic syndrome, are common characteristics of women with prior gestational diabetes mellitus (GDM). Due to increasing incidence of diabetes and obesity, the metabolic syndrome might comprise a major health problem among these women. Objective: The objective was to estimate the prevalence of the metabolic syndrome by three different criteria [World Health Organization 1999 (WHO), The National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults 2001, and European Group for the Study of Insulin Resistance 2002] among women with previous GDM. Design: We conducted a follow-up study of a Danish cohort of women admitted in 1978–1996 to the Diabetes and Pregnancy Center, Rigshospitalet, Copenhagen University Hospital, with diet-treated GDM. The follow-up took place in 2000–2002 at median 9.8 yr (interquartile range 6.4–17.2) after pregnancy. Results were compared with a control group of 1000 age-matched women from a population-based sample (Inter99). Participants: Four hundred eighty-one women at median age 43 yr (interquartile range 38–48) participated. Main Outcome Measures: The main outcome measures were body mass index (BMI), glucose tolerance, blood pressure, lipid profile, and insulin resistance. Results: Independent of the criteria, the prevalence of the metabolic syndrome was three times higher in the prior GDM group, compared with the control group (e.g. WHO: 38.4 vs. 13.4%, P < 0.0005). Age- and BMI-adjusted odds ratio for having the WHO-defined metabolic syndrome was 3.4 (95% confidence interval 2.5–4.8) for the prior GDM group vs. the control group. Obese women (BMI > 30 kg/m2) with previous GDM had a more than 7-fold increased prevalence of the metabolic syndrome (WHO), compared with normal-weight prior GDM women (BMI < 25 kg/m2). In glucose-tolerant women, the prevalence was doubled in the prior GDM group, compared with control group. Conclusion: The prevalence of the metabolic syndrome was three times as high in women with prior diet-treated GDM, compared with age-matched control subjects.
Published: 2005

34. Variation in NCB5OR

Author: Anders Johansen, Jakob Ek, Oluf Pedersen, Kevin Larade, C. S. Rose, Torben Hansen, Peter Damm, Knut Borch-Johnsen, Jianxin Xie, Lise Wegner, Jeannet Lauenborg, Gitte Andersen, H. Franklin Bunn, Thomas Drivsholm, and Hao Zhu
Subjects: medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Type 2 diabetes, Quantitative trait locus, Biology, medicine.disease, Maturity onset diabetes of the young, Gestational diabetes, Pathogenesis, Endocrinology, Internal medicine, Diabetes mellitus, Internal Medicine, medicine, Coding region, Gene
Abstract: Recent data show that homozygous Ncb5or−/− knock-out mice present with an early-onset nonautoimmune diabetes phenotype. Furthermore, genome-wide scans have reported linkage to the chromosome 6q14.2 region close to the human NCB5OR. We therefore considered NCB5OR to be a biological and positional candidate gene and examined the coding region of NCB5OR in 120 type 2 diabetic patients and 63 patients with maturity-onset diabetes of the young using denaturing high-performance liquid chromatography. We identified a total of 22 novel nucleotide variants. Three variants [IVS5+7del(CT), Gln187Arg, and His223Arg] were genotyped in a case-control design comprising 1,246 subjects (717 type 2 diabetic patients and 529 subjects with normal glucose tolerance). In addition, four rare variants were investigated for cosegregation with diabetes in multiplex type 2 diabetic families. The IVS5+7del(CT) variant was associated with common late-onset type 2 diabetes; however, we failed to relate this variant to any diabetes-related quantitative traits among the 529 control subjects. Thus, variation in the coding region of NCB5OR is not a major contributor in the pathogenesis of nonautoimmune diabetes.
Published: 2004

35. Increasing Incidence of Diabetes After Gestational Diabetes

Author: Lars Mølsted-Pedersen, Torben Hansen, Henning Locht, Peter J. Hornnes, Jeannet Lauenborg, Oluf Pedesen, Peter Damm, Henrik Vestergaard, and Dorte Møller Jensen
Subjects: medicine.medical_specialty, Pediatrics, Endocrinology, Diabetes and Metabolism, Type 2 diabetes, Overweight, Impaired glucose tolerance, Diabetes mellitus, Internal medicine, Internal Medicine, medicine, Advanced and Specialized Nursing, Glucose tolerance test, medicine.diagnostic_test, business.industry, Obstetrics and Gynecology, nutritional and metabolic diseases, General Medicine, Impaired fasting glucose, medicine.disease, Gestational diabetes, Endocrinology, Cohort, medicine.symptom, business, Postpartum period, Cohort study
Abstract: Women with gestational diabetes mellitus (GDM) are known to be at increased risk of having overt diabetes, especially type 2 diabetes, later in life. Most long-term studies, however, involved non-European populations and did not distinguish between dietary and insulin treatment. The investigators determined the long-term risk of diabetes in Danish women having diet-treated GDM. An "old" cohort of 241 women presented in 1978-1985 and followed up for 2 to 11 years. A "new" cohort of 512 women presented at the same center in 1987-1996 and were reassessed in 2000-2002. The oral glucose tolerance test, done using 50 or 75 g of glucose, was read as abnormal if at least 2 of 7 blood glucose values exceeded 3 standard deviations above the mean for nonpregnant women. A total of 481 women, nearly two thirds of the total, were followed up a median of 9.8 years after the index pregnancy. Diabetes was present at follow up in 40% of women and impaired glucose tolerance or impaired fasting glucose in 27%. Type 2 diabetes was diagnosed in 171 of 192 patients affected. All 12 women with overt diabetes in the postpartum period had diabetes at follow up. The incidence of diabetes was more than 2-fold higher in the new cohort than in the old one in 1990, but rates were similar at follow up in 2002. On multiple logistic regression analysis, diabetes was independently associated with being in the new cohort, overweight or obesity before pregnancy, an early diagnosis of GDM, a high fasting glucose at the time of oral glucose tolerance testing, and impaired glucose tolerance in the postpartum period. This study demonstrated a doubling in the incidence of diabetes and impaired glucose tolerance or impaired fasting glucose over a 10-year period in women having diet-treated GDM. Prepregnancy obesity further increased the risk, suggesting that timely intervention might prevent or delay the development of overt diabetes.
Published: 2004

36. Screening for Gestational Diabetes

Author: Peter J. Hornnes and Jeannet Lauenborg
Subjects: medicine.medical_specialty, business.industry, Obstetrics, Overweight, medicine.disease, Asymptomatic, Obesity, Gestational diabetes, Increased risk, Diabetes mellitus, General screening, Health care, Medicine, medicine.symptom, business
Abstract: Gestational diabetes is an asymptomatic condition associated with adverse outcome for mother and child. Overweight and obesity confer a higher risk of gestational diabetes – up to 11-fold. Health care providers of pregnant women should ensure that a strategy for screening gestational diabetes is in place. Either general screening programmes or selective screening programmes may be employed. Women with gestational diabetes should be monitored and treated vigorously. After delivery, glucose metabolism is most often normalised, but women with previous gestational diabetes have an increased risk of developing type-2 diabetes in later years. Therefore, they should be counselled about healthy lifestyles and offered exanimations for diabetes or pre-diabetes with 1–3 year intervals.
Published: 2013

37. Contributors

Author: Annie S. Anderson, Richard A. Anderson, Sabaratnam Arulkumaran, J. Balani, Alexander Baldacchino, Sarah Beake, Harish Malappa Bhandari, Siladitya Bhattacharya, Debra Bick, Mairead Black, Alexander Bolyakov, Savita Brito-Mutunayagam, Fiona Broughton-Pipkin, Christy Burden, Gail Busby, Sharon Cameron, Carolyn Chiswick, David Churchill, W. Colin Duncan, Angela M. Craigie, Hilary O.D. Critchley, Konstantinos Dafopoulos, Sujeetha Damodaran, Dilip Dan, Debbie M. Smith, Zsolt Demetrovics, Fiona C. Denison, Kavita Deonarine, Anjum Doshan, Tim Draycott, Leroy C. Edozien, Lindsay Edwards, Joanne Ellison, Margaret J. Evans, Gemma Forbes, J.T. George, Peter D. Gluckman, Cindy M. Gray, Mark Hamilton, Mark A. Hanson, Adnan Hasan, Rohana N. Haththotuwa, Pak Chung Ho, Peter Hornnes, Shahzya S. Huda, Stephen Hyer, Ioannidis Ioannis, Amanda Jefferys, Vanessa J. Kay, Khalid S. Khan, Gyöngyi Kökönyei, Justin C. Konje, Karen Siu Ling Lam, Jeannet Lauenborg, Tina Lavender, Alistair Lee, Chin Peng Lee, Hang Wun Raymond Li, Boon H. Lim, Chu Lim, R.C.W. Ma, Kate Maclaran, Abha Maheshwari, Tahir Mahmood, Mani Malarselvi, Sarah Martins da Silva, Fionnuala M. McAuliffe, Rhona J. McInnes, Sarah McRobbie, Mohamed K. Mehasseb, Christina I. Messini, Ioannis E. Messinis, Alistair Milne, Scott M. Nelson, Darius A. Paduch, Nick Panay, Grigoropoulou Pinelopi, Siobhan Quenby, Rebecca M. Reynolds, Yana Richens, Mourad W. Seif, Upul Senarath, Mahmood I. Shafi, Hassan Shehata, Krishnan Swaminathan, Surujpal Teelucksingh, Shakila Thangaratinam, Omar Thanoon, Andrew Thomson, Douglas G. Tincello, Róbert Urbán, Laurent Vaucher, Gerard H.A. Visser, Sanjay Vyas, M. Wagner, Jennifer M. Walsh, Chandrika N. Wijeyaratne, and Yariv Yogev
Published: 2013

38. [Vasa Previa]

Author: Lone Nikoline, Nørgaard and Jeannet, Lauenborg
Subjects: Adult, Cesarean Section, Pregnancy, Placenta, Pregnancy Trimester, Third, Vasa Previa, Extraembryonic Membranes, Humans, Female, Ultrasonography, Doppler, Color, Ultrasonography, Prenatal, Umbilical Cord
Published: 2012

39. The risk of adverse pregnancy outcome after bariatric surgery: a nationwide register-based matched cohort study

Author: Mette Mandrup Kjær, Jeannet Lauenborg, Birger Michael Breum, and Lisbeth Nilas
Subjects: Adult, medicine.medical_specialty, Birth weight, Denmark, Bariatric Surgery, Gestational Age, Lower risk, Risk Assessment, Cohort Studies, Pregnancy, medicine, Birth Weight, Humans, Obesity, Registries, Obstetrics, business.industry, Case-control study, Infant, Newborn, Pregnancy Outcome, Obstetrics and Gynecology, Gestational age, medicine.disease, Surgery, Pregnancy Complications, Case-Control Studies, Infant, Small for Gestational Age, Small for gestational age, Female, business, Body mass index, Cohort study
Abstract: The aim of this study was to describe the risk of adverse obstetric and neonatal outcome after bariatric surgery.Nationwide register-based matched cohort study of singleton deliveries after bariatric surgery during 2004-2010. Data were extracted from The Danish National Patient Registry and The Medical Birth Register. Each woman with bariatric surgery (exposed) was individually matched with 4 women without bariatric surgery (unexposed) on body mass index, age, parity, and date of delivery. Continuous variables were analyzed with the paired t test and binary outcomes were analyzed by logistic regression.We identified 339 women with a singleton delivery after bariatric surgery (84.4% gastric bypass). They were matched to 1277 unexposed women. Infants in the exposed group had shorter mean gestational age (274 vs 278 days; P.001), lower mean birthweight (3312 vs 3585 g; P.001), lower risk of being large for gestational age (adjusted odds ratio, 0.31; 95% confidence interval, 0.15-0.65), and higher risk of being small for gestational age (SGA) (adjusted odds ratio, 2.29; 95% confidence interval, 1.32-3.96) compared with infants in the unexposed group. No statistically significant difference was found between the groups regarding the risk of gestational diabetes mellitus, preeclampsia, labor induction, cesarean section, postpartum hemorrhage, Apgar score less than 7, admission to neonatal intensive care unit or perinatal death.Infants born after maternal bariatric surgery have lower birthweight, lower gestational age, 3.3-times lower risk of large for gestational age, and 2.3-times higher risk of SGA than infants born by a matched group of women without bariatric surgery. The impact on SGA was even higher in the subgroup with gastric bypass.
Published: 2012

40. The FIB-PPH trial: fibrinogen concentrate as initial treatment for postpartum haemorrhage: study protocol for a randomised controlled trial

Author: Gabriele Hanke, Arash Afshari, Kim Ekelund, Jens Svare, Jens Langhoff-Roos, Mette Gøttge Madsen, Heidi Sharif, Birgit Bødker, Lars Møller Pedersen, Jeannet Lauenborg, Anne Juul Wikkelsoe, Charlotte Krebs Albrechtsen, Ane Troelstrup, Jakob Stensballe, Ann Merete Møller, and Anja U Mitchell
Subjects: medicine.medical_specialty, Time Factors, Blood transfusion, Denmark, medicine.medical_treatment, Medicine (miscellaneous), Fibrinogen, Hemostatics, Postpartum haemorrhage, law.invention, Study Protocol, Double-Blind Method, Randomized controlled trial, Predictive Value of Tests, Pregnancy, law, medicine, Coagulation testing, Humans, Pharmacology (medical), Blood coagulation test, Blood type, lcsh:R5-920, Coagulation, medicine.diagnostic_test, Obstetrics, business.industry, Postpartum Hemorrhage, Perioperative, Thromboelastography, Thrombelastography, Surgery, Treatment Outcome, Research Design, Fibrinogen concentrate, Female, Blood Coagulation Tests, lcsh:Medicine (General), business, Haemostasis, medicine.drug
Abstract: Background Postpartum haemorrhage (PPH) remains a leading cause of maternal mortality worldwide. In Denmark 2% of parturients receive blood transfusion. During the course of bleeding fibrinogen (coagulation factor I) may be depleted and fall to critically low levels, impairing haemostasis and thus worsening the ongoing bleeding. A plasma level of fibrinogen below 2 g/L in the early phase of postpartum haemorrhage is associated with subsequent development of severe haemorrhage. Use of fibrinogen concentrate allows high-dose substitution without the need for blood type crossmatch. So far no publications of randomised controlled trials involving acutely bleeding patients in the obstetrical setting have been published. This trial aims to investigate if early treatment with fibrinogen concentrate reduces the need for blood transfusion in women suffering severe PPH. Methods/Design In this randomised placebo-controlled double-blind multicentre trial, parturients with primary PPH are eligible following vaginal delivery in case of: manual removal of placenta (blood loss ≥ 500 ml) or manual exploration of the uterus after the birth of placenta (blood loss ≥ 1000 ml). Caesarean sections are also eligible in case of perioperative blood loss ≥ 1000 ml. The exclusion criteria are known inherited haemostatic deficiencies, prepartum treatment with antithrombotics, pre-pregnancy weight Primary outcome is the need for blood transfusion. To investigate a 33% reduction in the need for blood transfusion, a total of 245 patients will be included. Four university-affiliated public tertiary care hospitals will include patients during a two-year period. Adverse events including thrombosis are assessed in accordance with International Conference on Harmonisation (ICH) good clinical practice (GCP). Discussion A widespread belief in the benefits of early fibrinogen substitution in cases of PPH has led to increased off-label use. The FIB-PPH trial is investigator-initiated and aims to provide an evidence-based platform for the recommendations of the early use of fibrinogen concentrate in PPH. Trial registration ClincialTrials.gov NCT01359878.
Published: 2012

41. The influence of parental history of diabetes and offspring birthweight on offspring glucose metabolism in adulthood

Author: Jeannet, Lauenborg, Mie K W, Jørgensen, Peter, Damm, Atheline, Major-Pedersen, Hans, Eiberg, Søren, Urhammer, Oluf, Pedersen, and Torben, Hansen
Subjects: Adult, Blood Glucose, Male, Parents, Glucose Tolerance Test, Middle Aged, Cohort Studies, Diabetes Mellitus, Type 2, Pregnancy, Insulin-Secreting Cells, Adult Children, Birth Weight, Humans, Female, Insulin Resistance
Abstract: Links are well established between both family history of diabetes and reduced birthweight and increased risk of diabetes in adulthood.1) To investigate the influence of parental history of type 2 diabetes (T2DM) on offspring birthweight and adult offspring glucose tolerance status in non-diabetic offspring of patients with T2DM and 2) to study the associations of birthweight with measures of pancreatic beta-cell function and insulin sensitivity.Family cohort study.Offspring of patients with verified T2DM diagnosed after age 40 years with a spouse without known diabetes.Oral glucose tolerance tests and frequently sampled intravenous glucose tolerance tests (FSIGT) in non-diabetic offspring. Birthweight and length obtained from birth records.Among 122 offspring with maternal history of T2DM, 14.8% had diabetes compared to 8.0% in 137 offspring with paternal history of diabetes, p=0.09. Offspring with maternal history of T2DM had a mean birthweight 196 g higher than offspring with paternal T2DM (3,651 ± 640 g (mean ± SD) vs. 3,456 ± 472g (p=0.01)). Non-diabetic offspring with birthweights in the lowest tertile had significantly higher plasma glucose levels after an oral glucose tolerance test (OGTT) [Area under the curve(glucOGTT) , mean (95%CI), 1 795 (1 725-1 866) vs. 1 683 (1 613-1 753) mmol/L/min, p=0.02], and lower insulin sensitivity index calculated from a frequently sampled intravenous glucose tolerance test - Si 9.60 [10(-5) (min*pmol/L)(-1) ] (8.23-10.97) vs. 11.79 (10.41-13.18), p=0.02 - in adulthood compared to offspring with birthweights in the upper tertile.Offspring with a family history of maternal T2DM have higher birthweights than those with paternal T2DM. Low birthweight associates with elevated plasma glucose levels after an oral glucose load and decreased insulin sensitivity in adulthood.
Published: 2011

42. Further evidence that mutations in INS can be a rare cause of Maturity-Onset Diabetes of the Young (MODY)

Author: Ondrej Cinek, Trine Welløv Boesgaard, Peter Damm, Jan Lebl, Jeannet Lauenborg, Flemming Pociot, Fabrizio Barbetti, Stepanka Pruhova, Torben Hansen, Charlotta Pisinger, Regine Bergholdt, Barbora Obermannova, Oluf Pedersen, and Ehm A. Andersson
Subjects: Proband, Male, lcsh:Internal medicine, medicine.medical_specialty, Pediatrics, lcsh:QH426-470, medicine.medical_treatment, Population, Maturity onset diabetes of the young, Young Adult, Mutation Carrier, Pregnancy, Diabetes mellitus, Internal medicine, Genetics, Medicine, Humans, Insulin, Genetics(clinical), Young adult, lcsh:RC31-1245, education, Genetics (clinical), education.field_of_study, business.industry, Genetic Variation, medicine.disease, Pedigree, Gestational diabetes, lcsh:Genetics, Diabetes, Gestational, Endocrinology, Diabetes Mellitus, Type 1, Phenotype, Diabetes Mellitus, Type 2, Mutation, Female, business, Research Article
Abstract: Background Insulin gene (INS) mutations have recently been described as a common cause of permanent neonatal diabetes (PNDM) and a rare cause of diabetes diagnosed in childhood or adulthood. Methods INS was sequenced in 116 maturity-onset diabetes of the young (MODYX) patients (n = 48 Danish and n = 68 Czech), 83 patients with gestational diabetes mellitus (GDM), 34 type 1 diabetic patients screened negative for glutamic acid decarboxylase (GAD), and 96 glucose tolerant individuals. The control group was randomly selected from the population-based sampled Inter99 study. Results One novel heterozygous mutation c.17G>A, R6H, was identified in the pre-proinsulin gene (INS) in a Danish MODYX family. The proband was diagnosed at 20 years of age with mild diabetes and treated with diet and oral hypoglycaemic agent. Two other family members who carried the INS R6H were diagnosed with diabetes when 51 years old and with GDM when 27 years old, respectively. A fourth mutation carrier had normal glucose tolerance when 20 years old. Two carriers of INS R6H were also examined twice with an oral glucose tolerance test (OGTT) with 5 years interval. They both had a ~30% reduction in beta-cell function measured as insulinogenic index. In a Czech MODYX family a previously described R46Q mutation was found. The proband was diagnosed at 13 years of age and had been treated with insulin since onset of diabetes. Her mother and grandmother were diagnosed at 14 and 35 years of age, respectively, and were treated with oral hypoglycaemic agents and/or insulin. Conclusion Mutations in INS can be a rare cause of MODY and we conclude that screening for mutations in INS should be recommended in MODYX patients.
Published: 2010

43. Overweight and the metabolic syndrome in adult offspring of women with diet-treated gestational diabetes mellitus or type 1 diabetes

Author: Tine D. Clausen, Lone Schmidt, Peter Damm, Dorte Møller Jensen, Oluf Pedersen, Torben Hansen, Jeannet Lauenborg, and Elisabeth R. Mathiesen
Subjects: Adult, Male, medicine.medical_specialty, Adolescent, Offspring, Endocrinology, Diabetes and Metabolism, Clinical Biochemistry, Population, Pregnancy in Diabetics, Overweight, Biochemistry, Cohort Studies, Young Adult, Endocrinology, Child of Impaired Parents, Pregnancy, Risk Factors, Internal medicine, Diabetes mellitus, medicine, Humans, education, Metabolic Syndrome, Type 1 diabetes, education.field_of_study, business.industry, Metabolic Syndrome X, Biochemistry (medical), nutritional and metabolic diseases, medicine.disease, Gestational diabetes, Diabetes, Gestational, Diabetes Mellitus, Type 1, Prenatal Exposure Delayed Effects, Adult Children, Female, Metabolic syndrome, medicine.symptom, business, Algorithms, Follow-Up Studies
Abstract: Udgivelsesdato: 2009-Jul CONTEXT: In animal studies, exposure to intrauterine hyperglycemia increases the risk of cardiovascular disease through only partly understood epigenetic mechanisms. Human long-term follow-up studies on the same topic are few. OBJECTIVE: The aim was to study the risk of overweight and the metabolic syndrome in adult offspring of women with diet-treated gestational diabetes mellitus (GDM) or type 1 diabetes, and additionally to study associations between estimates of maternal hyperglycemia and outcome in the offspring. DESIGN AND SETTING: We conducted a follow-up study of 1066 primarily Caucasian women aged 18-27 yr in the Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark. PARTICIPANTS: Offspring of women with diet-treated GDM (n = 168) and an unexposed reference group (n = 141) participated, as well as offspring of women with type 1 diabetes (n = 160) and offspring from the background population representing an unexposed reference group (n = 128). The follow-up rate was 56% (597 of 1066). MAIN OUTCOME MEASURES: Women with body mass index of at least 25 kg/m(2) were considered overweight. The metabolic syndrome was determined by the International Diabetes Federation 2006 criteria. Results: The risk of overweight was doubled in offspring of women with diet-treated GDM or type 1 diabetes compared with offspring from the background population, whereas the risk of the metabolic syndrome was 4- and 2.5-fold increased, respectively. Offspring risk of the metabolic syndrome increased significantly with increasing maternal fasting blood glucose as well as 2-h blood glucose (during oral glucose tolerance test). CONCLUSIONS: Adult offspring of women with diet-treated GDM or type 1 diabetes are risk groups for overweight and the metabolic syndrome. Intrauterine hyperglycemia may in addition to genetics and other factors contribute to the pathogenesis of overweight and the metabolic syndrome.
Published: 2009

44. Common type 2 diabetes risk gene variants associate with gestational diabetes

Author: Peter Damm, Torben Jørgensen, Jeannet Lauenborg, Torben Hansen, Oluf Pedersen, Niels Grarup, and Knut Borch-Johnsen
Subjects: Adult, Risk, medicine.medical_specialty, endocrine system diseases, Endocrinology, Diabetes and Metabolism, Clinical Biochemistry, Population, Type 2 diabetes, Biochemistry, Body Mass Index, Cohort Studies, Endocrinology, Gene Frequency, Pregnancy, Diabetes mellitus, Internal medicine, medicine, Humans, Genetic Predisposition to Disease, education, CDKAL1, education.field_of_study, SLC30A8, biology, business.industry, Biochemistry (medical), nutritional and metabolic diseases, Odds ratio, medicine.disease, Gestational diabetes, Diabetes, Gestational, Diabetes Mellitus, Type 2, ROC Curve, biology.protein, Female, business, TCF7L2
Abstract: Objective: We aimed to examine the association between gestational diabetes mellitus (GDM) and 11 recently identified type 2 diabetes susceptibility loci. Research Design and Methods: Type 2 diabetes risk variants in TCF7L2, CDKAL1, SLC30A8, HHEX/IDE, CDKN2A/2B, IGF2BP2, FTO, TCF2, PPARG, KCNJ11, and WFS1 loci were genotyped in a cohort of women with a history of GDM (n = 283) and glucose-tolerant women of the population-based Inter99 cohort (n = 2446). Results: All the risk alleles in the 11 examined type 2 diabetes risk variants showed an odds ratio (OR) greater than 1 for the GDM group compared with the control group ranging from 1.13 [95% confidence interval (CI) 0.88–1.46] to 1.44 (95% CI 1.19–1.74) except for the WFS1 rs10010131 variant with OR 0.87 (95% CI 0.73–1.05). Combined analysis of all 11 variants showed a highly significant additive effect of multiple risk alleles on risk of GDM [OR 1.18 (95% CI 1.10–1.27)] per risk allele, P = 3.2 × 10−6). Applying receiver-operating characteristic showed an area under the receiver-operating characteristic curve of 0.62 for the genetic test alone and 0.73 when combining information on age, body mass index, and genotypes of the 11 gene variants. Conclusions: The prevalence in a prior GDM group of several previously proven type 2 diabetes risk alleles equals the findings from association studies on type 2 diabetes. This supports the hypothesis that GDM and type 2 diabetes are two of the same entity.
Published: 2008

45. Diabetes mellitus and the metabolic syndrome after gestational diabetes

Author: Peter Damm, Lars Mølsted-Pedersen, Jeannet Lauenborg, and Elisabeth R. Mathiesen
Subjects: Gestational diabetes, Pediatrics, medicine.medical_specialty, business.industry, Diabetes mellitus, medicine, Metabolic syndrome, medicine.disease, business
Published: 2008

46. High prevalence of type 2 diabetes and pre-diabetes in adult offspring of women with gestational diabetes mellitus or type 1 diabetes: the role of intrauterine hyperglycemia

Author: Tine D, Clausen, Elisabeth R, Mathiesen, Torben, Hansen, Oluf, Pedersen, Dorte M, Jensen, Jeannet, Lauenborg, and Peter, Damm
Subjects: Adult, Denmark, Smoking, Glucose Tolerance Test, Overweight, Prediabetic State, Pregnancy Complications, Diabetes, Gestational, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Pregnancy, Hyperglycemia, Humans, Regression Analysis, Female, Genetic Predisposition to Disease
Abstract: The role of intrauterine hyperglycemia and future risk of type 2 diabetes in human offspring is debated. We studied glucose tolerance in adult offspring of women with either gestational diabetes mellitus (GDM) or type 1 diabetes, taking the impact of both intrauterine hyperglycemia and genetic predisposition to type 2 diabetes into account.The glucose tolerance status following a 2-h 75-g oral glucose tolerance test (OGTT) was evaluated in 597 subjects, primarily Caucasians, aged 18-27 years. They were subdivided into four groups according to maternal glucose metabolism during pregnancy and genetic predisposition to type 2 diabetes: 1) offspring of women with diet-treated GDM (O-GDM), 2) offspring of genetically predisposed women with a normal OGTT (O-NoGDM), 3) offspring of women with type 1 diabetes (O-type 1), and 4) offspring of women from the background population (O-BP).The prevalence of type 2 diabetes and pre-diabetes (impaired glucose tolerance or impaired fasting glucose) in the four groups was 21, 12, 11, and 4%, respectively. In multiple logistic regression analysis, the adjusted odds ratios (ORs) for type 2 diabetes/pre-diabetes were 7.76 (95% CI 2.58-23.39) in O-GDM and 4.02 (1.31-12.33) in O-type 1 compared with O-BP. In O-type 1, the risk of type 2 diabetes/pre-diabetes was significantly associated with elevated maternal blood glucose in late pregnancy: OR 1.41 (1.04-1.91) per mmol/l.A hyperglycemic intrauterine environment appears to be involved in the pathogenesis of type 2 diabetes/pre-diabetes in adult offspring of primarily Caucasian women with either diet-treated GDM or type 1 diabetes during pregnancy.
Published: 2007

47. Variation in NCB5OR: studies of relationships to type 2 diabetes, maturity-onset diabetes of the young, and gestational diabetes mellitus

Author: Gitte, Andersen, Lise, Wegner, Christian Schack, Rose, Jianxin, Xie, Hao, Zhu, Kevin, Larade, Anders, Johansen, Jakob, Ek, Jeannet, Lauenborg, Thomas, Drivsholm, Knut, Borch-Johnsen, Peter, Damm, Torben, Hansen, H Franklin, Bunn, and Oluf, Pedersen
Subjects: Male, Mice, Knockout, Chromosome Mapping, Genetic Variation, Middle Aged, White People, Article, Diabetes, Gestational, Mice, Diabetes Mellitus, Type 2, Pregnancy, Animals, Humans, Chromosomes, Human, Pair 6, Female, Cytochrome-B(5) Reductase
Abstract: Recent data show that homozygous Ncb5or(-/-) knock-out mice present with an early-onset nonautoimmune diabetes phenotype. Furthermore, genome-wide scans have reported linkage to the chromosome 6q14.2 region close to the human NCB5OR. We therefore considered NCB5OR to be a biological and positional candidate gene and examined the coding region of NCB5OR in 120 type 2 diabetic patients and 63 patients with maturity-onset diabetes of the young using denaturing high-performance liquid chromatography. We identified a total of 22 novel nucleotide variants. Three variants [IVS5+7del(CT), Gln187Arg, and His223Arg] were genotyped in a case-control design comprising 1,246 subjects (717 type 2 diabetic patients and 529 subjects with normal glucose tolerance). In addition, four rare variants were investigated for cosegregation with diabetes in multiplex type 2 diabetic families. The IVS5+7del(CT) variant was associated with common late-onset type 2 diabetes; however, we failed to relate this variant to any diabetes-related quantitative traits among the 529 control subjects. Thus, variation in the coding region of NCB5OR is not a major contributor in the pathogenesis of nonautoimmune diabetes.
Published: 2004

48. Increasing incidence of diabetes after gestational diabetes: a long-term follow-up in a Danish population

Author: Jeannet, Lauenborg, Torben, Hansen, Dorte Møller, Jensen, Henrik, Vestergaard, Lars, Mølsted-Pedersen, Peter, Hornnes, Henning, Locht, Oluf, Pedersen, and Peter, Damm
Subjects: Adult, Time Factors, Denmark, Incidence, Infant, Newborn, Gestational Age, Glucose Tolerance Test, Middle Aged, Glucagon, Body Mass Index, Cohort Studies, Diabetes, Gestational, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Pregnancy, Diabetes Mellitus, Humans, Female, Follow-Up Studies
Abstract: To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes.Women with diet-treated GDM during 1978-1985 (old cohort, n = 241, also followed up around 1990) or 1987-1996 (new cohort, n = 512) were examined in 2000-2002. Women were classified by a 2-h, 75-g oral glucose tolerance test according to the World Health Organization criteria or an intravenous glucagon test supplemented by measurement of GAD antibodies. Historical data from index-pregnancy and anthropometrical measurements were collected.A total of 481 (63.9%) women were examined (median 9.8 years [interquartile range 6.4-17.2]) after index pregnancy. Diabetes and impaired glucose tolerance (IGT)/impaired fasting glucose were present in 40.0 and 27.0% of women, respectively. In the new cohort, 40.9% had diabetes compared with 18.3% in the old cohort at the 1990 follow-up (P0.0005). Prepregnancy BMI was significantly higher in the new compared with the old cohort (26.0 [22.5-30.8] vs. 22.9 kg/m2 [20.2-28.0], P0.0005). Among others, new-cohort membership, prepregnancy overweight (BMIor = 25 kg/m2), and IGT postpartum were identified as independent predictors of diabetes by multiple logistic regression analyses.The incidence of diabetes among Danish women with previous diet-treated GDM was very high and had more than doubled over a 10-year period. This seems to be due to a substantial increase in BMI in women with GDM.
Published: 2004

49. 40(th) EASD Annual Meeting of the European Association for the Study of Diabetes : Munich, Germany, 5-9 September 2004

Author: S. Artigas, A V Dreval, Mark I. McCarthy, C Watson, Peter H. Bennett, M Quint, Y Ikeda, E Alpert, F Schiele, H Sekihara, Erik Gylfe, P Lowe, J Kuhlmann, Alain Golay, V Longo, Shahidul Alam Khan Akm., L G Mantovani, M Zawodniak-Szalapska, G Winkler, T Harrity, L Virág, U Johne, Kuo S-W., Linda C Tapsell, J Rodriguez, Michel Komajda, K Kankova, Carole A. Cull, M Sporna, E Estilles, U Ribel, M C Spruce, E Buzzigoli, T Prazak, J K McLaughlin, M K Lingohr, M Lim, F Calara, A Siebenhofer, G Meregalli, Roberto Anichini, A D Baron, R Kurashvili, P C Butler, G I Fantus, T. E. De Gooyer, Park Y-M., R. Walther, S Heinrich, Agnieszka Zawiejska, S Mukherjee, Nikolaos Papanas, G Wong, Ian D. Caterson, David M. Maahs, Shuichi Kaneko, Alexandra E. Butler, Francisco Javier Ampudia-Blasco, O N Kong, Attali J-R., C A Hedman, K Oshinyemi, Nicolle Müller, I C Cranston, N Okumus, M V Vlaiculescu, Balasubramanian Ravikumar, W W Cheatham, K Mukasa, K B Biswas, Annunziata Lapolla, Phil McEwan, G Mader, Gilles Chassot, Dragi Anevski, Werner A. Scherbaum, M Donath, C Hesselmann, R A Gandhi, David E. Moller, Ezio Bonifacio, C Garcia, V Ifandi, P Hornnes, Nieuwenhoven Fav., C Puech, S Pérez-Del-Pulgar, Kim S-R., G Hines, C Rubio Terrés, Michael Gaster, N. Hosszufalusi, A Scholze, Andrew A. Young, Stavros Liatis, F Hariri, S Tan, Paul Valensi, Allan E. Karlsen, J Kim, E. Moberg, J Kaiser, L Berman, G Nelson, A Altkrüger, P Kothare, D B Cook, S Doran, G. van Dijk, Shahnaz Shahinfar, Kim C-S., P Stahl, M Manousaki, S Sigrist, S K Lim, M. P. Stern, A Guberti, C Rezzani, J McKenney, Karl Thomaseth, Sofia Carlsson, M Julia, R Brillante, I Rubesova, T Darkow, E Matsumoto, Wendy M. Macfarlane, M Di Martino, G Bardini, Rossella Menghini, D Duhot, E Farcasiu, Annalisa Natalicchio, I Lindner, J Buvat, Christian L. Brand, Harry Dorchy, Iwona Pietrzak, Z T Luo, P Home, M Ekelund, Jesper Gromada, Kristine Færch, F Piarulli, H Kim, R Mentel, Zsuzsanna K. Zsengellér, Dullaart Rpf., Anton Luger, Thomas A. Pearson, V Manicardi, P Rösen, Feng Y-M., R Morganti, Lars Hansen, Demuth H-U., Haruo Kasai, A Shostak, Rudi Steffensen, G Taylor, Markolf Hanefeld, C Santini, E Hamaguchi, Roberto Miccoli, F Storms, M Cooper, Y Lee, Allison E. Aiello, P Smith, T Suehiro, K Treece, M Waluś, Timothy A Welborn, Simone Baltrusch, E Kontela, S Chai, J Crean, H Yokoyama, Johan G. Eriksson, Rafael Hernández Hernández, J Rodríguez-Saldaña, M P Tornero, G Formoso, D. Lovell, E Bingham, A Mylonakis, M Manteghetti, D Fedele, Antonio Martín-Duce, Ralph A. DeFronzo, D Salcedo, Kurt Højlund, Antonio Petrone, Sheu Whh., C Gutierrez, Flavia Pricci, S Kurita, Z G Abbas, M M Benedetti, Philippe A. 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D, Torjesen, P, Kilhovd, B, Berg, T, Sandvik, L, Hanssen, K, Mentink, C, Donchenko, G, Stepanenko, S, Maingrette, F, Deng, H, Lindenmair, A, Freudenthaler, A, Baumgartner parzer, S, Nizheradze, K, Khoruzhenko, A, Tronko, N, Sheu, W, Ou, H, Shen, H, Lin, T, Wu, H, Yang, C, Mogylnytska, L, Schmoelzer, I, Davies, J, Band, M, Struthers, A, Prázný, M, Škrha, J, Kasalová, Z, Neelotpol, S, Jahan, P, Kauschke, S, Harrop, C, Schäfer, A, Widder, J, Eigenthaler, M, Walter, U, Uchimura, I, Ikebukuro, M, Kaibara, M, Hirata, M, Helal, R, Pervin, F, Yang, X, Jansson, P, Nagaev, I, Jack, M, Carvalho, E, Sunnerhagen, K, Cam, M, Cushman, S, Smith, U, Creely, S, Farmer, J, Gustafson, B, Kusminski, C, Krusinova, E, Wohl, P, Klementova, M, Lanska, V, Mcdougall, C, Kelly, I, Abbas, Z, Lutale, J, Archibald, L, Karunajeewa, H, Stingemore, N, Stuccio, G, Mcgechie, D, Muller, L, Hak, E, Goudzwaard, W, Montorsi, F, Homering, M, Sprenger, K, Goldstein, I, Asnaghi, V, Ferrari, G, Rastaldi, M, Gabellini, D, Dell'Antonio, G, Maestroni, A, Ruggieri, D, Luzi, L, Piemonti, L, Zerbini, G, Anafaroglu, I, Tutuncu, N, Sultana, M, Siddiqua, N, Iwasaki, T, Nakajima, A, Yoneda, M, Mukasa, K, Tanaka, S, and Sekihara, H
Subjects: 0303 health sciences, medicine.medical_specialty, business.industry, EASD, Endocrinology, Diabetes and Metabolism, Human physiology, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Diabetes mellitus, Family medicine, Internal Medicine, Medicine, business, 030217 neurology & neurosurgery, 030304 developmental biology
Published: 2004

50. Audit on stillbirths in women with pregestational type 1 diabetes

Author: Jes G. Westergaard, Elisabeth R. Mathiesen, Peter Damm, Per Ovesen, Pia Ekbom, Jeannet Lauenborg, and Lars Mølsted-Pedersen
Subjects: medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Pregnancy, Diabetes mellitus, Internal Medicine, medicine, Humans, reproductive and urinary physiology, Glycemic, Retrospective Studies, Advanced and Specialized Nursing, Hemoglobin A, Glycosylated, Glycated Hemoglobin, Type 1 diabetes, Medical Audit, business.industry, Obstetrics, Incidence (epidemiology), Infant, Newborn, Pregnancy Outcome, Retrospective cohort study, medicine.disease, female genital diseases and pregnancy complications, Surgery, Diabetes, Gestational, Diabetes Mellitus, Type 1, Etiology, Gestation, Female, business
Abstract: OBJECTIVE—To audit stillbirth cases in women with type 1 diabetes to search for specific characteristics in order to improve antenatal care and treatment RESEARCH DESIGN AND METHODS—Retrospectively identified cases of stillbirths in women with type 1 diabetes during 1990–2000 were analyzed regarding characteristics of the mother, the pregnancy, glycemic control, and the stillborn. The cause of stillbirth was categorized as explainable, likely, or without obvious cause. RESULTS—We found 22 women with 25 stillbirths among 1,361 singleton births by women with type 1 diabetes. In seven stillbirths the cause was categorized as explainable and in six as likely. In 12 cases no obvious cause was found; however, glycemic control was suboptimal in 9 of these cases. A total of 14 women reported daily smoking, and 10 of 19 with low education were unemployed. CONCLUSIONS—Women experiencing stillbirth were characterized by a high incidence of suboptimal glycemic control, diabetic nephropathy, smoking, and low social status.
Published: 2003

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