The role of inflammation in cases with gestational diabetes mellitus: Systemic immune inflammatory index according to trimesters

PROBLEM

This study aims to investigate the role of the systemic immune-inflammatory index (SII) in inflammation by analyzing SII values by trimester in gestational diabetes mellitus (GDM).

METHOD OF STUDY

Between May 2019 and June 2020, we retrospectively enrolled 467 pregnant women who were followed from the first trimester to delivery in our hospital. We evaluated the sociodemographic characteristics, laboratory test results, SII values, Apgar scores, and newborn birth weights of pregnant women diagnosed with GDM. We also compared the SII values of GDM for the 1st, 2nd, and 3rd trimesters with the control group.

RESULTS

When examining the SII values of the GDM group in these three trimesters, without including the control group, we found that the SII value of the GDM group in the 3rd trimester was significantly higher than in the 1st trimester, with a gradual increase with each trimester (p = .007). Additionally, the SII value was higher in the GDM group compared to the control group (p = .008). We conducted a Receiver Operating Characteristic (ROC) analysis of the SII value between the groups by trimester. The diagnostic significance of SII between the GDM and control groups was observed in the 3rd trimester, as the area under the curve (AUC) was close to 0.5 and not associated with a specific cutoff value. When examining the relationship between 3rd-trimester SII and study parameters, we found it had a positive and low correlation with the length of prepartum hospitalization, 50 g Oral Glucose Tolerance Test (OGTT), and maximal vertical pocket.

CONCLUSION

SII levels were significantly higher in third-trimester GDM patients; however, despite elevated levels of inflammation, fetuses did not experience harm.

Effect of Probiotic Supplementation on Newborn Birth Weight for Mother with Gestational Diabetes Mellitus or Overweight/Obesity: A Systematic Review and Meta-Analysis

High birth weight indicates the future risk of obesity and increased fat mass in childhood. Maternal gestational diabetes mellitus (GDM) or overweight are powerful predictors of high birth weight. Studies on probiotic supplementation during pregnancy have reported its benefits in modulating gut microbiota composition and improving glucose and lipid metabolism in pregnant women. Therefore, probiotic intervention during pregnancy was proposed to interrupt the transmission of obesity from mothers to newborns. Thus, we performed a meta-analysis to investigate the effect of probiotic intervention in pregnant women with GDM or overweight on newborn birth weight. We searched PubMed, EMBASE, Cochrane Library, and Web of Science databases up to 18 December 2019. Randomized controlled trials (RCTs) comparing pregnant women with GDM or overweight who received probiotic intervention during pregnancy with those receiving placebo were eligible for the analysis. Newborn birth weights were pooled to calculate the mean difference with a 95% confidence interval (CI). Two reviewers assessed the trial quality and extracted data independently. Seven RCTs involving 1093 participants were included in the analysis. Compared with the placebo, probiotics had little effect on newborn birth weight of pregnant women with GDM or overweight (mean difference = -10.27, 95% CI = -90.17 to 69.63, p = 0.801). The subgroup analysis revealed that probiotic intake by women with GDM decreased newborn birth weight, whereas probiotic intake by obese pregnant women increased newborn birth weight. Thus, no evidence indicates that probiotic intake by pregnant women with GDM or overweight can control newborn birth weight.

Maternal smoking and newborn sex, birth weight and breastfeeding: a population-based study

OBJECTIVE

Today, it is acknowledged that smoking during pregnancy and/or the postnatal period has significant risks for a foetus and newborn child. This research examines the relationship between smoking only postnatally, both during pregnancy and postnatally, and the newborn sex, birth weight and breastfeeding.

METHODS

Total 664 women of randomly selected five primary healthcare centres between the dates 20 February 2010 and 20 July 2010 were included in the research. Statistical analyses were performed with SPSS for Windows 19.0 (Statistical Package for Social Sciences software package). Data were described as mean, standard deviation, percentages and Chi-square tests and backward stepwise logistic regression were analysed.

RESULTS

It was found that the percentage of smoking women with daughters is 2.5 times higher than women with sons. Women who smoke are 3.9 times more likely to start feeding their baby with supplementary infant foods at 4 months or earlier than those who do not smoke. Finally, the risk of a birth weight under 2500 g is 3.8 times higher for maternal smokers.

CONCLUSIONS

This study suggests that women who expect a girl smoke more heavily than those who expect a boy. The birth weight of maternal smokers' newborns is lower. Those women who smoke while breastfeeding start feeding their babies with supplementary infant foods at an earlier age.