1
|
Namkoong J, Andraweera PH, Pathirana M, Munawar D, Downie M, Edwards S, Averbuj P, Arstall MA. A systematic review and meta-analysis of the diagnosis and surgical management of carcinoid heart disease. Front Cardiovasc Med 2024; 11:1353612. [PMID: 38572311 PMCID: PMC10987853 DOI: 10.3389/fcvm.2024.1353612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/11/2024] [Indexed: 04/05/2024] Open
Abstract
Introduction Carcinoid heart disease (CHD), a complication of carcinoid syndrome (CS), is a rare condition that can lead to right sided valvular heart disease and has been traditionally associated with a poor prognosis. We conducted a systematic review and meta-analysis to explore the accuracy of biomarkers and echocardiography in diagnosing CHD amongst patients who are already known to have neuroendocrine tumours and to assess whether surgical management of CHD leads to a reduction in mortality. Methods A systematic literature search of MEDLINE, EMBASE, EBM Reviews, Google Scholar, ClinicalTrials.gov was conducted. All studies on patients with carcinoid heart disease (CHD) reporting on biomarkers, echocardiographic and surgical outcomes were included. The National Heart, Lung, and Blood Institute quality assessment tool was used to assess the methodological study quality. Data analysis was performed using Stata Statistical Software and R Studio, and individual meta-analyses were performed for biomarkers, echocardiographic findings, and surgical outcomes. Results A total of 36 articles were included in the systematic review analysis. N terminal pro-brain natriuretic peptide (NTproBNP) and 5-hydroxyindole acetate (5-HIAA) levels were higher in patients with CHD compared with those without CHD. 32% of CS patients had echocardiographic evidence of cardiac involvement, of which 79% involved tricuspid valve abnormalities. Moderate-severe tricuspid regurgitation was the most common echocardiographic abnormality (70% of patients). However, these analyses had substantial heterogeneity due to the high variability of cardiac involvement across studies. Pooled surgical mortality for CHD was 11% at 1 month, 31% at 12 months and 56% at 24 months. When assessing surgical outcomes longitudinally, the one-month surgical results showed a trend towards more recent surgeries having lower mortality rates than those reported in earlier years, however this was not statistically significant. Discussion There is not enough data in current literature to determine a clear cut-off value of NTproBNP and 5-HIAA to help diagnose or determine CHD severity. Surgical management of CHD is yet to show significant mortality benefit, and there are no consistent comparisons to medical treatment in current literature.
Collapse
Affiliation(s)
- Jenny Namkoong
- Department of Cardiology, Lyell McEwin Hospital, SA Health, Elizabeth Vale, SA, Australia
| | - Prabha H. Andraweera
- Department of Cardiology, Lyell McEwin Hospital, SA Health, Elizabeth Vale, SA, Australia
- Adelaide Medical School, The University of Adelaide, North Terrace Adelaide, SA, Australia
| | - Maleesa Pathirana
- Department of Cardiology, Lyell McEwin Hospital, SA Health, Elizabeth Vale, SA, Australia
- Adelaide Medical School, The University of Adelaide, North Terrace Adelaide, SA, Australia
| | - Dian Munawar
- Department of Cardiology, Lyell McEwin Hospital, SA Health, Elizabeth Vale, SA, Australia
| | - Michael Downie
- SA Health Library Service, Lyell McEwin Hospital, SA Health, Elizabeth Vale, SA, Australia
| | - Suzanne Edwards
- Adelaide Medical School, The University of Adelaide, North Terrace Adelaide, SA, Australia
| | - Paula Averbuj
- Department of Cardiology, Lyell McEwin Hospital, SA Health, Elizabeth Vale, SA, Australia
| | - Margaret A. Arstall
- Department of Cardiology, Lyell McEwin Hospital, SA Health, Elizabeth Vale, SA, Australia
- Adelaide Medical School, The University of Adelaide, North Terrace Adelaide, SA, Australia
| |
Collapse
|
2
|
Khoja A, Andraweera PH, Lassi ZS, Padhani ZA, Ali A, Zheng M, Pathirana MM, Aldridge E, Wittwer MR, Chaudhuri DD, Tavella R, Arstall MA. Modifiable and Non-Modifiable Risk Factors for Premature Coronary Heart Disease (PCHD): Systematic Review and Meta-Analysis. Heart Lung Circ 2024; 33:265-280. [PMID: 38365496 DOI: 10.1016/j.hlc.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 12/01/2023] [Accepted: 12/07/2023] [Indexed: 02/18/2024]
Abstract
AIM We aimed to compare the prevalence of modifiable and non-modifiable coronary heart disease (CHD) risk factors among those with premature CHD and healthy individuals. METHODS PubMed, CINAHL, Embase, and Web of Science databases were searched (review protocol is registered in PROSPERO CRD42020173216). The quality of studies was assessed using the National Heart, Lung and Blood Institute tool for cross-sectional, cohort and case-control studies. Meta-analyses were performed using Review Manager 5.3. Effect sizes for categorical and continuous variables, odds ratio (OR) and mean differences (MD)/standardised mean differences (SMD) with 95% confidence intervals (CI) were reported. RESULTS A total of n=208 primary studies were included in this review. Individuals presenting with premature CHD (PCHD, age ≤65 years) had higher mean body mass index (MD 0.54 kg/m2, 95% CI 0.24, 0.83), total cholesterol (SMD 0.27, 95% CI 0.17, 0.38), triglycerides (SMD 0.50, 95% CI 0.41, 0.60) and lower high-density lipoprotein cholesterol (SMD 0.79, 95% CI: -0.91, -0.68) compared with healthy individuals. Individuals presenting with PCHD were more likely to be smokers (OR 2.88, 95% CI 2.51, 3.31), consumed excessive alcohol (OR 1.40, 95% CI 1.05, 1.86), had higher mean lipoprotein (a) levels (SMD 0.41, 95% CI 0.28, 0.54), and had a positive family history of CHD (OR 3.65, 95% CI 2.87, 4.66) compared with healthy individuals. Also, they were more likely to be obese (OR 1.59, 95% CI 1.32, 1.91), and to have had dyslipidaemia (OR 2.74, 95% CI 2.18, 3.45), hypertension (OR 2.80, 95% CI 2.28, 3.45), and type 2 diabetes mellitus (OR 2.93, 95% CI 2.50, 3.45) compared with healthy individuals. CONCLUSION This meta-analysis confirms current knowledge of risk factors for PCHD, and identifying these early may reduce CHD in young adults.
Collapse
Affiliation(s)
- Adeel Khoja
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia; Cardiology Unit, Northern Adelaide Local Health Network, Adelaide, SA, Australia.
| | - Prabha H Andraweera
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia; Cardiology Unit, Northern Adelaide Local Health Network, Adelaide, SA, Australia
| | - Zohra S Lassi
- The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia; School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia
| | - Zahra A Padhani
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | - Anna Ali
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | - Mingyue Zheng
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; School of Health and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Maleesa M Pathirana
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia; Cardiology Unit, Northern Adelaide Local Health Network, Adelaide, SA, Australia
| | - Emily Aldridge
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia; Cardiology Unit, Northern Adelaide Local Health Network, Adelaide, SA, Australia
| | - Melanie R Wittwer
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; Cardiology Unit, Northern Adelaide Local Health Network, Adelaide, SA, Australia
| | - Debajyoti D Chaudhuri
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; Cardiology Unit, Northern Adelaide Local Health Network, Adelaide, SA, Australia
| | - Rosanna Tavella
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; Department of Cardiology, Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Adelaide, SA, Australia
| | - Margaret A Arstall
- Cardiology Unit, Northern Adelaide Local Health Network, Adelaide, SA, Australia; Medical Specialties, Faculty of Health Sciences, The University of Adelaide, Adelaide, SA, Australia
| |
Collapse
|
3
|
Khoja A, Andraweera PH, Tavella R, Gill TK, Dekker GA, Roberts CT, Edwards S, Arstall MA. Influence of Socioeconomic Status on the Association Between Pregnancy Complications and Premature Coronary Artery Disease: Linking Three Cohorts. Womens Health Rep (New Rochelle) 2024; 5:120-131. [PMID: 38404672 PMCID: PMC10890942 DOI: 10.1089/whr.2023.0092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/11/2024] [Indexed: 02/27/2024]
Abstract
Background We hypothesized that there is an influence of socioeconomic status (SES) on association between pregnancy complications and premature coronary artery disease (PCAD) risk. Materials and Methods This project involved a data linkage approach merging three databases of South Australian cohorts using retrospective, age-matched case-control study design. Cases (n = 721), that is, women aged <60 years from Coronary Angiogram Database of South Australia (CADOSA) were linked to South Australian Perinatal Statistics Collection (SAPSC) to ascertain prior pregnancy outcomes and SES. Controls (n = 194) were selected from North West Adelaide Health Study (NWAHS), comprising women who were healthy or had health conditions unrelated to CAD, age matched to CADOSA (±5 years), and linked to SAPSC to determine prior pregnancy outcomes and SES. This project performed comparative analysis of SES using socioeconomic indexes for areas-index of relative socioeconomic advantage and disadvantage (SEIFA-IRSAD) scores across three databases. Results Findings revealed that SEIFA-IRSAD scores at the time of pregnancy (p-value = 0.005) and increase in SEIFA-IRSAD scores over time (p-value = 0.040) were significantly associated with PCAD. In addition, when models were adjusted for SEIFA-IRSAD scores at the time of pregnancy and age, risk factors including placenta-mediated pregnancy complications such as preterm birth (odds ratio [OR] = 4.77, 95% confidence interval [CI]: 1.74-13.03) and history of a miscarriage (OR = 2.14, 95% CI: 1.02-4.49), and cardiovascular disease (CVD) risk factors including smoking (OR = 8.60, 95% CI: 3.25-22.75) were significantly associated with PCAD. When the model was adjusted for change in SEIFA-IRSAD scores (from CADOSA/NWAHS to SAPSC) and age, pregnancy-mediated pregnancy complications including preterm birth (OR = 4.40, 95% CI: 1.61-12.05) and history of a miscarriage (OR = 2.09, 95% CI: 1.00-4.35), and CVD risk factor smoking (OR = 8.75, 95% CI: 3.32-23.07) were significantly associated with PCAD. Conclusion SES at the time of pregnancy and change in SES were not associated with PCAD risk.
Collapse
Affiliation(s)
- Adeel Khoja
- Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
- Department of Medicine, The Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Department of Cardiology, Cardiology Unit, Northern Adelaide Local Health Network, Adelaide, Australia
| | - Prabha H. Andraweera
- Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
- Department of Medicine, The Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Department of Cardiology, Cardiology Unit, Northern Adelaide Local Health Network, Adelaide, Australia
| | - Rosanna Tavella
- Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
- Department of Cardiology, Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Woodville South, Australia
| | - Tiffany K. Gill
- Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Gustaaf A. Dekker
- Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
- Department of Medicine, The Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Department of Obstetrics and Gynaecology, Lyell McEwin Hospital, University of Adelaide, Adelaide, Australia
| | - Claire T. Roberts
- Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
- Department of Medicine, The Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Department of Medicine, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, Australia
| | - Suzanne Edwards
- Department of Medicine, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, Australia
| | - Margaret A. Arstall
- Department of Cardiology, Cardiology Unit, Northern Adelaide Local Health Network, Adelaide, Australia
- Department of Medicine, Medical Specialties, Faculty of Health Sciences, The University of Adelaide, Adelaide, Australia
| |
Collapse
|
4
|
Pathirana MM, Andraweera PH, Leemaqz S, Aldridge E, Arstall MA, Dekker GA, Roberts CT. Anxiety and Depression in Early Gestation and the Association with Subsequent Gestational Diabetes Mellitus in a Disadvantaged Population. Matern Child Health J 2023; 27:2185-2193. [PMID: 37823988 PMCID: PMC10618298 DOI: 10.1007/s10995-023-03778-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVES Evaluate the association between poor mental health and risk of developing gestational diabetes mellitus (GDM) in a cohort of women from a socioeconomically disadvantaged community. METHODS A total of 1363 nulliparous women with singleton pregnancies recruited to the Screening Tests to Predict Poor Outcomes of Pregnancy study in Adelaide, Australia. Women were assessed for mental health in the first trimester, including likelihood of depression, high functioning anxiety, perceived stress and risk of developing a mental health disorder. GDM was diagnosed based on the International Association of Diabetes in Pregnancy Study Group (IADPSG) criteria. Socioeconomic status was measured using the New Zealand Socioeconomic Index (NZSEI). RESULTS Complete mental health data was available for 1281 participants. There was no statistically significant difference in SEI, depression, risk of mental health issues, high functioning anxiety and perceived stress between women who developed GDM and those who did not. There was no difference in history of depression nor risk of developing a high mental health disorder in first trimester after adjusting for SEI, BMI in first trimester, smoking status in first trimester and maternal age between women with a GDM pregnancy and those who did not. CONCLUSIONS FOR PRACTICE There was no difference in markers of poor mental health in early pregnancy between women who subsequently did or did not develop GDM. Cohort participants were socioeconomically disadvantaged, potentially contributing to the lack of apparent differences in depression observed between groups. Socioeconomically disadvantaged women should be targeted in pre-conception planning to reduce risk of GDM.
Collapse
Affiliation(s)
- Maleesa M Pathirana
- Adelaide Medical School, The University of Adelaide, Adelaide Health and Medical Sciences Building, North Terrace, Adelaide, SA, 5000, Australia.
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia.
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, Australia.
| | - Prabha H Andraweera
- Adelaide Medical School, The University of Adelaide, Adelaide Health and Medical Sciences Building, North Terrace, Adelaide, SA, 5000, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, Australia
| | - Shalem Leemaqz
- Adelaide Medical School, The University of Adelaide, Adelaide Health and Medical Sciences Building, North Terrace, Adelaide, SA, 5000, Australia
- Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, 5042, Australia
| | - Emily Aldridge
- Adelaide Medical School, The University of Adelaide, Adelaide Health and Medical Sciences Building, North Terrace, Adelaide, SA, 5000, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, Australia
| | - Margaret A Arstall
- Adelaide Medical School, The University of Adelaide, Adelaide Health and Medical Sciences Building, North Terrace, Adelaide, SA, 5000, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, Australia
| | - Gustaaf A Dekker
- Adelaide Medical School, The University of Adelaide, Adelaide Health and Medical Sciences Building, North Terrace, Adelaide, SA, 5000, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Division of Women's Health, Lyell McEwin Hospital, Elizabeth Vale, Australia
| | - Claire T Roberts
- Adelaide Medical School, The University of Adelaide, Adelaide Health and Medical Sciences Building, North Terrace, Adelaide, SA, 5000, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, 5042, Australia
| |
Collapse
|
5
|
Khoja A, Andraweera PH, Tavella R, Gill TK, Dekker GA, Roberts CT, Edwards S, Arstall MA. Pregnancy Complications Are Associated with Premature Coronary Artery Disease: Linking Three Cohorts. J Womens Health (Larchmt) 2023; 32:1208-1218. [PMID: 37815882 DOI: 10.1089/jwh.2023.0239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023] Open
Abstract
Background: There is increasing evidence that women who experience placenta-mediated pregnancy complications and gestational diabetes mellitus (GDM) are at higher risk for the development of coronary artery disease (CAD) later in life. We hypothesized that there is an association between placenta-mediated pregnancy complications, GDM, and risk of premature CAD (PCAD). Methods: This research project involved a data linkage approach merging three databases of South Australian cohorts by using a retrospective, age-matched case-control study design. Cases (n = 721) were ascertained from the Coronary Angiogram Database of South Australia (CADOSA). Women <60 years from CADOSA were linked to South Australian Perinatal Statistics Collection (SAPSC) to ascertain their prior pregnancy outcomes. Controls (n = 194) were selected from North West Adelaide Health Study (NWAHS) and comprised women who were healthy or had other health conditions unrelated to CAD, age-matched to CADOSA (±5 years), and linked to SAPSC to determine their pregnancy outcomes. PCAD was defined as >50% stenosis in one or more coronary arteries at coronary angiography. Results: Compared with women without a history of PCAD, women who were diagnosed with PCAD were more likely to have experienced the placenta-mediated pregnancy complications of preterm birth (adjusted odds ratio [OR] = 2.46, 95% confidence interval [CI]: 1.21-5.00) or low-birth weight (adjusted OR = 2.44, 95% CI: 1.22-4.88), or have been diagnosed with active asthma during pregnancy (adjusted OR = 3.52, 95% CI: 1.05-11.76). Conclusion: Placenta-mediated pregnancy complications should be recognized as clear risk markers for future PCAD.
Collapse
Affiliation(s)
- Adeel Khoja
- Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
- Department of Medicine, The Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Cardiology Unit, Northern Adelaide Local Health Network, Adelaide, Australia
| | - Prabha H Andraweera
- Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
- Department of Medicine, The Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Cardiology Unit, Northern Adelaide Local Health Network, Adelaide, Australia
| | - Rosanna Tavella
- Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
- Department of Cardiology, Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Woodville South, Australia
| | - Tiffany K Gill
- Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Gustaaf A Dekker
- Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
- Department of Medicine, The Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Department of Obstetrics and Gynaecology, Lyell McEwin Hospital, The University of Adelaide, Adelaide, Australia
| | - Claire T Roberts
- Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
- Department of Medicine, The Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Department of Medicine, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, Australia
| | - Suzanne Edwards
- Department of Medicine, Adelaide Health Technology Assessment, School of Public Health, The University of Adelaide, Adelaide, Australia
| | - Margaret A Arstall
- Cardiology Unit, Northern Adelaide Local Health Network, Adelaide, Australia
- Department of Medicine, Medical Specialties, Faculty of Health Sciences, The University of Adelaide, Adelaide, Australia
| |
Collapse
|
6
|
Khoja A, Andraweera PH, Lassi ZS, Ali A, Zheng M, Pathirana MM, Aldridge E, Wittwer MR, Chaudhuri DD, Tavella R, Arstall MA. Risk Factors for Early-Onset Versus Late-Onset Coronary Heart Disease (CHD): Systematic Review and Meta-Analysis. Heart Lung Circ 2023; 32:1277-1311. [PMID: 37777398 DOI: 10.1016/j.hlc.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 07/18/2023] [Accepted: 07/20/2023] [Indexed: 10/02/2023]
Abstract
AIM We aimed to systematically compare literature on prevalence of modifiable and non-modifiable risk factors for early compared to late-onset coronary heart disease (CHD). METHODS PubMed, CINAHL, Embase, and Web of Science databases were searched (review protocol registered in PROSPERO CRD42020173216). Study quality was assessed using the National Heart, Lung and Blood Institute tool for observational and case-control studies. Review Manager 5.3 was used for meta-analysis. Effect sizes were expressed as odds ratio (OR) and mean differences (MD)/standardised MD (SMD) with 95% confidence intervals (CI) for categorical and continuous variables. RESULTS Individuals presenting with early-onset CHD (age <65 years) compared to late-onset CHD had higher mean body mass index (MD 1.07 kg/m2; 95% CI 0.31-1.83), total cholesterol (SMD 0.43; 95% CI 0.23-0.62), low-density lipoprotein (SMD 0.26; 95% CI 0.15-0.36) and triglycerides (SMD 0.50; 95% CI 0.22-0.68) with lower high-density lipoprotein-cholesterol (SMD 0.26; 95% CI -0.42--0.11). They were more likely to be smokers (OR 1.76, 95% CI 1.39-2.22) and have a positive family history of CHD (OR 2.08, 95% CI 1.74-2.48). They had lower mean systolic blood pressure (MD 4.07 mmHg; 95% CI -7.36--0.78) and were less likely to have hypertension (OR 0.47, 95% CI 0.39-0.57), diabetes mellitus (OR 0.56, 95% CI 0.51-0.61) or stroke (OR 0.31, 95% CI 0.24-0.42). CONCLUSION A focus on weight management and smoking cessation and aggressive management of dyslipidaemia in young adults may reduce the risk of early-onset CHD.
Collapse
Affiliation(s)
- Adeel Khoja
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia; Cardiology Unit, Northern Adelaide Local Health Network, South Australia, Australia.
| | - Prabha H Andraweera
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia; Cardiology Unit, Northern Adelaide Local Health Network, South Australia, Australia
| | - Zohra S Lassi
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | - Anna Ali
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | - Mingyue Zheng
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; School of Health and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Maleesa M Pathirana
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia; Cardiology Unit, Northern Adelaide Local Health Network, South Australia, Australia
| | - Emily Aldridge
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia; Cardiology Unit, Northern Adelaide Local Health Network, South Australia, Australia
| | - Melanie R Wittwer
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; Cardiology Unit, Northern Adelaide Local Health Network, South Australia, Australia
| | - Debajyoti D Chaudhuri
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; Cardiology Unit, Northern Adelaide Local Health Network, South Australia, Australia
| | - Rosanna Tavella
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; Department of Cardiology, Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Adelaide, SA, Australia
| | - Margaret A Arstall
- Cardiology Unit, Northern Adelaide Local Health Network, South Australia, Australia; Medical Specialties, Faculty of Health Sciences, The University of Adelaide, SA, Australia
| |
Collapse
|
7
|
Khoja A, Andraweera PH, Lassi ZS, Ali A, Zheng M, Pathirana MM, Aldridge E, Wittwer MR, Chaudhuri DD, Tavella R, Arstall MA. Risk Factors for Premature Coronary Heart Disease in Women Compared to Men: Systematic Review and Meta-Analysis. J Womens Health (Larchmt) 2023; 32:908-920. [PMID: 37184900 DOI: 10.1089/jwh.2022.0517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
Background: We aimed to systematically examine literature on the prevalence of known modifiable and nonmodifiable risk factors for premature coronary heart disease (PCHD) in women compared with men. Materials and Methods: PubMed, CINAHL, Embase, and Web of Science databases were searched. Review protocol is registered in PROSPERO (CRD42020173216). Quality was assessed using the National Heart, Lung, and Blood Institute tool. Review Manager 5.3 was used for meta-analysis. Effect sizes were expressed as odds ratio (OR) and mean differences/standardized mean differences (SMD) with 95% confidence intervals (CIs) for categorical and continuous variables. Results: In this PCHD cohort (age <65 years), the mean age of presentation in women was 3 years older than men. Women had higher total cholesterol (SMD 0.11; 95% CI 0.00 to 0.23) and higher high-density lipoprotein cholesterol (SMD 0.49; 95% CI 0.29 to 0.69). Women were more likely to have hypertension (OR 1.51, 95% CI 1.42 to 1.60), diabetes mellitus (OR 1.78, 95% CI 1.55 to 2.04), obesity (OR 1.33, 95% CI 1.24 to 1.42), metabolic syndrome (OR 3.73, 95% CI 1.60 to 8.69), stroke (OR 1.63, 95% CI 1.51 to 1.77), peripheral vascular disorder (OR 1.67, 95% CI 1.43 to 1.96), and depression (OR 2.29, 95% CI 1.96 to 2.67). Women were less likely to be smokers (OR 0.60, 95% CI 0.55 to 0.66), have reported alcohol intake (OR 0.36, 95% CI 0.33 to 0.40), and reported use of illicit drug (OR 0.32, 95% CI 0.16 to 0.62). Conclusions: Risk factor profile in PCHD has a clear sex difference that supports early, aggressive, holistic, but sex-specific, approach to prevention.
Collapse
Affiliation(s)
- Adeel Khoja
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- The Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
- Cardiology Unit, Northern Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Prabha H Andraweera
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- The Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
- Cardiology Unit, Northern Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Zohra S Lassi
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- The Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
| | - Anna Ali
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- The Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
| | - Mingyue Zheng
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- School of Health and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Maleesa M Pathirana
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- The Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
- Cardiology Unit, Northern Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Emily Aldridge
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- The Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
- Cardiology Unit, Northern Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Melanie R Wittwer
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Cardiology Unit, Northern Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Debajyoti D Chaudhuri
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Cardiology Unit, Northern Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Rosanna Tavella
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Department of Cardiology, Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia
| | - Margaret A Arstall
- Cardiology Unit, Northern Adelaide Local Health Network, Adelaide, South Australia, Australia
- Medical Specialties, Faculty of Health Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| |
Collapse
|
8
|
Pathirana MM, Andraweera PH, Aldridge E, Harrison M, Harrison J, Leemaqz S, Arstall MA, Dekker GA, Roberts CT. The association of breast feeding for at least six months with hemodynamic and metabolic health of women and their children aged three years: an observational cohort study. Int Breastfeed J 2023; 18:35. [PMID: 37468924 DOI: 10.1186/s13006-023-00571-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/25/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Breastfeeding is important for both mother and child in reducing risk of future cardiovascular disease. Therefore, it may be an effective method to improve cardio-metabolic health, particularly those who are exposed to pregnancy complications which increase later CVD risk for both mother and child. The aim of this study is to assess differences in cardiometabolic health at three years postpartum in mothers who breastfed for at least six months and their children compared to those who did not. METHODS Women and children from the Screening Tests to Predict Poor Outcomes of Pregnancy (STOP) study (2015-2017) were invited to attend a health check-up at three years postpartum. Women's breastfeeding status at least six months postpartum was ascertained through their child health record. Anthropometric and hemodynamic measurements were taken from women and their children. A fasting blood sample was taken from women to measure blood glucose and lipids. RESULTS A total of 160 woman-child dyads were assessed in this study. Women who breastfed for at least six months had significantly lower maternal BMI, systolic blood pressure, diastolic blood pressure, mean arterial pressure, central systolic blood pressure, and central diastolic blood pressure than those who did not and this did not change after adjusting for BMI and socioeconomic index in early pregnancy, prenatal smoking and maternal age in early pregnancy. Subgroup analysis on women who had one or more pregnancy complications during the index pregnancy (i.e. preeclampsia, gestational hypertension, delivery of a small for gestational age infant, delivery of a preterm infant, and/or gestational diabetes mellitus) demonstrated that women who breastfed for at least six months had significantly lower maternal systolic and diastolic blood pressures, serum insulin and triglycerides, and higher HDL cholesterol. There were no differences in child anthropometric or hemodynamic variables at three years of age between those children who had been breastfed for at least six months and those who had not. CONCLUSION Breastfeeding for at least six months may reduce some maternal; cardiovascular risk factors in women at three years postpartum, in particular, in those who have experienced a complication of pregnancy. TRIAL REGISTRATION ACTRN12614000985684 (12/09/2014).
Collapse
Affiliation(s)
- Maleesa M Pathirana
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, 5000, Australia.
- Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, 5005, Australia.
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, South Australia, 5112, Australia.
| | - Prabha H Andraweera
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, 5000, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, 5005, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, South Australia, 5112, Australia
| | - Emily Aldridge
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, 5000, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, 5005, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, South Australia, 5112, Australia
| | - Madeline Harrison
- Flinders Health and Medical Research Institute, Flinders Medical Centre, Flinders University of South Australia, Bedford Park, South Australia, 5042, Australia
| | - Jade Harrison
- Flinders Health and Medical Research Institute, Flinders Medical Centre, Flinders University of South Australia, Bedford Park, South Australia, 5042, Australia
| | - Shalem Leemaqz
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, 5000, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, 5005, Australia
- Flinders Health and Medical Research Institute, Flinders Medical Centre, Flinders University of South Australia, Bedford Park, South Australia, 5042, Australia
| | - Margaret A Arstall
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, 5000, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, South Australia, 5112, Australia
| | - Gustaaf A Dekker
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, 5000, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, 5005, Australia
- Division of Women's Health, Lyell McEwin Hospital, Elizabeth Vale, South Australia, 5112, Australia
| | - Claire T Roberts
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, 5000, Australia.
- Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, 5005, Australia.
- Flinders Health and Medical Research Institute, Flinders Medical Centre, Flinders University of South Australia, Bedford Park, South Australia, 5042, Australia.
| |
Collapse
|
9
|
Andraweera PH, Wang B, Danchin M, Blyth C, Vlaev I, Ong J, Dodd J, Couper J, Sullivan TR, Karnon J, Spurrier N, Cusack M, Mordaunt D, Simatos D, Dekker G, Carlson S, Tuckerman J, Wood N, Whop L, Marshall HS. Randomised controlled trials of behavioural nudges delivered through text messages to increase influenza and COVID-19 vaccines among pregnant women (the EPIC study): study protocol. Trials 2023; 24:454. [PMID: 37438776 DOI: 10.1186/s13063-023-07485-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 06/28/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Influenza and COVID-19 infections during pregnancy may have serious adverse consequences for women as well as their infants. However, uptake of influenza and COVID-19 vaccines during pregnancy remains suboptimal. This study aims to assess the effectiveness of a multi-component nudge intervention to improve influenza and COVID-19 vaccine uptake among pregnant women. METHODS Pregnant women who receive antenatal care at five tertiary hospitals in South Australia, Western Australia and Victoria will be recruited to two separate randomised controlled trials (RCTs). Women will be eligible for the COVID-19 RCT is they have received two or less doses of a COVID-19 vaccine. Women will be eligible for the influenza RCT if they have not received the 2023 seasonal influenza vaccine. Vaccination status at all stages of the trial will be confirmed by the Australian Immunisation Register (AIR). Participants will be randomised (1:1) to standard care or intervention group (n = 1038 for each RCT). The nudge intervention in each RCT will comprise three SMS text message reminders with links to short educational videos from obstetricians, pregnant women and midwives and vaccine safety information. The primary outcome is at least one dose of a COVID-19 or influenza vaccine during pregnancy, as applicable. Logistic regression will compare the proportion vaccinated between groups. The effect of treatment will be described using odds ratio with a 95% CI. DISCUSSION Behavioural nudges that facilitate individual choices within a complex context have been successfully used in other disciplines to stir preferred behaviour towards better health choices. If our text-based nudges prove to be successful in improving influenza and COVID-19 vaccine uptake among pregnant women, they can easily be implemented at a national level. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT05613751. Registered on November 14, 2022.
Collapse
Affiliation(s)
- Prabha H Andraweera
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Hospital, SA Health, Adelaide, South Australia, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Bing Wang
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Hospital, SA Health, Adelaide, South Australia, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Margie Danchin
- The Royal Children's Hospital, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Christopher Blyth
- Perth Children's Hospital, Perth, Western Australia, Australia
- Department of Paediatrics, The University of Western Australia, Perth, Western Australia, Australia
| | - Ivo Vlaev
- School of Business, Warwick University, Warwick, UK
| | - Jason Ong
- School of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jodie Dodd
- Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Women's and Babies Division, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Jennifer Couper
- Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Division of Paediatrics, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Thomas R Sullivan
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Jonathan Karnon
- Discipline of Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Nicola Spurrier
- Discipline of Paediatrics, Flinders University, Adelaide, South Australia, Australia
- SA Health, South Australian Government, Adelaide, South Australia, Australia
| | - Michael Cusack
- SA Health, South Australian Government, Adelaide, South Australia, Australia
| | - Dylan Mordaunt
- Discipline of Paediatrics, Flinders University, Adelaide, South Australia, Australia
| | - Dimi Simatos
- Discipline of Paediatrics, Lyell McEwin Hospital, Elizabeth Vale, South Australia, Australia
| | - Gus Dekker
- Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Discipline of Women's Health, Lyell McEwin Hospital, Elizabeth Vale, South Australia, Australia
| | - Samantha Carlson
- Department of Paediatrics, The University of Western Australia, Perth, Western Australia, Australia
| | - Jane Tuckerman
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Nicholas Wood
- Discipline of Paediatrics, University of Sydney, Sydney, New South Wales, Australia
- Children's Hospital Westmead, Sydney, New South Wales, Australia
| | - Lisa Whop
- Discipline of Public Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Helen S Marshall
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Hospital, SA Health, Adelaide, South Australia, Australia.
- Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia.
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
| |
Collapse
|
10
|
Andraweera PH, Plummer MD, Garrett A, Leemaqz S, Wittwer MR, Aldridge E, Pathirana MM, Dekker GA, Roberts CT, Arstall MA. Early pregnancy cardio metabolic risk factors and the prevalence of metabolic syndrome 10 years after the first pregnancy. PLoS One 2023; 18:e0280451. [PMID: 36662760 PMCID: PMC9858479 DOI: 10.1371/journal.pone.0280451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 12/29/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND We aimed to compare risk factors for CVD 10 years postpartum among women who had ≥ 1 compared to no cardio metabolic risk factor in early first pregnancy. METHODS Women of the SCOPE (Screening fOr Pregnancy Endpoints) study from Adelaide, South Australia were invited to participate in a cardiovascular risk assessment 10 years after the delivery of the first child. Data from 141 women who completed all the assessments are included in the analyses. RESULT Compared to women who did not have any cardio metabolic risk factor at 15 ± 1 weeks' gestation during the first pregnancy, those who had ≥ 1 risk factor were 5.5 times more likely to have metabolic syndrome 10 years postpartum (aOR = 5.5, 95% CI 1.8-17.3, p = 0.004). Women who had ≥ 1cardio metabolic risk factor during the first pregnancy were more likely to be obese (p = 0.001), have high total cholesterol levels (p <0.001) or have increased insulin resistance (p <0.001) 10 years later compared to women who had no risk factor during the first pregnancy. 63.5% of the women with no cardio metabolic risk factor compared to 39% of women who had ≥ 1 risk factor in first pregnancy, had neither a complicated first pregnancy nor was diagnosed with MetS 10 years postpartum (p = 0.023). CONCLUSION Cardio metabolic risk factors at the booking visit in the first pregnancy may be useful in identifying young women at risk of future CVD.
Collapse
Affiliation(s)
- Prabha H. Andraweera
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, Australia
| | - Michelle D. Plummer
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
| | - Amy Garrett
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
| | - Shalem Leemaqz
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, Australia
| | - Melanie R. Wittwer
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, Australia
| | - Emily Aldridge
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, Australia
| | - Maleesa M. Pathirana
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
| | - Gus A. Dekker
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Division of Women’s Health, Lyell McEwin Hospital, Elizabeth Vale, Australia
| | - Claire T. Roberts
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, Australia
| | - Margaret A. Arstall
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, Australia
| |
Collapse
|
11
|
Mohammed H, Pham-Tran DD, Yeoh ZYM, Wang B, McMillan M, Andraweera PH, Marshall HS. A Systematic Review and Meta-Analysis on the Real-World Effectiveness of COVID-19 Vaccines against Infection, Symptomatic and Severe COVID-19 Disease Caused by the Omicron Variant (B.1.1.529). Vaccines (Basel) 2023; 11:vaccines11020224. [PMID: 36851102 PMCID: PMC9965204 DOI: 10.3390/vaccines11020224] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/12/2023] [Accepted: 01/14/2023] [Indexed: 01/20/2023] Open
Abstract
Real-world data on the effectiveness of COVID-19 vaccines against the Omicron variant (B.1.1.529) is limited. This systematic review aimed to investigate the real-world effectiveness and durability of protection conferred by primary course and booster vaccines against confirmed Omicron infection, and severe outcomes. We systematically searched literature up to 1 August 2022. Meta-analysis was performed with the DerSimonian-Laird random-effects model to estimate the pooled vaccine effectiveness (VE). Overall, 28 studies were included representing 11 million individuals. The pooled VE against Omicron infection was 20.4% (95%CI: 12.1-28.7%) and 23.4% (95%CI: 13.5-33.3%) against symptomatic infection with variation based on vaccine type and age groups. VE sharply declined from 28.1% (95%CI: 19.1-37.1%) at three months to 3.9% (95%CI: -24.8-32.7%) at six months. Similar trends were observed for symptomatic Omicron infection. A booster dose restored protection against Omicron infection up to 51.1% (95%CI: 43.8-58.3%) and 57.3% (95%CI: 54.0-60.5%) against symptomatic infection within three months; however, this waned to 32.8% (95%CI: 16.8-48.7%) within six months. VE against severe Omicron infection following the primary course was 63.6% (95%CI: 57.5-69.7%) at three months, decreased to 49% (95%CI: 35.7-63.4%) within six months, and increased to 86% after the first or second booster dose.
Collapse
Affiliation(s)
- Hassen Mohammed
- Vaccinology and Immunology Research Trials Unit, Women’s and Children’s Health Network, Adelaide, SA 5006, Australia
- Robinson Research Institute and Adelaide Medical School, the University of Adelaide, Adelaide, SA 5006, Australia
- Correspondence: ; Tel.: +61-8-8161-9157
| | - Dan Duy Pham-Tran
- Robinson Research Institute and Adelaide Medical School, the University of Adelaide, Adelaide, SA 5006, Australia
| | - Zi Yi Michelle Yeoh
- Robinson Research Institute and Adelaide Medical School, the University of Adelaide, Adelaide, SA 5006, Australia
| | - Bing Wang
- Vaccinology and Immunology Research Trials Unit, Women’s and Children’s Health Network, Adelaide, SA 5006, Australia
- Robinson Research Institute and Adelaide Medical School, the University of Adelaide, Adelaide, SA 5006, Australia
| | - Mark McMillan
- Vaccinology and Immunology Research Trials Unit, Women’s and Children’s Health Network, Adelaide, SA 5006, Australia
- Robinson Research Institute and Adelaide Medical School, the University of Adelaide, Adelaide, SA 5006, Australia
| | - Prabha H. Andraweera
- Vaccinology and Immunology Research Trials Unit, Women’s and Children’s Health Network, Adelaide, SA 5006, Australia
- Robinson Research Institute and Adelaide Medical School, the University of Adelaide, Adelaide, SA 5006, Australia
| | - Helen S. Marshall
- Vaccinology and Immunology Research Trials Unit, Women’s and Children’s Health Network, Adelaide, SA 5006, Australia
- Robinson Research Institute and Adelaide Medical School, the University of Adelaide, Adelaide, SA 5006, Australia
| |
Collapse
|
12
|
Tiong P, Kosmider L, Lassi ZS, Arstall MA, Andraweera PH. Asymmetric dimethylarginine and gestational diabetes mellitus: a systematic review and meta-analysis. Endocrine 2022; 80:283-291. [PMID: 36449126 DOI: 10.1007/s12020-022-03260-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/08/2022] [Indexed: 12/05/2022]
Abstract
PURPOSE Emerging evidence demonstrates that asymmetric dimethylarginine (ADMA) levels are elevated in patients with or at risk of cardiovascular disease (CVD). Since women with gestational diabetes mellitus (GDM) are at high risk of future CVD, we conducted a systematic review and meta-analysis to compare ADMA concentrations between women with and without GDM during pregnancy and postpartum. METHODS PubMed, Google Scholar, EMBASE, and CINAHL databases were searched. The review protocol is registered in PROSPERO (CRD42021276796). Study selection, data extraction, and data analyses were performed in accordance with PRISMA guidelines. Random-effects model was used to quantify ADMA levels in the study groups. RESULTS Eleven studies provided data on 1148 women. Mean plasma ADMA concentration was 0.04 μmol/L (95% confidence interval (CI) -0.06-0.15) higher in pregnant women with GDM than those without GDM, but no significant difference was observed. In contrast, our meta-analysis demonstrated a significant increase in postpartum mean ADMA concentration (Mean Difference (MD) 0.11 μmol/L; 95% CI 0.05-0.16) among women with previous GDM compared to women without previous GDM. CONCLUSION Elevated ADMA levels in GDM may be a CVD risk factor, suggesting that ADMA may be a potential biomarker for early CVD risk prediction in women with GDM.
Collapse
Affiliation(s)
- Patricia Tiong
- Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | - Logan Kosmider
- Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | - Zohra S Lassi
- Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | - Margaret A Arstall
- Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, Adelaide, SA, Australia
| | - Prabha H Andraweera
- Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia.
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia.
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, Adelaide, SA, Australia.
| |
Collapse
|
13
|
Pathirana MM, Andraweera PH, Aldridge E, Leemaqz SY, Harrison M, Harrison J, Verburg PE, Arstall MA, Dekker GA, Roberts CT. Gestational diabetes mellitus and cardio-metabolic risk factors in women and children at 3 years postpartum. Acta Diabetol 2022; 59:1237-1246. [PMID: 35817936 PMCID: PMC9329416 DOI: 10.1007/s00592-022-01914-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 05/30/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Gestational diabetes mellitus (GDM) is thought to be associated with cardio-metabolic risk factor development in women and their children during the early postpartum period and early childhood. We hypothesized that these women and their children would exhibit increased abnormal cardio-metabolic risk factors three years after pregnancy. METHODS Women from the Screening Tests to Predict Poor Outcomes of Pregnancy study were invited to attend a follow-up with the child from their index pregnancy at 3 years postpartum. Women and children were assessed for anthropometric measures and haemodynamic function. Fasting blood samples were obtained from women to assess lipid and glucose status. RESULTS A total of 281 woman-child dyads participated in the 3-year follow-up, with 40 women developing GDM during their index pregnancy. Fasting serum insulin was higher in women with GDM in index pregnancy compared to those with an uncomplicated pregnancy. However, this association was mediated by early pregnancy BMI and socioeconomic index (SEI). The rate of metabolic syndrome was higher in the GDM group than the uncomplicated pregnancy group. Maternal GDM was associated with elevated maternal fasting serum triglycerides at 3 years after adjustment for early pregnancy BMI and SEI. Children exposed to GDM in utero had higher waist circumference compared to children born after an uncomplicated pregnancy, but this is mediated the above covariates. CONCLUSION Exposure to GDM is associated with elevated serum triglycerides in women at 3 years postpartum but other cardiometabolic outcomes in women and children appear to be mediated by early pregnancy BMI and SEI.
Collapse
Affiliation(s)
- Maleesa M Pathirana
- Level 6, Adelaide Health and Medical Sciences Building, The University of Adelaide, Adelaide, SA, 5005, Australia.
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, 5005, Australia.
- Department of Cardiology, Lyell McEwin Hospital, Haydown Road, Elizabeth Vale, SA, 5112, Australia.
| | - Prabha H Andraweera
- Level 6, Adelaide Health and Medical Sciences Building, The University of Adelaide, Adelaide, SA, 5005, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, 5005, Australia
- Department of Cardiology, Lyell McEwin Hospital, Haydown Road, Elizabeth Vale, SA, 5112, Australia
| | - Emily Aldridge
- Level 6, Adelaide Health and Medical Sciences Building, The University of Adelaide, Adelaide, SA, 5005, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, 5005, Australia
- Department of Cardiology, Lyell McEwin Hospital, Haydown Road, Elizabeth Vale, SA, 5112, Australia
| | - Shalem Y Leemaqz
- Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, 5042, Australia
| | - Madeline Harrison
- Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, 5042, Australia
| | - Jade Harrison
- Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, 5042, Australia
| | - Petra E Verburg
- Level 6, Adelaide Health and Medical Sciences Building, The University of Adelaide, Adelaide, SA, 5005, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Margaret A Arstall
- Level 6, Adelaide Health and Medical Sciences Building, The University of Adelaide, Adelaide, SA, 5005, Australia
- Department of Cardiology, Lyell McEwin Hospital, Haydown Road, Elizabeth Vale, SA, 5112, Australia
| | - Gustaaf A Dekker
- Level 6, Adelaide Health and Medical Sciences Building, The University of Adelaide, Adelaide, SA, 5005, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, 5005, Australia
- Department of Obstetrics and Gynaecology, Lyell McEwin Hospital, Haydown Road, Elizabeth Vale, SA, 5112, Australia
| | - Claire T Roberts
- Level 6, Adelaide Health and Medical Sciences Building, The University of Adelaide, Adelaide, SA, 5005, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, 5005, Australia
- Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, 5042, Australia
| |
Collapse
|
14
|
Pathirana MM, Ali A, Lassi ZS, Arstall MA, Roberts CT, Andraweera PH. Protective Influence of Breastfeeding on Cardiovascular Risk Factors in Women With Previous Gestational Diabetes Mellitus and Their Children: A Systematic Review and Meta-Analysis. J Hum Lact 2022; 38:501-512. [PMID: 34609211 DOI: 10.1177/08903344211034779] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND There is evidence that breastfeeding may provide protection against cardiovascular risk factors in mothers with a history of gestational diabetes mellitus and their children who were exposed in utero. RESEARCH AIM To perform a systematic review and meta-analysis of observational studies to ascertain the effects of breastfeeding on cardiovascular risk factors in women with previous gestational diabetes mellitus and their children exposed in utero. METHODS Studies assessing conventional cardiovascular risk factors in women with previous gestational diabetes mellitus and children exposed in utero stratified by breastfeeding/no breastfeeding or breastfed/not breastfed were included. Gestational diabetes mellitus was defined based on the International Association of Diabetes in Pregnancy Study Group definition or previous accepted definitions. Breastfeeding was defined as reported in each study. RESULTS The literature search yielded 260 titles, of which 17 studies were selected to be in the review. Women with previous gestational diabetes mellitus who did not breastfeed had higher blood glucose (SMD: 0.32, 95% CI [0.12, 0.53]) and a greater risk of developing Type 2 diabetes mellitus (RR: 2.08 95% CI [1.44, 3.00]) compared to women with no history. There were not enough studies to conduct a meta-analysis on the effects of breastfeeding on risk factors for cardiovascular disease among children exposed to gestational diabetes mellitus in utero. CONCLUSION Breastfeeding appears to be protective against cardiovascular risk factors among women who experience gestational diabetes mellitus.
Collapse
Affiliation(s)
- Maleesa M Pathirana
- Adelaide Medical School and Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia.,Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Anna Ali
- Adelaide Medical School and Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia.,Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia.,Health Performance and Policy Research Unit, Basil Hetzel Institute, University of Adelaide, Woodville South, SA, Australia.,Adelaide G-TRAC Centre & CRE Frailty & Healthy Ageing Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Zohra S Lassi
- Adelaide Medical School and Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia.,Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Margaret A Arstall
- Adelaide Medical School and Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia.,Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, SA, Australia
| | - Claire T Roberts
- Adelaide Medical School and Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia.,Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, Australia
| | - Prabha H Andraweera
- Adelaide Medical School and Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia.,Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia.,Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, Australia
| |
Collapse
|
15
|
Andraweera PH, Lassi ZS, Pathirana MM, Plummer MD, Dekker GA, Roberts CT, Arstall MA. Pregnancy complications and cardiovascular disease risk perception: A qualitative study. PLoS One 2022; 17:e0271722. [PMID: 35862420 PMCID: PMC9302856 DOI: 10.1371/journal.pone.0271722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 07/06/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES We aimed to assess women's perceptions on the long-term risks for cardiovascular disease (CVD) after major pregnancy complications. METHODS Women who experienced major pregnancy complications and those who experienced uncomplicated pregnancies were invited to participate in a qualitative study. Focus group discussions (FGDs) and self-administered questionnaires were used to explore: The knowledge of long-term sequelae after experiencing a major pregnancy complication; Importance of education on heart health; The practicality of referral to a clinic after pregnancy complications; Willingness for regular postpartum clinic visits after pregnancy complications. A thematic qualitative analysis was undertaken. RESULTS 26 women participated in four FGDs. The majority of women did not know of the association between major pregnancy complications and CVD. The main views expressed were: Women who experience pregnancy complications should receive education on improving heart health; An appointment for the first CVD risk screening visit needs to be made prior to discharge from the delivery suite; Women will benefit by having the option to select between a hospital and a general-practitioner based model of follow up. CONCLUSIONS These views are important in developing postpartum strategies to reduce CVD risk among women who experience pregnancy complications.
Collapse
Affiliation(s)
- Prabha H. Andraweera
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, Australia
| | - Zohra S. Lassi
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
| | - Maleesa M. Pathirana
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
| | - Michelle D. Plummer
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
| | - Gus A. Dekker
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Division of Women’s Health, Lyell McEwin Hospital, Elizabeth Vale, Australia
| | - Claire T. Roberts
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia, Australia
| | - Margaret A. Arstall
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, Australia
| |
Collapse
|
16
|
Habibi N, Mousa A, Tay CT, Khomami MB, Patten RK, Andraweera PH, Wassie M, Vandersluys J, Aflatounian A, Bianco‐Miotto T, Zhou SJ, Grieger JA. Maternal metabolic factors and the association with gestational diabetes: A systematic review and meta-analysis. Diabetes Metab Res Rev 2022; 38:e3532. [PMID: 35421281 PMCID: PMC9540632 DOI: 10.1002/dmrr.3532] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/10/2022] [Accepted: 02/26/2022] [Indexed: 11/10/2022]
Abstract
Gestational diabetes (GDM) is associated with several adverse outcomes for the mother and child. Higher levels of individual lipids are associated with risk of GDM and metabolic syndrome (MetS), a clustering of risk factors also increases risk for GDM. Metabolic factors can be modified by diet and lifestyle. This review comprehensively evaluates the association between MetS and its components, measured in early pregnancy, and risk for GDM. Databases (Cumulative Index to Nursing and Allied Health Literature, PubMed, Embase, and Cochrane Library) were searched from inception to 5 May 2021. Eligible studies included ≥1 metabolic factor (waist circumference, blood pressure, fasting plasma glucose (FPG), triglycerides, and high-density lipoprotein cholesterol), measured at <16 weeks' gestation. At least two authors independently screened potentially eligible studies. Heterogeneity was quantified using I2 . Data were pooled by random-effects models and expressed as odds ratio and 95% confidence intervals (CIs). Of 7213 articles identified, 40 unique articles were included in meta-analysis. In analyses adjusting for maternal age and body mass index, GDM was increased with increasing FPG (odds ratios [OR] 1.92; 95% CI 1.39-2.64, k = 7 studies) or having MetS (OR 2.52; 1.65, 3.84, k = 3). Women with overweight (OR 2.17; 95% CI 1.89, 2.50, k = 12) or obesity (OR 4.34; 95% CI 2.79-6.74, k = 9) also were at increased risk for GDM. Early pregnancy assessment of glucose or the MetS, offers a potential opportunity to detect and treat individual risk factors as an approach towards GDM prevention; weight loss for pregnant women with overweight or obesity is not recommended. Systematic review registration: PROSPERO CRD42020199225.
Collapse
Affiliation(s)
- Nahal Habibi
- Robinson Research InstituteUniversity of AdelaideAdelaideSouth AustraliaAustralia
- Adelaide Medical SchoolUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Aya Mousa
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash UniversityMelbourneVictoriaAustralia
| | - Chau Thien Tay
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash UniversityMelbourneVictoriaAustralia
| | - Mahnaz Bahri Khomami
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash UniversityMelbourneVictoriaAustralia
| | - Rhiannon K. Patten
- Institute for Health and SportVictoria UniversityMelbourneVictoriaAustralia
| | - Prabha H. Andraweera
- Robinson Research InstituteUniversity of AdelaideAdelaideSouth AustraliaAustralia
- Adelaide Medical SchoolUniversity of AdelaideAdelaideSouth AustraliaAustralia
- Department of Cardiology, Lyell McEwin HospitalElizabeth ValeSouth AustraliaAustralia
| | - Molla Wassie
- School of Agriculture, Food and Wine, and Waite Research Institute, University of AdelaideAdelaideSouth AustraliaAustralia
| | - Jared Vandersluys
- School of Agriculture, Food and Wine, and Waite Research Institute, University of AdelaideAdelaideSouth AustraliaAustralia
| | - Ali Aflatounian
- School of Women's and Children's Health, University of New South WalesSydneyNew South WalesAustralia
| | - Tina Bianco‐Miotto
- Robinson Research InstituteUniversity of AdelaideAdelaideSouth AustraliaAustralia
- School of Agriculture, Food and Wine, and Waite Research Institute, University of AdelaideAdelaideSouth AustraliaAustralia
| | - Shao J. Zhou
- Robinson Research InstituteUniversity of AdelaideAdelaideSouth AustraliaAustralia
- School of Agriculture, Food and Wine, and Waite Research Institute, University of AdelaideAdelaideSouth AustraliaAustralia
| | - Jessica A. Grieger
- Robinson Research InstituteUniversity of AdelaideAdelaideSouth AustraliaAustralia
- Adelaide Medical SchoolUniversity of AdelaideAdelaideSouth AustraliaAustralia
| |
Collapse
|
17
|
Khoja A, Andraweera PH, Lassi ZS, Zheng M, Pathirana MM, Ali A, Aldridge E, Wittwer MR, Chaudhuri DD, Tavella R, Arstall MA. Risk factors for premature coronary artery disease (PCAD) in adults: a systematic review protocol. F1000Res 2021; 10:1228. [PMID: 35106139 PMCID: PMC8772521 DOI: 10.12688/f1000research.74926.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/26/2021] [Indexed: 12/03/2022] Open
Abstract
PCAD possesses a public health challenge resulting in years of productive life lost and an escalating burden on health systems. Objective of this review is to compare modifiable and non-modifiable risk factors for PCAD compared to those without PCAD. This review will include all comparative observational studies conducted in adults aged >18 years with confirmed diagnosis of PCAD (on angiography) compared to those without PCAD. Databases to be searched include; PubMed, CINAHL, Embase, Web of Science, and grey literature (Google Scholar). All identified studies will be screened for title and abstract and full-text against the inclusion criteria on Covidence software. Data relevant to exposures and outcomes will be extracted from all included studies. All studies selected for data extraction will be critically appraised for methodological quality. Meta-analysis using random-effects model will be performed using Review Manager 5.3. Effect sizes for categorical risk factors will be expressed as odds ratios with 95% confidence intervals. For risk factors measured in continuous form, mean difference (if units are consistent) otherwise standardized mean difference (if units are different across studies) will be reported. Heterogeneity between studies will be assessed using I 2 test statistics. GRADE will be used to assess the certainty of the findings. Systematic review registration number:PROSPERO Registration # CRD42020173216.
Collapse
Affiliation(s)
- Adeel Khoja
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, 5005, Australia
- The Robinson Research Institute, University of Adelaide, Adelaide, South Australia, 5006, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, South Australia, 5112, Australia
| | - Prabha H. Andraweera
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, 5005, Australia
- The Robinson Research Institute, University of Adelaide, Adelaide, South Australia, 5006, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, South Australia, 5112, Australia
| | - Zohra S. Lassi
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, 5005, Australia
- The Robinson Research Institute, University of Adelaide, Adelaide, South Australia, 5006, Australia
| | - Mingyue Zheng
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, 5005, Australia
- School of Health and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Maleesa M. Pathirana
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, 5005, Australia
- The Robinson Research Institute, University of Adelaide, Adelaide, South Australia, 5006, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, South Australia, 5112, Australia
| | - Anna Ali
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, 5005, Australia
- The Robinson Research Institute, University of Adelaide, Adelaide, South Australia, 5006, Australia
| | - Emily Aldridge
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, 5005, Australia
- The Robinson Research Institute, University of Adelaide, Adelaide, South Australia, 5006, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, South Australia, 5112, Australia
| | - Melanie R. Wittwer
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, 5005, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, South Australia, 5112, Australia
| | - Debajyoti D. Chaudhuri
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, 5005, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, South Australia, 5112, Australia
| | - Rosanna Tavella
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, 5005, Australia
- Department of Cardiology, Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Woodville South, South Australia, 5011, Australia
| | - Margaret A. Arstall
- Cardiology Unit, Northern Adelaide Local Health Network, Adelaide, South Australia, 5112, Australia
- Medical Specialties, Faculty of Health Sciences, University of Adelaide, Adelaide, South Australia, 5005, Australia
| |
Collapse
|
18
|
Pathirana MM, Lassi Z, Ali A, Arstall M, Roberts CT, Andraweera PH. Cardiovascular risk factors in women with previous gestational diabetes mellitus: A systematic review and meta-analysis. Rev Endocr Metab Disord 2021; 22:729-761. [PMID: 33106997 DOI: 10.1007/s11154-020-09587-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/26/2020] [Indexed: 12/16/2022]
Abstract
This systematic review and meta-analysis aimed to synthesize evidence on conventional cardiovascular disease (CVD) risk factors among women with previous Gestational Diabetes Mellitus (GDM). The review protocol is registered with PROSPERO (CRD42019118149). PubMed, CINAHL, SCOPUS, and EMBASE databases were searched. Studies reporting on CVD risk factors in women with previous GDM compared to women without previous GDM were selected. A total of 139 studies were eligible, of which 93 were included in the meta-analysis. Women with previous GDM have significantly higher systolic blood pressure (2.47 mmHg 95% CI 1.74 to 3.40, n = 48, 50,118 participants) diastolic blood pressure (1.89 mmHg 95% CI 1.32 to 2.46, n = 48, 49,495 participants), BMI (1.54 kg/m2 95% CI 1.32 to 2.46, n = 78, 255,308 participants), total cholesterol (0.26 SMD 95% CI 0.15 to 0.37, n = 48, 38,561 participants), LDL cholesterol (0.19 SMD 95% CI 0.08 to 0.30, n = 44, 16,980 participants), triglycerides (0.56 SMD 95% CI 0.42 to 0.70, n = 46, 13,175 participants), glucose (0.69 SMD 95% CI 0.56 to 0.81, n = 55, 127,900 participants), insulin (0.41 SMD 95% CI 0.23 to 0.59, n = 32, 8881 participants) and significantly lower HDL cholesterol (-0.28 SMD 95% CI -0.39 to -0.16, n = 56, 35,882 participants), compared to women without previous GDM. The increased blood pressure, total cholesterol, triglycerides and glucose are seen as early as <1 year post-partum.Women with previous GDM have a higher risk of CVD based on significant increases in conventional risk factors. Some risk factors are seen as early as <1 year post-partum. Women with GDM may benefit from early screening to identify modifiable CVD risk factors.
Collapse
Affiliation(s)
- Maleesa M Pathirana
- Adelaide Medical School and The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
- Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Zohra Lassi
- Adelaide Medical School and The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
- Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Anna Ali
- Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
- Basil Hetzel Institute, The Queen Elizabeth Hospital, Woodville, SA, Australia
- Adelaide G-TRAC Centre & CRE Frailty & Healthy Ageing Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Margaret Arstall
- Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, SA, Australia
| | - Claire T Roberts
- Adelaide Medical School and The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
- Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
- Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, Australia
| | - Prabha H Andraweera
- Adelaide Medical School and The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia.
- Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia.
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, SA, Australia.
| |
Collapse
|
19
|
Mohammed H, McMillan M, Andraweera PH, Elliott SR, Marshall HS. A rapid global review of strategies to improve influenza vaccination uptake in Australia. Hum Vaccin Immunother 2021; 17:5487-5499. [PMID: 34623221 PMCID: PMC8904008 DOI: 10.1080/21645515.2021.1978797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
This study aimed to identify effective strategies for improving the uptake of influenza vaccination and to inform recommendations for influenza vaccination programs in Australia. A rapid systematic review was conducted to assimilate and synthesize peer-reviewed articles identified in PubMed. The National Health and Medical Research Council (NHMRC) Hierarchy of Evidence was used to appraise the quality of evidence. A systematic search identified 4373 articles and 52 that met the inclusion criteria were included. The evidence suggests influenza vaccination uptake may be improved by interventions that (1) increase community/patient demand and access to influenza vaccine and overcome practice-related barriers; (2) reinforce the critical role healthcare providers play in driving influenza vaccination uptake. Strategies such as standing orders, reminder and recall efforts were successful in improving influenza vaccination rates. Community pharmacies, particularly in regional/remote areas, are well positioned to improve influenza vaccine coverage. The findings of this rapid review can be utilized to improve the performance of influenza immunization programs in Australia and other countries with comparable programs; and recommend priorities for future evaluation of interventions to improve influenza vaccination uptake.
Collapse
Affiliation(s)
- Hassen Mohammed
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, Adelaide, Australia.,Robinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Mark McMillan
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, Adelaide, Australia.,Robinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Prabha H Andraweera
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, Adelaide, Australia.,Robinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Salenna R Elliott
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, Adelaide, Australia
| | - Helen S Marshall
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, Adelaide, Australia.,Robinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| |
Collapse
|
20
|
Andraweera ND, Andraweera PH, Lassi ZS, Kochiyil V. Effectiveness of Botulinum Toxin A Injection in Managing Mobility-Related Outcomes in Adult Patients With Cerebral Palsy: Systematic Review. Am J Phys Med Rehabil 2021; 100:851-857. [PMID: 33252471 DOI: 10.1097/phm.0000000000001653] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE Intramuscular botulinum toxin A (BTX-A) is used in the management of focal spasticity in cerebral palsy (CP). The aim was to conduct a systematic review to assess current literature on the use of BTX-A in the management of mobility-related outcomes among adult persons with spastic CP. METHODS All studies reporting on the use of BTX-A in the management of spastic CP among adult persons were identified by searching the following electronic databases: PubMed, CINAHL, the Cochrane Library, and EMBASE. RESULTS Six studies were included in the review. Most studies were conducted in mixed patient groups comprising patients with movement disorders, traumatic brain injury, CP, and other disorders requiring therapy for spasticity. BTX-A was shown to be effective in improving spasticity-related outcomes among persons with CP, but mixed results were shown for functional outcomes. CONCLUSIONS More studies are required on exclusive CP cohorts using recommended and currently used scales, incorporating quality of life and patient satisfaction scales. Results from long-term follow-up studies will be valuable for better evaluation of the effectiveness of BTX-A in the management of spasticity-related outcomes among adult persons with CP.
Collapse
Affiliation(s)
- Nalinda D Andraweera
- From the Department of Rehabilitation Medicine, Modbury Public Hospital, Modbury (NDA, VK); and Adelaide Medical School, The University of Adelaide, Adelaide, Australia (NDA, PHA, ZSL, VK)
| | | | | | | |
Collapse
|
21
|
Marshall HS, Andraweera PH, Wang B, McMillan M, Koehler AP, Lally N, Almond S, Denehy E, A’Houre M, Giles LC, Flood L. Evaluating the effectiveness of the 4CMenB vaccine against invasive meningococcal disease and gonorrhoea in an infant, child and adolescent program: protocol. Hum Vaccin Immunother 2021; 17:1450-1454. [PMID: 33428528 PMCID: PMC8078704 DOI: 10.1080/21645515.2020.1827614] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/25/2020] [Accepted: 09/20/2020] [Indexed: 12/30/2022] Open
Abstract
Invasive meningococcal disease causes significant morbidity and mortality worldwide, with serogroup B being one of the predominant serogroups in Australia for many years. The South Australian (SA) State Government recently funded the introduction of a 4CMenB vaccination program for infants, children and adolescents. In addition to protecting against invasive meningococcal disease, emerging evidence suggests the 4CMenB vaccine may also be effective against gonorrhoea due to genetic similarities between Neisseria meningitidis and Neisseria gonorrhoeae. The proposed project aims to evaluate the effectiveness of the SA 4CMenB vaccination program against invasive meningococcal disease and gonorrhoea through a combination of observational studies using routine surveillance and research data. The main methodological approaches involve an interrupted time series regression model, screening, and case-control analyses with different sets of controls to estimate vaccine impact and effectiveness. These analyses are designed to minimize potential biases inherent in all observational studies and to provide critical data on the effectiveness of the 4CMenB vaccine against two diseases of major global public health concern.
Collapse
Affiliation(s)
- Helen S. Marshall
- Vaccinology and Immunology Research Trials Unit, Women’s and Children’s Hospital, SA Health, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Prabha H. Andraweera
- Vaccinology and Immunology Research Trials Unit, Women’s and Children’s Hospital, SA Health, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Bing Wang
- Vaccinology and Immunology Research Trials Unit, Women’s and Children’s Hospital, SA Health, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Mark McMillan
- Vaccinology and Immunology Research Trials Unit, Women’s and Children’s Hospital, SA Health, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Ann P. Koehler
- Communicable Disease Control Branch, SA Health, Adelaide, Australia
| | - Noel Lally
- Communicable Disease Control Branch, SA Health, Adelaide, Australia
| | - Sara Almond
- Communicable Disease Control Branch, SA Health, Adelaide, Australia
| | - Emma Denehy
- Communicable Disease Control Branch, SA Health, Adelaide, Australia
| | - Michele A’Houre
- Communicable Disease Control Branch, SA Health, Adelaide, Australia
| | - Lynne C. Giles
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- School of Public Health, The University of Adelaide, Adelaide, Australia
| | - Louise Flood
- Communicable Disease Control Branch, SA Health, Adelaide, Australia
| |
Collapse
|
22
|
Pathirana MM, Lassi ZS, Ali A, Arstall MA, Roberts CT, Andraweera PH. Association between metabolic syndrome and gestational diabetes mellitus in women and their children: a systematic review and meta-analysis. Endocrine 2021; 71:310-320. [PMID: 32930949 DOI: 10.1007/s12020-020-02492-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 09/03/2020] [Indexed: 01/08/2023]
Abstract
PURPOSE The primary aim of this systematic review and meta-analysis was to determine the association between gestational diabetes mellitus (GDM) and metabolic syndrome (MetS) in women and children. Our secondary aim was to assess the development of MetS with respect to the elapsed time postpartum at which MetS was diagnosed. METHODS This review is registered with PROSPERO (CRD42020173319). PubMed, CINHAL, SCOPUS, and EMBASE databases were searched. Studies reporting on the rate of MetS in pregnant women with GDM, the rate of MetS in women with a history of GDM, and the rate of MetS in offspring exposed to GDM in utero compared to healthy controls were selected. RESULTS We identified 588 articles from the literature search. Fifty-one studies were included in the review and of those 35 were included in the meta-analysis. Quantitative summary measures showed that women with a history of GDM had an increased risk of developing MetS compared to those without a history of GDM (RR 2.36, 95% CI 1.77-3.14, 29 studies, 13,390 participants; heterogeneity: χ2 p < 0.00001; I2 = 93%). Offspring exposed to GDM in utero have an increased risk of developing MetS compared to those not exposed to GDM in utero. (RR 2.07, 95% CI 1.26-3.42, three studies, 4,421 participants; heterogeneity: χ2 p = 0.33; I2 = 12%). Women diagnosed with GDM have an increased risk of developing MetS during pregnancy (RR 20.51, 95% CI 5.04-83.55; three studies, 406 participants; heterogeneity: χ2 p = 0.96; I2 = 0%). Subgroup analysis revealed that MetS is diagnosed as early as <1 year postpartum in women with a history of GDM. CONCLUSIONS/INTERPRETATION Women with GDM have an increased risk of developing MetS during pregnancy. Women with a history of GDM and offspring exposed to GDM in utero have higher risks of developing MetS compared to those with no history of GDM. Metabolic syndrome in women with a history of GDM is seen as early as <1 year postpartum.
Collapse
Affiliation(s)
- Maleesa M Pathirana
- Adelaide Medical School and Robinson Research Institute, The University of Adelaide, Adelaide, SA, 5005, Australia
- Faculty of Health and Medical Sciences, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Zohra S Lassi
- Adelaide Medical School and Robinson Research Institute, The University of Adelaide, Adelaide, SA, 5005, Australia
- Faculty of Health and Medical Sciences, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Anna Ali
- Health Performance and Policy Research Unit, Basil Hetzel Institute, The University of Adelaide, Adelaide, SA, Australia
- Adelaide G-TRAC Centre and CRE Frailty and Healthy Ageing Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Margaret A Arstall
- Faculty of Health and Medical Sciences, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, SA, Australia
| | - Claire T Roberts
- Adelaide Medical School and Robinson Research Institute, The University of Adelaide, Adelaide, SA, 5005, Australia
- Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, 5042, Australia
| | - Prabha H Andraweera
- Adelaide Medical School and Robinson Research Institute, The University of Adelaide, Adelaide, SA, 5005, Australia.
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, SA, Australia.
| |
Collapse
|
23
|
Jankovic‐Karasoulos T, Furness DL, Leemaqz SY, Dekker GA, Grzeskowiak LE, Grieger JA, Andraweera PH, McCullough D, McAninch D, McCowan LM, Bianco‐Miotto T, Roberts CT. Maternal folate, one-carbon metabolism and pregnancy outcomes. Matern Child Nutr 2021; 17:e13064. [PMID: 32720760 PMCID: PMC7729528 DOI: 10.1111/mcn.13064] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 05/22/2020] [Accepted: 06/24/2020] [Indexed: 12/12/2022]
Abstract
Single nucleotide polymorphisms and pre- and peri-conception folic acid (FA) supplementation and dietary data were used to identify one-carbon metabolic factors associated with pregnancy outcomes in 3196 nulliparous women. In 325 participants, we also measured circulating folate, vitamin B12 and homocysteine. Pregnancy outcomes included preeclampsia (PE), gestational hypertension (GHT), small for gestational age (SGA), spontaneous preterm birth (sPTB) and gestational diabetes mellitus (GDM). Study findings show that maternal genotype MTHFR A1298C(CC) was associated with increased risk for PE, whereas TCN2 C766G(GG) had a reduced risk for sPTB. Paternal MTHFR A1298C(CC) and MTHFD1 G1958A(AA) genotypes were associated with reduced risk for sPTB, whereas MTHFR C677T(CT) genotype had an increased risk for GHT. FA supplementation was associated with higher serum folate and vitamin B12 concentrations, reduced uterine artery resistance index and increased birth weight. Women who supplemented with <800 μg daily FA at 15-week gestation had a higher incidence of PE (10.3%) compared with women who did not supplement (6.1%) or who supplemented with ≥800 μg (5.4%) (P < .0001). Higher serum folate levels were found in women who later developed GDM compared with women with uncomplicated pregnancies (Mean ± SD: 37.6 ± 8 nmol L-1 vs. 31.9 ± 11.2, P = .007). Fast food consumption was associated with increased risk for developing GDM, whereas low consumption of green leafy vegetables and fruit were independent risk factors for SGA and GDM and sPTB and SGA, respectively. In conclusion, maternal and paternal genotypes, together with maternal circulating folate and homocysteine concentrations, and pre- and early-pregnancy dietary factors, are independent risk factors for pregnancy complications.
Collapse
Affiliation(s)
- Tanja Jankovic‐Karasoulos
- Robinson Research InstituteUniversity of AdelaideAdelaideSouth AustraliaAustralia
- Adelaide Medical SchoolUniversity of AdelaideAdelaideSouth AustraliaAustralia
- College of Medical and Public HealthFlinders UniversityBedford ParkSouth AustraliaAustralia
| | - Denise L. Furness
- Robinson Research InstituteUniversity of AdelaideAdelaideSouth AustraliaAustralia
- Adelaide Medical SchoolUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Shalem Y. Leemaqz
- Robinson Research InstituteUniversity of AdelaideAdelaideSouth AustraliaAustralia
- Adelaide Medical SchoolUniversity of AdelaideAdelaideSouth AustraliaAustralia
- College of Medical and Public HealthFlinders UniversityBedford ParkSouth AustraliaAustralia
| | - Gustaaf A. Dekker
- Robinson Research InstituteUniversity of AdelaideAdelaideSouth AustraliaAustralia
- Adelaide Medical SchoolUniversity of AdelaideAdelaideSouth AustraliaAustralia
- Department of Obstetrics and GynaecologyLyell McEwin HospitalElizabeth ValeSouth AustraliaAustralia
| | - Luke E. Grzeskowiak
- Robinson Research InstituteUniversity of AdelaideAdelaideSouth AustraliaAustralia
- Adelaide Medical SchoolUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Jessica A. Grieger
- Robinson Research InstituteUniversity of AdelaideAdelaideSouth AustraliaAustralia
- Adelaide Medical SchoolUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Prabha H. Andraweera
- Robinson Research InstituteUniversity of AdelaideAdelaideSouth AustraliaAustralia
- Adelaide Medical SchoolUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Dylan McCullough
- Robinson Research InstituteUniversity of AdelaideAdelaideSouth AustraliaAustralia
- Adelaide Medical SchoolUniversity of AdelaideAdelaideSouth AustraliaAustralia
- College of Medical and Public HealthFlinders UniversityBedford ParkSouth AustraliaAustralia
| | - Dale McAninch
- Robinson Research InstituteUniversity of AdelaideAdelaideSouth AustraliaAustralia
- Adelaide Medical SchoolUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Lesley M. McCowan
- Department of Obstetrics and GynaecologyUniversity of AucklandAucklandNew Zealand
| | - Tina Bianco‐Miotto
- Robinson Research InstituteUniversity of AdelaideAdelaideSouth AustraliaAustralia
- School of Agriculture Food and Wine, Waite Research InstituteUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Claire T. Roberts
- Robinson Research InstituteUniversity of AdelaideAdelaideSouth AustraliaAustralia
- Adelaide Medical SchoolUniversity of AdelaideAdelaideSouth AustraliaAustralia
- College of Medical and Public HealthFlinders UniversityBedford ParkSouth AustraliaAustralia
| |
Collapse
|
24
|
McAninch D, Bianco-Miotto T, Gatford KL, Leemaqz SY, Andraweera PH, Garrett A, Plummer MD, Dekker GA, Roberts CT, Smithers LG, Grieger JA. The metabolic syndrome in pregnancy and its association with child telomere length. Diabetologia 2020; 63:2140-2149. [PMID: 32728890 DOI: 10.1007/s00125-020-05242-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 06/24/2020] [Indexed: 12/19/2022]
Abstract
AIMS/HYPOTHESIS The aim of this study was to determine whether presence of the metabolic syndrome in pregnancy associates with child telomere length or child anthropometry (weight, BMI) and BP, measured at 10 years of age. METHODS The Screening for Pregnancy Endpoints study (SCOPE) was a multicentre, international prospective cohort of nulliparous pregnant women recruited from Australia, New Zealand, Ireland and the UK (N = 5628). The current analysis is a 10 year follow-up of SCOPE pregnant women and their children, from the Australian cohort. Clinical data collected at 14-16 weeks' gestation during the SCOPE study were used to diagnose the metabolic syndrome using IDF criteria. Telomere length, a biomarker of ageing, was assessed by quantitative PCR from children's saliva collected at 10 years of age. RESULTS In women who completed follow-up (n = 255), 20% had the metabolic syndrome in pregnancy. After adjusting for a range of confounders, children of mothers who had the metabolic syndrome in pregnancy had 14% shorter telomeres than children of mothers without the metabolic syndrome in pregnancy (mean difference -0.36 [95% CI -0.74, 0.01]). Height- and weight-for-age, and BMI z scores were similar in children of mothers who did and did not have the metabolic syndrome during pregnancy. CONCLUSIONS/INTERPRETATION Children of mothers who had the metabolic syndrome in pregnancy have shorter telomeres, a biomarker of accelerated ageing. These findings warrant further studies in larger cohorts of children, as well as investigations into whether telomere length measured in cord blood associates with telomere length in childhood.
Collapse
Affiliation(s)
- Dale McAninch
- Robinson Research Institute, University of Adelaide, North Adelaide, SA, 5005, Australia
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Tina Bianco-Miotto
- Robinson Research Institute, University of Adelaide, North Adelaide, SA, 5005, Australia
- Waite Research Institute, School of Agriculture, Food and Wine, University of Adelaide, Adelaide, SA, Australia
| | - Kathy L Gatford
- Robinson Research Institute, University of Adelaide, North Adelaide, SA, 5005, Australia
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Shalem Y Leemaqz
- Robinson Research Institute, University of Adelaide, North Adelaide, SA, 5005, Australia
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
- College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | - Prabha H Andraweera
- Robinson Research Institute, University of Adelaide, North Adelaide, SA, 5005, Australia
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Amy Garrett
- Robinson Research Institute, University of Adelaide, North Adelaide, SA, 5005, Australia
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Michelle D Plummer
- Robinson Research Institute, University of Adelaide, North Adelaide, SA, 5005, Australia
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Gus A Dekker
- Robinson Research Institute, University of Adelaide, North Adelaide, SA, 5005, Australia
- Women and Children's Division, Lyell McEwin Hospital, University of Adelaide, Adelaide, SA, Australia
| | - Claire T Roberts
- Robinson Research Institute, University of Adelaide, North Adelaide, SA, 5005, Australia
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
- College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | - Lisa G Smithers
- Robinson Research Institute, University of Adelaide, North Adelaide, SA, 5005, Australia
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - Jessica A Grieger
- Robinson Research Institute, University of Adelaide, North Adelaide, SA, 5005, Australia.
- Adelaide Medical School, University of Adelaide, Adelaide, Australia.
| |
Collapse
|
25
|
Abstract
Preeclampsia is a common pregnancy complication, affecting 2% to 8% of pregnancies worldwide, and is an important cause of both maternal and fetal morbidity and mortality. Importantly, although aspirin and calcium are able to prevent preeclampsia in some women, there is no cure apart from delivery of the placenta and fetus, often necessitating iatrogenic preterm birth. Preclinical models of preeclampsia are widely used to investigate the causes and consequences of preeclampsia and to evaluate safety and efficacy of potential preventative and therapeutic interventions. In this review, we provide a summary of the published preclinical models of preeclampsia that meet human diagnostic criteria, including the development of maternal hypertension, together with new-onset proteinuria, maternal organ dysfunction, and uteroplacental dysfunction. We then discuss evidence from preclinical models for multiple causal factors of preeclampsia, including those implicated in early-onset and late-onset preeclampsia. Next, we discuss the impact of exposure to a preeclampsia-like environment for later maternal and progeny health. The presence of long-term impairment, particularly cardiovascular outcomes, in mothers and progeny after an experimentally induced preeclampsia-like pregnancy, implies that later onset or reduced severity of preeclampsia will improve later maternal and progeny health. Finally, we summarize published intervention studies in preclinical models and identify gaps in knowledge that we consider should be targets for future research.
Collapse
Affiliation(s)
- Kathryn L Gatford
- From the Adelaide Medical School and Robinson Research Institute, The University of Adelaide, Australia
| | - Prabha H Andraweera
- From the Adelaide Medical School and Robinson Research Institute, The University of Adelaide, Australia
| | - Claire T Roberts
- From the Adelaide Medical School and Robinson Research Institute, The University of Adelaide, Australia
| | - Alison S Care
- From the Adelaide Medical School and Robinson Research Institute, The University of Adelaide, Australia
| |
Collapse
|
26
|
Mulder CL, Lassi ZS, Grieger JA, Ali A, Jankovic‐Karasoulos T, Roberts CT, Andraweera PH. Cardio‐metabolic risk factors among young infertile women: a systematic review and meta‐analysis. BJOG 2020; 127:930-939. [DOI: 10.1111/1471-0528.16171] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2020] [Indexed: 11/30/2022]
Affiliation(s)
- CL Mulder
- Robinson Research Institute University of Adelaide Adelaide SA Australia
- Centre for Reproductive Medicine Amsterdam Reproduction and Development Research Institute Amsterdam UMC University of Amsterdam AZ Amsterdam the Netherlands
| | - ZS Lassi
- Robinson Research Institute University of Adelaide Adelaide SA Australia
- Adelaide Medical School University of Adelaide Adelaide SA Australia
| | - JA Grieger
- Robinson Research Institute University of Adelaide Adelaide SA Australia
- Adelaide Medical School University of Adelaide Adelaide SA Australia
| | - A Ali
- Basil Hetzel Institute The University of Adelaide Adelaide SA Australia
| | - T Jankovic‐Karasoulos
- Robinson Research Institute University of Adelaide Adelaide SA Australia
- Adelaide Medical School University of Adelaide Adelaide SA Australia
| | - CT Roberts
- Robinson Research Institute University of Adelaide Adelaide SA Australia
- Adelaide Medical School University of Adelaide Adelaide SA Australia
| | - PH Andraweera
- Robinson Research Institute University of Adelaide Adelaide SA Australia
- Adelaide Medical School University of Adelaide Adelaide SA Australia
| |
Collapse
|
27
|
Andraweera PH, Lassi ZS. Cardiovascular Risk Factors in Offspring of Preeclamptic Pregnancies-Systematic Review and Meta-Analysis. J Pediatr 2019; 208:104-113.e6. [PMID: 30876753 DOI: 10.1016/j.jpeds.2018.12.008] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 11/01/2018] [Accepted: 12/05/2018] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To evaluate evidence for increased cardiovascular disease (CVD) risk factors in children exposed to preeclampsia in utero. STUDY DESIGN PubMed, the Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, and EMBASE electronic databases were searched with an end of search date of June 4, 2018. Prospective and retrospective studies that compared CVD risk factors in those exposed to preeclampsia in utero with controls were eligible. Information was extracted on established CVD risk factors, including blood pressure, lipid profile, blood glucose, fasting insulin, body mass index, and endothelial/microvascular function. RESULTS Thirty-six studies provided cumulated data on 53 029 individuals. In utero exposure to preeclampsia was associated with 5.17 mm Hg (95% CI 1.60-8.73) greater mean systolic, 4.06 mm Hg (95% CI 0.67-7.44) greater mean diastolic blood pressure, and 0.36 kg/m2 (95% CI 0.04-0.68) greater mean body mass index during childhood or young adulthood. No significant association was seen between exposure to preeclampsia in utero and other CVD risk factors. CONCLUSIONS Offspring of preeclamptic pregnancies demonstrate risk factors for CVD during childhood and young adult life. Early blood pressure screening of children born after preeclamptic pregnancies may identify those that require interventions or preventive strategies to reduce later life CVD risk.
Collapse
Affiliation(s)
- Prabha H Andraweera
- Adelaide Medical School and The Robinson Research Institute, The University of Adelaide, Adelaide, Australia.
| | - Zohra S Lassi
- Adelaide Medical School and The Robinson Research Institute, The University of Adelaide, Adelaide, Australia
| |
Collapse
|
28
|
Andraweera PH, Dekker G, Leemaqz S, McCowan L, Myers J, Kenny L, Walker J, Poston L, Roberts CT. Effect of Birth Weight and Early Pregnancy BMI on Risk for Pregnancy Complications. Obesity (Silver Spring) 2019; 27:237-244. [PMID: 30565423 DOI: 10.1002/oby.22375] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 10/29/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This study investigated the influence of birth weight on the risk of pregnancy complications, including preeclampsia (PE), gestational hypertension (GH), small for gestational age (SGA) pregnancy, spontaneous preterm birth, and gestational diabetes mellitus (GDM), and assessed the effect of early pregnancy BMI on this relationship. METHODS A total of 5,336 nulliparous women from the SCreening fOr Pregnancy Endpoints (SCOPE) study were included. Women's birth weights were self-reported and confirmed via medical records when possible. A birth weight of 3,000 to 3,499 g was considered the reference. RESULTS After adjusting for confounders, birth weight < 2,500 g was associated with increased risk of GH (adjusted odds ratio [aOR] = 2.2, 95% CI = 1.3-3.7), PE (aOR = 1.7, 95% CI = 1.0-2.9), small for gestational age (aOR = 1.9, 95% CI = 1.1-3.2), and GDM (aOR = 2.4, 95% CI = 1.0-5.8) compared with the referent. Women born with birth weight < 2,500 g and who subsequently developed overweight or were diagnosed with obesity were at increased risk of GH (aOR = 2.2, 95% CI = 1.1-4.5), PE (aOR = 2.3, 95% CI = 1.2-4.5), and GDM (aOR = 3.2, 95% CI = 1.1-9.5) compared with women with birth weight ≥ 2,500 g and remained lean. CONCLUSIONS Women who were born with a low birth weight are at increased risk of pregnancy complications. Those born small may have undergone "programming" in response to unfavorable intrauterine conditions. In such women, the physiological demands of pregnancy may act as a "second hit," leading to pregnancy complications.
Collapse
Affiliation(s)
- Prabha H Andraweera
- Adelaide Medical School, University of Adelaide, South Australia, Australia
- Robinson Research Institute, University of Adelaide, South Australia, Australia
| | - Gus Dekker
- Adelaide Medical School, University of Adelaide, South Australia, Australia
- Robinson Research Institute, University of Adelaide, South Australia, Australia
- Division of Women's Health, Lyell McEwin Hospital, Elizabeth Vale, South Australia
| | - Shalem Leemaqz
- Adelaide Medical School, University of Adelaide, South Australia, Australia
- Robinson Research Institute, University of Adelaide, South Australia, Australia
| | - Lesley McCowan
- Department of Obstetrics and Gynaecology, The University of Auckland, New Zealand
| | - Jenny Myers
- Maternal and Fetal Health Research Centre, University of Manchester, UK
| | - Louise Kenny
- Department of Obstetrics and Gynaecology, University College Cork, Ireland
| | - James Walker
- Department of Obstetrics and Gynaecology, Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, UK
| | - Lucilla Poston
- Division of Women's Health, King's College London, St Thomas' Hospital, London, UK
| | - Claire T Roberts
- Adelaide Medical School, University of Adelaide, South Australia, Australia
- Robinson Research Institute, University of Adelaide, South Australia, Australia
| | | |
Collapse
|
29
|
Kos BJP, Leemaqz SY, McCormack CD, Andraweera PH, Furness DL, Roberts CT, Dekker GA. The association of parental methylenetetrahydrofolate reductase polymorphisms ( MTHFR 677C > T and 1298A > C) and fetal loss: a case-control study in South Australia. J Matern Fetal Neonatal Med 2018; 33:752-757. [PMID: 30001659 DOI: 10.1080/14767058.2018.1500546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objective: To determine the association between parental MTHFR 677C > T (RS1801133) and 1298A > C (RS1801131), and fetal loss (FL).Design: Case-control study.Setting: Department of Obstetrics and Gynecology, Lyell McEwin Hospital (LMH), and the Women's and Children's Hospital (WCH) in Adelaide, Australia.Patients: A total of 222 couples with FL and 988 couples with uncomplicated pregnancies.Measurements: The main outcomes were FL and hyperhomocysteinemia (HHcy). All couples were tested for MTHFR 677C > T and 1298A > C. Fasting homocysteine was measured in the women with FL.Results: The main finding was a significant difference between the FL group and controls in couples with ≥4 abnormal alleles compared to <4 [p=.0232, OR 1.9 (95% CI 1.1-3.3)]. None of the couples with FL had zero abnormal alleles (both parents 677CC/1298 AA). However, this was also rare amongst the controls. Maternal carriage of both 677C > T and the 1298A > C polymorphisms was similar between the FL group and controls. The prevalence of paternal 677TT/1298AA and 677CC/1298AC was significantly higher in the FL group compared with controls. HHcy was significantly more common in the FL group compared with controls.Conclusion: The presence of parental MTHFR 677C > T and 1298A > C is associated with FL. The association between maternal MTHFR genotypes with FL is less pronounced than in previously published articles investigating first trimester miscarriages. Maternal HHcy is a significant risk factor for FL.
Collapse
Affiliation(s)
- Britt J P Kos
- Adelaide Medical School, Robinson Research Institute, University of Adelaide, Adelaide, Australia.,Women and Children's Division, Lyell McEwin Hospital, Elizabeth Vale, South Australia, Australia
| | - Shalem Y Leemaqz
- Adelaide Medical School, Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | | | - Prabha H Andraweera
- Adelaide Medical School, Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | - Denise L Furness
- Adelaide Medical School, Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | - Claire T Roberts
- Adelaide Medical School, Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | - Gustaaf A Dekker
- Adelaide Medical School, Robinson Research Institute, University of Adelaide, Adelaide, Australia.,Women and Children's Division, Lyell McEwin Hospital, Elizabeth Vale, South Australia, Australia
| |
Collapse
|
30
|
Akison LK, Andraweera PH, Bertoldo MJ, Brown HM, Cuffe JSM, Fullston T, Holland O, Schjenken JE. The current state of reproductive biology research in Australia and New Zealand: core themes from the Society for Reproductive Biology Annual Meeting, 2016. Reprod Fertil Dev 2018; 29:1883-1889. [PMID: 27918727 DOI: 10.1071/rd16382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 10/24/2016] [Indexed: 11/23/2022] Open
Abstract
Because reproduction is essential for all life, it is central to our understanding of all aspects of biology. The Society for Reproductive Biology (SRB) 2016 conference held on the Gold Coast (Qld, Australia) displayed the current breadth of reproductive research in Australia and New Zealand, with additional insights from world leaders in the field. This conference review provides a focused summary of the key questions, emerging ideas and novel technologies that were presented in the symposia. Presented research demonstrated key advances in how stem cell biology may allow us to better understand pluripotency, as well as how environmental and lifestyle factors, such as circadian disruption, smoking, alcohol and diet, affect gametogenesis, embryo implantation, placental function and reproductive capacity. Sessions also highlighted the role of reproductive biology in providing insight into the mechanisms and processes governing a wide range of biological science disciplines, including cancer research and therapies, oncofertility, conservation of native species and chronic non-communicable diseases. Recurring themes included the importance of male and female gamete quality for reproductive potential and the critical and varied roles of the placenta in the maintenance of a healthy pregnancy. Dysregulation of reproductive processes can contribute to a variety of pathological states that affect future health, fertility and fecundity. Research being conducted by the SRB has the potential to shape not only the fertility of the current generation, but also the health and reproductive viability of future generations.
Collapse
Affiliation(s)
- L K Akison
- School of Biomedical Sciences, Sir William MacGregor Building, The University of Queensland, St Lucia, Qld 4072, Australia
| | - P H Andraweera
- Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Medical School North, Frome Rd, Adelaide, SA 5005, Australia
| | - M J Bertoldo
- School of Women's and Children's Health, The University of New South Wales, Wallace Wurth Building, Botany Street, Sydney, NSW 2052, Australia
| | - H M Brown
- Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Medical School North, Frome Rd, Adelaide, SA 5005, Australia
| | - J S M Cuffe
- School of Medical Science, Menzies Health Institute Queensland, Griffith University, Parklands Dve, Southport, Qld 4222, Australia
| | - T Fullston
- Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Medical School North, Frome Rd, Adelaide, SA 5005, Australia
| | - O Holland
- School of Medical Science, Menzies Health Institute Queensland, Griffith University, Parklands Dve, Southport, Qld 4222, Australia
| | - J E Schjenken
- Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Medical School North, Frome Rd, Adelaide, SA 5005, Australia
| |
Collapse
|
31
|
Bertoldo MJ, Andraweera PH, Bromfield EG, Cousins FL, Lindsay LA, Paiva P, Regan SL, Rose RD, Akison LK. Recent and emerging reproductive biology research in Australia and New Zealand: highlights from the Society for Reproductive Biology Annual Meeting, 2017. Reprod Fertil Dev 2018; 30:1049-1054. [PMID: 29381876 DOI: 10.1071/rd17445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 12/09/2017] [Indexed: 12/27/2022] Open
Abstract
Research in reproductive science is essential to promote new developments in reproductive health and medicine, agriculture and conservation. The Society for Reproductive Biology (SRB) 2017 conference held in Perth (WA, Australia) provided a valuable update on current research programs in Australia and New Zealand. This conference review delivers a dedicated summary of significant questions, emerging concepts and innovative technologies presented in the symposia. This research demonstrates significant advances in the identification of precursors for a healthy pregnancy, birth and child, and discusses how these factors can influence disease risk. A key theme included preconception parental health and its effect on gametogenesis, embryo and fetal development and placental function. In addition, the perturbation of key developmental checkpoints was shown to contribute to a variety of pathological states that have the capacity to affect health and fertility. Importantly, the symposia discussed in this review emphasised the role of reproductive biology as a conduit for understanding the transmission of non-communicable diseases, such as metabolic disorders and cancers. The research presented at SRB 2017 has revealed key findings that have the prospect to change not only the fertility of the present generation, but also the health and reproductive capacity of future generations.
Collapse
Affiliation(s)
- M J Bertoldo
- Fertility and Research Centre, School of Women's and Children's Health, The University of New South Wales, Wallace Wurth Building, Randwick, NSW 2052, Australia
| | - P H Andraweera
- Adelaide Medical School and Robinson Research Institute, The University of Adelaide, North Terrace, Adelaide, SA 5005, Australia
| | - E G Bromfield
- Priority Research Centre for Reproductive Science, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - F L Cousins
- The Ritchie Centre, Hudson Institute of Medical Research, 27-31 Wright Street, Clayton, Vic. 3141, Australia
| | - L A Lindsay
- School of Medical Sciences (Anatomy and Histology), The University of Sydney, Anderson Stuart Building, F13, Sydney, NSW 2006, Australia
| | - P Paiva
- Gynaecology Research Centre, Department of Obstetrics and Gynaecology, Royal Women's Hospital, The University of Melbourne, Parkville, Vic. 3010, Australia
| | - S L Regan
- Stem Cell and Cancer Biology Laboratory, School of Biomedical Sciences, Curtin Health Innovation Research Institute, Curtin University, Perth, WA 6102, Australia
| | - R D Rose
- Adelaide Medical School and Robinson Research Institute, The University of Adelaide, North Terrace, Adelaide, SA 5005, Australia
| | - L K Akison
- School of Biomedical Sciences, Sir William MacGregor Building, The University of Queensland, St Lucia, Qld 4072, Australia
| |
Collapse
|
32
|
Andraweera PH, Gatford KL, Dekker GA, Leemaqz S, Jayasekara RW, Dissanayake VHW, McCowan L, Roberts CT. The INSR rs2059806 single nucleotide polymorphism, a genetic risk factor for vascular and metabolic disease, associates with pre-eclampsia. Reprod Biomed Online 2017; 34:392-398. [PMID: 28117222 DOI: 10.1016/j.rbmo.2017.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 01/01/2017] [Accepted: 01/04/2017] [Indexed: 12/16/2022]
Abstract
Pre-eclampsia is a risk factor for later life vascular and metabolic diseases. This study postulates that this reflects a common genetic cause, and investigates whether the INSR rs2059806 single nucleotide polymorphism (SNP) (a risk factor for essential hypertension, type 2 diabetes and metabolic syndrome) is also associated with pre-eclampsia. The association of INSR rs2059806 with pre-eclampsia was tested in two cohorts - a Caucasian case control group (123 pre-eclamptic mother-father-baby trios and 1185 mother-father-baby trios from uncomplicated pregnancies) and an independent cohort of Sinhalese women (175 women with pre-eclampsia and 171 women with uncomplicated pregnancies). In the Caucasian cohort, the prevalence of the INSR rs2059806 AA genotype was greater among pre-eclamptic women compared with the uncomplicated pregnancies (12.7% versus 4.7%, OR[95%CI] = 3.1[1.6-5.8], P = 0.0003). In the Sinhalese cohort, maternal INSR rs2059806 AA genotype was greater among pre-eclamptic women who delivered small for gestational age infants compared with the uncomplicated pregnancies (10.8% versus 4.2%, OR[95%CI] = 2.8[1.0-7.4], P = 0.03). Thus, it was found that the INSR rs2059806 SNP is also associated with pre-eclampsia phenotypes in two independent cohorts suggesting that genetic susceptibility may be implicated in the link between pre-eclampsia and subsequent vascular and metabolic diseases.
Collapse
Affiliation(s)
- Prabha H Andraweera
- Discipline of Obstetrics and Gynaecology, School of Medicine and Robinson Research Institute, The University of Adelaide, Adelaide, Australia.
| | - Kathryn L Gatford
- Discipline of Obstetrics and Gynaecology, School of Medicine and Robinson Research Institute, The University of Adelaide, Adelaide, Australia
| | - Gustaaf A Dekker
- Discipline of Obstetrics and Gynaecology, School of Medicine and Robinson Research Institute, The University of Adelaide, Adelaide, Australia; Women's and Children's Division, Lyell McEwin Hospital, Elizabeth Vale, Australia
| | - Shalem Leemaqz
- Discipline of Obstetrics and Gynaecology, School of Medicine and Robinson Research Institute, The University of Adelaide, Adelaide, Australia
| | - Rohan W Jayasekara
- Human Genetics Unit, Faculty of Medicine, The University of Colombo, Colombo, Sri Lanka
| | | | - Lesley McCowan
- Department of Obstetrics and Gynaecology, The University of Auckland, Auckland, New Zealand
| | - Claire T Roberts
- Discipline of Obstetrics and Gynaecology, School of Medicine and Robinson Research Institute, The University of Adelaide, Adelaide, Australia
| |
Collapse
|
33
|
Andraweera PH, Dekker GA, Leemaqz S, McCowan L, Roberts CT. The obesity associated FTO gene variant and the risk of adverse pregnancy outcomes: Evidence from the SCOPE study. Obesity (Silver Spring) 2016; 24:2600-2607. [PMID: 27768255 DOI: 10.1002/oby.21662] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 07/19/2016] [Accepted: 08/02/2016] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To investigate whether the FTO rs9939609 single nucleotide polymorphism (SNP), which is a risk factor for obesity and vascular diseases, is also associated with pregnancy complications including pre-eclampsia, gestational hypertension, small for gestational age pregnancy (SGA), and spontaneous preterm birth (sPTB). METHODS A case-control study of 1,741 nulliparous Caucasian women, their partners, and infants was conducted. DNA was extracted from peripheral blood or saliva from parents and cord blood from infants and genotyped using the Sequenom MassARRAY system. RESULTS The prevalence of maternal and infant AA genotype of FTO rs9939609 was increased in the SGA group compared with the uncomplicated pregnancy group (19.2% vs. 13.4%, OR = 1.7, 95% CI = 1.1-2.6, P = 0.02 and 24.6% vs. 12.5%, OR = 2.7, 95% CI = 1.6-4.6, P = 0.0002). The prevalence of maternal and infant AA genotype of FTO rs9939609 was also increased in the sPTB group compared with the uncomplicated pregnancy group (20.8% vs. 13.4%, OR = 2.1, 95% CI = 1.2-3.8, P = 0.009 and 20.0% vs. 12.5%, OR = 2.4, 95% CI = 1.0-5.3, P = 0.03). CONCLUSIONS The maternal and infant AA genotype of the obesity associated FTO rs9939609 SNP associates with increased risk for SGA and sPTB. This SNP may be important in predicting the risk of these pregnancy complications and subsequent vascular diseases.
Collapse
Affiliation(s)
- Prabha H Andraweera
- Discipline of Obstetrics and Gynaecology, Adelaide Medical School, Robinson Research Institute, The University of Adelaide, Adelaide, Australia
| | - Gustaaf A Dekker
- Discipline of Obstetrics and Gynaecology, Adelaide Medical School, Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Women's and Children's Division, Lyell McEwin Hospital, Adelaide, South Australia
| | - Shalem Leemaqz
- Discipline of Obstetrics and Gynaecology, Adelaide Medical School, Robinson Research Institute, The University of Adelaide, Adelaide, Australia
| | - Lesley McCowan
- Department of Obstetrics and Gynaecology, The University of Auckland, Auckland, New Zealand
| | - Claire T Roberts
- Discipline of Obstetrics and Gynaecology, Adelaide Medical School, Robinson Research Institute, The University of Adelaide, Adelaide, Australia
| | | |
Collapse
|
34
|
Andraweera PH, Bobek G, Bowen C, Burton GJ, Correa Frigerio P, Chaparro A, Dickinson H, Duncombe G, Hyett J, Illanes SE, Johnstone E, Kumar S, Morgan TK, Myers J, Orefice R, Roberts CT, Salafia CM, Thornburg KL, Whitehead CL, Bainbridge SA. IFPA meeting 2015 workshop report II: mechanistic role of the placenta in fetal programming; biomarkers of placental function and complications of pregnancy. Placenta 2015; 48 Suppl 1:S7-S11. [PMID: 26733365 DOI: 10.1016/j.placenta.2015.12.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 12/14/2015] [Accepted: 12/18/2015] [Indexed: 11/17/2022]
Abstract
Workshops are an integral component of the annual International Federation of Placenta Association (IFPA) meeting, allowing for networking and focused discussion related to specialized topics on the placenta. At the 2015 IFPA meeting (Brisbane, Australia) twelve themed workshops were held, three of which are summarized in this report. These workshops focused on various aspects of placental function, particularly in cases of placenta-mediated disease. Collectively, these inter-connected workshops highlighted the role of the placenta in fetal programming, the use of various biomarkers to monitor placental function across pregnancy, and the clinical impact of novel diagnostic and surveillance modalities in instances of late onset fetal growth restriction (FGR).
Collapse
Affiliation(s)
- P H Andraweera
- Discipline of Obstetrics and Gynaecology, School of Medicine, Robinson Research Institute, The University of Adelaide, Adelaide, Australia
| | - G Bobek
- University of Western Sydney, Australia
| | - C Bowen
- Shimadzu Scientific, Australia
| | - G J Burton
- Centre for Trophoblast Research, University of Cambridge, Cambridge, UK
| | - P Correa Frigerio
- Biology of Reproduction Laboratory, Universidad de los Andes, Santiago, Chile
| | - A Chaparro
- Biology of Reproduction Laboratory, Universidad de los Andes, Santiago, Chile
| | - H Dickinson
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Australia
| | - G Duncombe
- University of Queensland Centre for Clinical Research, Brisbane, Queensland, Australia
| | - J Hyett
- Department of High Risk Obstetrics, RPA Women and Babies, Royal Prince Alfred Hospital, Discipline of Obstetrics, Gynaecology and Neonatology, Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia
| | - S E Illanes
- Biology of Reproduction Laboratory, Universidad de los Andes, Santiago, Chile
| | - E Johnstone
- Maternal and Fetal Health Research Centre, University of Manchester, Manchester, UK
| | - S Kumar
- Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia
| | - T K Morgan
- Oregon Health Science University, Portland, OR, USA
| | - J Myers
- Maternal and Fetal Health Research Centre, University of Manchester, Manchester, UK; Manchester Academic Health Science Centre, Manchester, UK
| | - R Orefice
- Australian National University, Canberra, Australia
| | - C T Roberts
- Discipline of Obstetrics and Gynaecology, School of Medicine, Robinson Research Institute, The University of Adelaide, Adelaide, Australia
| | - C M Salafia
- Placental Analytics, LLC, Larchmont, NY, USA; Institute for Basic Research, Staten Island, NY, USA
| | | | - C L Whitehead
- Translational Obstetrics Group, University of Melbourne, Melbourne, Australia
| | - S A Bainbridge
- Interdisciplinary School of Health Sciences and Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Canada.
| |
Collapse
|
35
|
Andraweera PH, Gatford KL, Dekker GA, Leemaqz S, Russell D, Thompson SD, McCowan L, Roberts CT. Insulin family polymorphisms in pregnancies complicated by small for gestational age infants. Mol Hum Reprod 2015; 21:745-52. [DOI: 10.1093/molehr/gav031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 06/01/2015] [Indexed: 11/12/2022] Open
|
36
|
Andraweera PH, Dekker GA, Jayasekara RW, Dissanayake VHW, Roberts CT. The obesity-related FTO gene variant associates with the risk of recurrent miscarriage. Acta Obstet Gynecol Scand 2015; 94:722-726. [PMID: 25845303 DOI: 10.1111/aogs.12640] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 03/29/2015] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To investigate the association of the fat mass and obesity associated gene (FTO) rs9939609 single nucleotide polymorphism with recurrent miscarriage. DESIGN Candidate gene association study. SETTING Human Genetics Unit, Colombo, Sri Lanka. POPULATION A total of 202 Sinhalese women with two or more first-trimester miscarriages and no living children (cases) and 202 age- and ethnicity-matched women with no history of miscarriage and having two or more living children (controls). METHODS Peripheral blood was collected from the participants and DNA was extracted. Genotyping was performed at the Australian genome Research Facility using the Sequenom MassARRAY system. Genotype and allele frequencies of cases were compared with controls using chi-squared testing. MAIN OUTCOME MEASURES The prevalence of the single nucleotide polymorphism in cases and controls. RESULTS The mean age of the women in the recurrent miscarriage group was 31.9 ± 0.4 years and that of the control group was 32.3 ± 0.3 years. Of the women in the recurrent miscarriage group, 140 (69.3%) had experienced three or more first-trimester miscarriages. The prevalence of the AA genotype [p = 0.0002, odds ratio (95% CI) = 3.8 (1.8-8.0)] and A allele [p = 0.002, odds ratio (95% CI) = 1.6 (1.2-2.2)] of the FTO rs9939609 single nucleotide polymorphism were increased in women in the recurrent miscarriage group compared with the control group. CONCLUSION The obesity-related FTO rs9939609 single nucleotide polymorphism associates with recurrent miscarriage. This finding warrants further investigation with controlling for important factors such as body mass index, diabetes and cardiovascular disease status. The single nucleotide polymorphism may be useful in predicting the risk of recurrent miscarriage.
Collapse
Affiliation(s)
- Prabha H Andraweera
- School of Paediatrics and Reproductive Health, Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.,Human Genetics Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Gustaaf A Dekker
- School of Paediatrics and Reproductive Health, Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.,Women's and Children's Division, Lyell McEwin Hospital, Elizabeth Vale, South Australia, Australia
| | - Rohan W Jayasekara
- Human Genetics Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | - Claire T Roberts
- School of Paediatrics and Reproductive Health, Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| |
Collapse
|
37
|
Andraweera PH, Dekker GA, Jayasekara RW, Dissanayake VHW, Roberts CT. Polymorphisms in the inflammatory pathway genes and the risk of preeclampsia in Sinhalese women. J Matern Fetal Neonatal Med 2015; 29:1072-6. [DOI: 10.3109/14767058.2015.1034102] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
38
|
Andraweera PH, Dekker GA, Thompson SD, Nowak RC, Jayasekara RW, Dissanayake VHW, Roberts CT. Polymorphisms in the fibrinolytic pathway genes and the risk of recurrent spontaneous abortion. Reprod Biomed Online 2014; 29:745-51. [PMID: 25444509 DOI: 10.1016/j.rbmo.2014.08.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Revised: 07/23/2014] [Accepted: 08/07/2014] [Indexed: 11/19/2022]
Abstract
Impaired fibrinolytic activity is implicated in the pathogenesis of recurrent spontaneous abortion (RSA). This case-control study assessed the prevalence of polymorphisms in fibrinolytic system genes in RSA. Cases comprised 202 Sinhalese women who had experienced at least two first-trimester spontaneous abortions and had no living children; controls were 202 women with no history of spontaneous abortion and two or more living children. The groups were matched for age and ethnicity. DNA was genotyped using the Sequenom MassARRAY system. The PLAUR rs4251923 A (OR 95% CI 2.3 [1.3 to 4.0]), SERBP2 rs6098 A (OR 95% CI 1.4 [1.1 to 1.9]) and SERBP2 rs6103 C alleles (OR 95% CI 1.4 [1.1 to 1.9]) were increased in the RSA group compared with controls. The prevalence of PLAUR rs4251923/ SERBP2 rs6098/ SERBP2 rs6103 GG/AA/CC (OR 95% CI 2.4 [1.2 to 4.9], GA/GA/GC(OR 95% CI 3.9 [1.3 to 11.2]), GA/AA/CC (OR 95% CI 2.9 [1.0 to 8.6] and GA/GG/GG (OR 95% CI 21.3 [1.1 to 410.3]) genotypes were also increased in cases. Polymorphisms in the fibrinolytic system genes are associated with RSA in Sinhalese women. These likely impair implantation.
Collapse
Affiliation(s)
- Prabha H Andraweera
- School of Paediatrics and Reproductive Health, Robinson Research Institute, University of Adelaide, Adelaide, Australia; Human Genetics Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
| | - Gustaaf A Dekker
- School of Paediatrics and Reproductive Health, Robinson Research Institute, University of Adelaide, Adelaide, Australia; Women's and Children's Division, Lyell McEwin Hospital, Elizabeth Vale, South Australia, Australia
| | - Steven D Thompson
- School of Paediatrics and Reproductive Health, Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | - Rachael C Nowak
- School of Paediatrics and Reproductive Health, Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | - Rohan W Jayasekara
- Human Genetics Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | - Claire T Roberts
- School of Paediatrics and Reproductive Health, Robinson Research Institute, University of Adelaide, Adelaide, Australia
| |
Collapse
|
39
|
Wettasinghe KT, Sirisena ND, Andraweera PH, Jayasekara RW, Dissanayake VHW. A case series of five sri lankan patients with ovotesticular disorder of sex development. Clin Pediatr Endocrinol 2013; 21:69-73. [PMID: 23926413 PMCID: PMC3687650 DOI: 10.1297/cpe.21.69] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Accepted: 07/17/2012] [Indexed: 11/04/2022] Open
Abstract
Ovotesticular disorder of sex development (OT-DSD) is a rare disorder of sexual differentiation in which the gonads of an individual are characterized by the presence of both mature ovarian and testicular tissues. The objective of this paper is to report the clinical, cytogenetic and histopathological findings in Sri Lankan patients diagnosed with OT-DSD who were referred to the Human Genetics Unit for cytogenetic evaluation during 2005 to 2011. Five patients had histopathologically confirmed OT-DSD. Their ages at presentation ranged from 2 mo to 47 yr. Clinical symptoms varied from ambiguous genitalia and inguinal hernias at birth to a lower abdominal mass presenting in adulthood. All 5 were reared as phenotypic males. An ovotestis was detected in all cases except one, and the predominant karyotype was 46,XY. The findings in this series of predominantly 46,XY karyotype are in contrast to previously published reports that have reported 46,XX as being the predominant karyotype. It is therefore recommended that individuals with ambiguous genitalia who have the 46,XY karyotype should be thoroughly investigated by ultrasonographic or laparoscopic assessment to determine the exact nature of their internal genital organs. OT-DSD should also be considered in the differential diagnosis of patients with cryptorchidism and inguinal hernia.
Collapse
Affiliation(s)
- Kalum T Wettasinghe
- Human Genetics Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | | | | | | |
Collapse
|
40
|
Andraweera PH, Dekker GA, Dissanayake VHW, Bianco-Miotto T, Jayasekara RW, Roberts CT. Vascular endothelial growth factor family gene polymorphisms in preeclampsia in Sinhalese women in Sri-Lanka. J Matern Fetal Neonatal Med 2012; 26:532-6. [PMID: 23102494 DOI: 10.3109/14767058.2012.743520] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To investigate the association of polymorphisms in the vascular endothelial growth factor (VEGF) family genes (VEGFA rs699947, VEGFA rs3025039, PGF rs1042886, KDR rs2071559 and KDR rs2305948) with preeclampsia in Sinhalese women in Sri-Lanka. METHODS We conducted a case-control study where 175 nulliparous Sinhalese women with preeclampsia and 171 normotensive women matched for age, ethnicity, parity and BMI were recruited in tertiary care maternity hospitals in Sri-Lanka. Preeclampsia was diagnosed using international guidelines. DNA extracted from peripheral venous blood and was genotyped using the Sequenom MassARRAY system. χ(2)-test was used to compare the distribution of allele and genotype frequencies between the cases and the control subjects. RESULTS The frequency of PGF rs1042886 variant allele (odds ratio (OR) 1.5, 95% confidence interval (CI) 1.1-2.1) and dominant genotype model (aOR 1.6, 95% CI 1.0-2.4) were increased in preeclamptic women compared to controls. VEGFA rs699947, VEGFA rs3025039, KDR rs2071559, and KDR rs2305948 polymorphisms were not associated with preeclampsia. CONCLUSION Maternal PGF rs1042886 polymorphism is associated with preeclampsia in Sinhalese women in Sri-Lanka.
Collapse
Affiliation(s)
- Prabha H Andraweera
- Discipline of Obstetrics and Gynaecology, Robinson Institute, University of Adelaide, Adelaide, Australia
| | | | | | | | | | | |
Collapse
|
41
|
Abstract
BACKGROUND Pre-eclampsia, small-for-gestational-age infants, preterm birth and recurrent miscarriage complicate a significant number of pregnancies. The vascular endothelial growth factor (VEGF) family of angiogenic growth factors is implicated in the pathophysiology of these complications. We aimed to elucidate the role of these angiogenic factors in placentation and to evaluate the predictive value of their protein concentrations and genetic variations in pregnancy complications. METHODS We performed a systematic search of PubMed, and retrieved original articles. The search included a combination of terms such as VEGF-A, placental growth factor (PlGF), kinase insert domain receptor, fms-like-tyrosine-kinase receptor 1, soluble fms-like-tyrosine-kinase receptor 1, pre-eclampsia, small-for-gestational-age infants, preterm birth, recurrent miscarriage, placenta, prediction and polymorphisms. RESULTS This review summarizes the current knowledge of the roles of the VEGF family in early placentation and of the abnormalities in maternal plasma and placental expression of angiogenic proteins in adverse pregnancy outcomes compared with normal pregnancy. PlGF and sFLT-1 in combination with other clinical and biochemical markers in late first or second trimester appear to predict early-onset pre-eclampsia with a high sensitivity and specificity. However, VEGF family proteins do not have sufficient power to accurately predict late-onset pre-eclampsia, small-for-gestational age pregnancies or preterm birth. Functional polymorphisms in these angiogenic genes are implicated in pregnancy complications, but their contribution appears to be minor. CONCLUSIONS Although the VEGF family has important roles in normal and complicated pregnancy, the current predictive value of the VEGF family as biomarkers appears to be limited to early-onset pre-eclampsia.
Collapse
Affiliation(s)
- P H Andraweera
- Discipline of Obstetrics and Gynaecology, Robinson Institute, University of Adelaide, Adelaide 5005, Australia
| | | | | |
Collapse
|
42
|
Andraweera PH, Dekker GA, Thompson SD, North RA, McCowan LM, Roberts CT. The interaction between the maternal BMI and angiogenic gene polymorphisms associates with the risk of spontaneous preterm birth. ACTA ACUST UNITED AC 2012; 18:459-65. [DOI: 10.1093/molehr/gas016] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
43
|
Andraweera PH, Dekker GA, Thompson SD, Roberts CT. Single-nucleotide polymorphisms in the KDR gene in pregnancies complicated by gestational hypertensive disorders and small-for-gestational-age infants. Reprod Sci 2012; 19:547-54. [PMID: 22344734 DOI: 10.1177/1933719111428520] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Pregnancies complicated by preeclampsia and small-for-gestational-age (SGA) infants share placental vascular abnormalities and both disorders confer increased risk of later life coronary artery disease. Kinase insert domain receptor (KDR) is the main receptor for vascular endothelial growth factor A, a potent angiogenic factor which regulates the development of the placental vasculature. Two polymorphisms in KDR (-604T/C and Val297Ile) are known to be associated with coronary artery disease. We investigated the association of these polymorphisms with preeclampsia, gestational hypertension, and SGA infants. METHOD Nulliparous pregnant women, their partners, and infants were recruited to a prospective cohort study (n = 1169). Doppler ultrasound of the uterine and umbilical arteries was performed at 20 weeks of gestation. Preeclampsia, gestational hypertension, and SGA were defined according to international guidelines. DNA extracted from peripheral venous or cord blood was genotyped using the Sequenom MassARRAY system. Multivariable logistic regression was used to compare the odds for the pregnancy complications between the genotype groups adjusting for potential confounders. RESULTS Among 937 Caucasian pregnancies, 427 (45.6%) were uncomplicated, 75 (8.0%) developed preeclampsia, 102 (10.9%) developed gestational hypertension, and 72 (7.7%) had SGA infants in the absence of maternal hypertensive disease. Paternal and neonatal KDR-604T/C was associated with preeclampsia (adjusted odds ratio [aOR] 1.6, 95% confidence interval [CI] 1.0-3.0 and aOR 2.2, 95% CI 1.0-4.4), SGA (aOR 1.9, 95% CI 1.1-3.3 and aOR 2.2, 95% CI 1.2-3.9), and SGA with abnormal Doppler (aOR 2.7, 95% CI 1.2-5.9 and aOR 3.2, 95% CI 1.2-5.9). CONCLUSION Paternal and neonatal carriage of the KDR-604T/C polymorphism is associated with the risk of preeclampsia and SGA infants.
Collapse
Affiliation(s)
- Prabha H Andraweera
- Discipline of Obstetrics and Gynaecology, Robinson Institute, University of Adelaide, Australia
| | | | | | | |
Collapse
|
44
|
Andraweera PH. Association of Vascular Endothelial Growth Factor +936 C/T Single-Nucleotide Polymorphism With Pregnancies Complicated by Small-for-Gestational-Age Babies. ACTA ACUST UNITED AC 2011; 165:1123-30. [DOI: 10.1001/archpediatrics.2011.796] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
45
|
Andraweera PH, Dekker GA, Thompson SD, North RA, McCowan LME, Roberts CT. A functional variant in the thrombospondin-1 gene and the risk of small for gestational age infants. J Thromb Haemost 2011; 9:2221-8. [PMID: 21883885 DOI: 10.1111/j.1538-7836.2011.04494.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Thrombospondin-1 (TSP-1) is a prothrombotic and anti-angiogenic glycoprotein expressed in the placenta. A functional single nucleotide polymorphism in the TSP-1 gene (TSP-1 A2210G) is a risk factor for familial premature myocardial infarction. Small for gestational age (SGA) infants are at increased risk of coronary artery disease in adult life and common genetic factors may underlie both conditions. We investigated the association of TSP-1 A2210G in SGA infants and their parents. METHOD The 3234 nulliparous pregnant women, their partners and babies were recruited in Adelaide and Auckland to a prospective multicenter cohort study. Amongst 2123 Caucasian women, 216 (10.2%) delivered an SGA infant, defined as birth weight < 10th customized centile adjusted for maternal height, weight, parity and ethnicity, as well as gestational age at delivery and infant sex. Uncomplicated pregnancies served as controls (n = 1185). DNA extracted from peripheral/cord blood or buccal swabs was genotyped using Sequenom MassARRAY. Multivariable logistic regression was used to compare the odds of SGA between the genotype groups adjusting for potential confounders. RESULTS Paternal (adjOR, 1.4; 95% CI 1.0-2.0) and neonatal (adjOR, 1.8; 95% CI, 1.1-2.7) TSP-1 A2210G associates with SGA. The maternal polymorphism approaches significance for an association with SGA (adjOR, 1.3; 95% CI, 0.9-1.9). Maternal TSP-1 A2210G associates with a reduced maternal birth weight adjusted for gestational age at delivery (P = 0.03). CONCLUSION The TSP-1 A2210G polymorphism, which is a risk factor for myocardial infarction, is associated with SGA pregnancies, suggesting that this polymorphism may associate with the risk of vascular disorders across the life course.
Collapse
Affiliation(s)
- P H Andraweera
- Discipline of Obstetrics and Gynaecology, Research Centre for Reproductive Health, University of Adelaide, Adelaide, Australia
| | | | | | | | | | | |
Collapse
|