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Dugalic S, Petronijevic M, Sengul D, Detanac DA, Sengul I, Veiga ECDA, Stanisavljevic T, Macura M, Todorovic J, Gojnic M. Hereditary thrombophilia and low -molecular -weight heparin in women: useful determinants, including thyroid dysfunction, incorporating the management of treatment and outcomes of the entity. Rev Assoc Med Bras (1992) 2023; 69:335-340. [PMID: 36888774 PMCID: PMC9983488 DOI: 10.1590/1806-9282.20221445] [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] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 11/04/2022] [Indexed: 03/08/2023]
Abstract
OBJECTIVE Our study purposed to examine the complex relationship between low-molecular-weight heparin therapy, multiple pregnancy determinants, and adverse pregnancy outcomes during the third trimester in women with inherited thrombophilia. METHODS Patients were selected from a prospective cohort of 358 pregnant patients recruited between 2016 and 2018 at the Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, Belgrade. RESULTS Gestational age at delivery (β=-0.081, p=0.014), resistance index of the umbilical artery (β=0.601, p=0.039), and D-dimer (β=0.245, p<0.001) between 36th and 38th weeks of gestation presented the direct predictors for adverse pregnancy outcomes. The model fit was examined using the root mean square error of approximation 0.00 (95%CI 0.00-0.18), the goodness-of-fit index was 0.998, and the adjusted goodness-of-fit index was 0.966. CONCLUSION There is a need for the introduction of more precise protocols for the assessment of hereditary thrombophilias and the need for the introduction of low-molecular-weight heparin.
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Affiliation(s)
- Stefan Dugalic
- University Clinical Center of Serbia, Clinic for Gynecology and Obstetrics - Belgrade, Serbia
| | - Milica Petronijevic
- Univerzitet u Beogradu, Faculty of Medicine, Department of Gynecology and Obstetrics - Belgrade, Serbia
| | - Demet Sengul
- Giresun Üniversitesi, Faculty of Medicine, Department of Pathology - Giresun, Turkey
| | - Dzenana A Detanac
- General Hospital Novi Pazar, Department of Ophthalmology - Novi Pazar, Serbia
| | - Ilker Sengul
- Giresun Üniversitesi, Faculty of Medicine, Division of Endocrine Surgery - Giresun, Turkey.,Giresun Üniversitesi, Faculty of Medicine, Department of General Surgery - Giresun, Turkey
| | - Eduardo Carvalho de Arruda Veiga
- Universidade de São Paulo, Faculty of Medicine of Ribeirão Preto, Department of Gynecology and Obstetrics - São Paulo (SP), Brazil
| | - Tamara Stanisavljevic
- Univerzitet u Beogradu, Faculty of Medicine, Department of Gynecology and Obstetrics - Belgrade, Serbia
| | - Maja Macura
- University Clinical Center of Serbia, Clinic for Gynecology and Obstetrics - Belgrade, Serbia
| | - Jovana Todorovic
- Univerzitet u Beogradu, Institute of Social Medicine, Faculty of Medicine - Belgrade, Serbia
| | - Miroslava Gojnic
- University Clinical Center of Serbia, Clinic for Gynecology and Obstetrics - Belgrade, Serbia.,Univerzitet u Beogradu, Institute of Social Medicine, Faculty of Medicine - Belgrade, Serbia
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Mostic Stanisic D, Kalezic N, Rajovic N, Ilic Mostic T, Cumic J, Stanisavljevic T, Beleslin A, Stulic J, Rudic I, Divac N, Milic N, Stojanovic R. Effect of regional vs general anesthesia on vital functions after cesarean section: a single center experience. Hypertens Pregnancy 2022; 41:198-203. [DOI: 10.1080/10641955.2022.2124417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Danka Mostic Stanisic
- Clinic for Gynecology and Obstetrics, Clinical Center “Dragisa Misovic–Dedinje”, Belgrade, Serbia
- Clinic of Gynecology and Obstetrics, Clinical Centre of Serbia, Belgrade, Serbia
| | - Nevena Kalezic
- Faculty of Medicine University of Belgrade, Belgrade, Serbia
- Department of Anesthesiology, Clinic of Gynecology and Obstetrics, Clinical Centre of Serbia, Belgrade, Serbia
| | - Nina Rajovic
- Institute for Medical Statistics and Informatics, Faculty of Medicine University of Belgrade, Belgrade, Serbia
| | - Tatjana Ilic Mostic
- Department of Anesthesiology, Clinic of Gynecology and Obstetrics, Clinical Centre of Serbia, Belgrade, Serbia
| | - Jelena Cumic
- Department of Anesthesiology, Clinic for Cardiac Surgery, Clinical Centre of Serbia, Belgrade, Serbia
| | | | - Aleksandra Beleslin
- Clinic of Gynecology and Obstetrics, Clinical Centre of Serbia, Belgrade, Serbia
| | - Jelena Stulic
- Clinic for Gynecology and Obstetrics “Narodni Front”, Belgrade, Serbia
| | - Ivana Rudic
- Clinic for Gynecology and Obstetrics “Narodni Front”, Belgrade, Serbia
| | - Nevena Divac
- Institute for Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine University of Belgrade, Serbia
| | - Natasa Milic
- Institute for Medical Statistics and Informatics, Faculty of Medicine University of Belgrade, Belgrade, Serbia
- Department of Internal Medicine, Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA
| | - Radan Stojanovic
- Institute for Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine University of Belgrade, Serbia
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Dugalic S, Petronijevic M, Vasiljevic B, Todorovic J, Stanisavljevic D, Jotic A, Lukic L, Milicic T, Lalić N, Lalic K, Stoiljkovic M, Terzic-Supic Z, Stanisavljevic T, Stefanovic A, Stefanovic K, Vrzic-Petronijevic S, Macura M, Pantic I, Piperac P, Jovanovic M, Cerovic R, Djurasevic S, Babic S, Perkovic-Kepeci S, Gojnic M. Trends of the Prevalence of Pre-gestational Diabetes in 2030 and 2050 in Belgrade Cohort. Int J Environ Res Public Health 2022; 19:ijerph19116517. [PMID: 35682099 PMCID: PMC9180675 DOI: 10.3390/ijerph19116517] [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] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/17/2022] [Accepted: 05/25/2022] [Indexed: 11/16/2022]
Abstract
The aim of this study was to analyze the trends in diabetes in pregnancy in Belgrade, Serbia for the period of the past decade and forecast the number of women with pre-gestational diabetes for the years 2030 and 2050. The study included the data on all pregnant women with diabetes from the registry of the deliveries in Belgrade, by the City Institute of Public Health of Belgrade, Serbia for the period between 2010 and 2020 and the published data on the deliveries on the territory of Belgrade. During the examined period the total number of live births in Belgrade was 196,987, and the prevalence of diabetes in pregnancy was 3.4%, with the total prevalence of pre-gestational diabetes of 0.7% and overall prevalence of GDM of 2.7%. The average age of women in our study was significantly lower in 2010 compared to 2020. The forecasted prevalence of pre-gestational diabetes among all pregnant women for 2030 is 2% and 4% for 2050 in our cohort. Our study showed that the prevalence of pre-gestational diabetes has increased both among all pregnant women and among women with diabetes in pregnancy in the past decade in Belgrade, Serbia and that it is expected to increase further in the next decades and to further double by 2050.
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Affiliation(s)
- Stefan Dugalic
- Faculty of Medicine, Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (S.D.); (M.P.); (A.S.); (K.S.); (S.V.-P.); (M.M.); (R.C.); (S.B.)
| | - Milos Petronijevic
- Faculty of Medicine, Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (S.D.); (M.P.); (A.S.); (K.S.); (S.V.-P.); (M.M.); (R.C.); (S.B.)
| | - Brankica Vasiljevic
- Maternity and Child Health Service, NMC Royal Hospital DIP, Dubai Hospital, Dubai P.O. Box 7832, United Arab Emirates;
| | - Jovana Todorovic
- Faculty of Medicine, Institute of Social Medicine, University of Belgrade, 11000 Belgrade, Serbia; (J.T.); (Z.T.-S.)
| | - Dejana Stanisavljevic
- Faculty of Medicine, Institute for Medical Statistics and Informatics, University of Belgrade, 11000 Belgrade, Serbia;
| | - Aleksandra Jotic
- Faculty of Medicine, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (A.J.); (L.L.); (T.M.); (N.L.); (K.L.); (M.S.)
| | - Ljiljana Lukic
- Faculty of Medicine, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (A.J.); (L.L.); (T.M.); (N.L.); (K.L.); (M.S.)
| | - Tanja Milicic
- Faculty of Medicine, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (A.J.); (L.L.); (T.M.); (N.L.); (K.L.); (M.S.)
| | - Nebojsa Lalić
- Faculty of Medicine, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (A.J.); (L.L.); (T.M.); (N.L.); (K.L.); (M.S.)
| | - Katarina Lalic
- Faculty of Medicine, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (A.J.); (L.L.); (T.M.); (N.L.); (K.L.); (M.S.)
| | - Milica Stoiljkovic
- Faculty of Medicine, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (A.J.); (L.L.); (T.M.); (N.L.); (K.L.); (M.S.)
| | - Zorica Terzic-Supic
- Faculty of Medicine, Institute of Social Medicine, University of Belgrade, 11000 Belgrade, Serbia; (J.T.); (Z.T.-S.)
| | | | - Aleksandar Stefanovic
- Faculty of Medicine, Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (S.D.); (M.P.); (A.S.); (K.S.); (S.V.-P.); (M.M.); (R.C.); (S.B.)
| | - Katarina Stefanovic
- Faculty of Medicine, Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (S.D.); (M.P.); (A.S.); (K.S.); (S.V.-P.); (M.M.); (R.C.); (S.B.)
| | - Svetlana Vrzic-Petronijevic
- Faculty of Medicine, Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (S.D.); (M.P.); (A.S.); (K.S.); (S.V.-P.); (M.M.); (R.C.); (S.B.)
| | - Maja Macura
- Faculty of Medicine, Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (S.D.); (M.P.); (A.S.); (K.S.); (S.V.-P.); (M.M.); (R.C.); (S.B.)
| | - Igor Pantic
- Faculty of Medicine, Institute for Medical Physiology, University of Belgrade, 11000 Belgrade, Serbia;
| | - Pavle Piperac
- Department for Humanities, University of Belgrade, Faculty of Medicine, 11000 Belgrade, Serbia;
| | | | - Radmila Cerovic
- Faculty of Medicine, Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (S.D.); (M.P.); (A.S.); (K.S.); (S.V.-P.); (M.M.); (R.C.); (S.B.)
| | | | - Sandra Babic
- Faculty of Medicine, Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (S.D.); (M.P.); (A.S.); (K.S.); (S.V.-P.); (M.M.); (R.C.); (S.B.)
| | | | - Miroslava Gojnic
- Faculty of Medicine, Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (S.D.); (M.P.); (A.S.); (K.S.); (S.V.-P.); (M.M.); (R.C.); (S.B.)
- Correspondence:
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Gojnic M, Todorovic J, Stanisavljevic D, Jotic A, Lukic L, Milicic T, Lalic N, Lalic K, Stoiljkovic M, Stanisavljevic T, Stefanovic A, Stefanovic K, Vrzic-Petronijevic S, Petronijevic M, Terzic-Supic Z, Macura M, Perovic M, Babic S, Piperac P, Jovanovic M, Parapid B, Doklestic K, Cerovic R, Djurasevic S, Dugalic S. Maternal and Fetal Outcomes among Pregnant Women with Diabetes. IJERPH 2022; 19:ijerph19063684. [PMID: 35329371 PMCID: PMC8953700 DOI: 10.3390/ijerph19063684] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/12/2022] [Accepted: 03/15/2022] [Indexed: 02/08/2023]
Abstract
The aim of this study was to examine the differences in pregnancy complications, delivery characteristics, and neonatal outcomes between women with type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), and gestational diabetes mellitus (GDM). This study included all pregnant women with diabetes in pregnancy in Belgrade, Serbia, between 2010 and 2020. The total sample consisted of 6737 patients. In total, 1318 (19.6%) patients had T1DM, 138 (2.0%) had T2DM, and 5281 patients (78.4%) had GDM. Multivariate logistic regression with the type of diabetes as an outcome variable showed that patients with T1DM had a lower likelihood of vaginal delivery (OR: 0.73, 95% CI: 0.64–0.83), gestational hypertension (OR: 0.47, 95% CI: 0.36–0.62), higher likelihood of chronic hypertension (OR: 1.88, 95% CI: 1.55–2.29),and a higher likelihood ofgestational age at delivery before 37 weeks (OR: 1.38, 95% CI: 1.18–1.63) compared to women with GDM. Multivariate logistic regression showed that patients with T2DM had a lower likelihood ofgestational hypertension compared to women with GDM (OR: 0.37, 95% CI: 0.15–0.92).Our results indicate that the highest percentage of diabetes in pregnancy is GDM, and the existence of differences in pregnancy complications, childbirth characteristics, and neonatal outcomes are predominantly between women with GDM and women with T1DM.
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Affiliation(s)
- Miroslava Gojnic
- Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia; (M.G.); (A.S.); (K.S.); (S.V.-P.); (M.P.); (M.M.); (S.B.); (R.C.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (A.J.); (L.L.); (T.M.); (N.L.); (K.L.); (M.S.); (T.S.)
| | - Jovana Todorovic
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (J.T.); (Z.T.-S.)
| | - Dejana Stanisavljevic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Aleksandra Jotic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (A.J.); (L.L.); (T.M.); (N.L.); (K.L.); (M.S.); (T.S.)
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, 11000 Belgrade, Serbia
| | - Ljiljana Lukic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (A.J.); (L.L.); (T.M.); (N.L.); (K.L.); (M.S.); (T.S.)
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, 11000 Belgrade, Serbia
| | - Tanja Milicic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (A.J.); (L.L.); (T.M.); (N.L.); (K.L.); (M.S.); (T.S.)
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, 11000 Belgrade, Serbia
| | - Nebojsa Lalic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (A.J.); (L.L.); (T.M.); (N.L.); (K.L.); (M.S.); (T.S.)
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, 11000 Belgrade, Serbia
| | - Katarina Lalic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (A.J.); (L.L.); (T.M.); (N.L.); (K.L.); (M.S.); (T.S.)
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, 11000 Belgrade, Serbia
| | - Milica Stoiljkovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (A.J.); (L.L.); (T.M.); (N.L.); (K.L.); (M.S.); (T.S.)
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, 11000 Belgrade, Serbia
| | - Tamara Stanisavljevic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (A.J.); (L.L.); (T.M.); (N.L.); (K.L.); (M.S.); (T.S.)
| | - Aleksandar Stefanovic
- Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia; (M.G.); (A.S.); (K.S.); (S.V.-P.); (M.P.); (M.M.); (S.B.); (R.C.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (A.J.); (L.L.); (T.M.); (N.L.); (K.L.); (M.S.); (T.S.)
| | - Katarina Stefanovic
- Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia; (M.G.); (A.S.); (K.S.); (S.V.-P.); (M.P.); (M.M.); (S.B.); (R.C.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (A.J.); (L.L.); (T.M.); (N.L.); (K.L.); (M.S.); (T.S.)
| | - Svetlana Vrzic-Petronijevic
- Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia; (M.G.); (A.S.); (K.S.); (S.V.-P.); (M.P.); (M.M.); (S.B.); (R.C.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (A.J.); (L.L.); (T.M.); (N.L.); (K.L.); (M.S.); (T.S.)
| | - Milos Petronijevic
- Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia; (M.G.); (A.S.); (K.S.); (S.V.-P.); (M.P.); (M.M.); (S.B.); (R.C.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (A.J.); (L.L.); (T.M.); (N.L.); (K.L.); (M.S.); (T.S.)
| | - Zorica Terzic-Supic
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (J.T.); (Z.T.-S.)
| | - Maja Macura
- Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia; (M.G.); (A.S.); (K.S.); (S.V.-P.); (M.P.); (M.M.); (S.B.); (R.C.)
| | - Milan Perovic
- Clinic for Gynecology and Obstetrics “NarodniFront”, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Sandra Babic
- Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia; (M.G.); (A.S.); (K.S.); (S.V.-P.); (M.P.); (M.M.); (S.B.); (R.C.)
| | - Pavle Piperac
- Department for Humanities, Faculty of Medicine, University of Belgrade, 11000 belgrade, Serbia;
| | | | - Bijana Parapid
- Clinic for Cardiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Krisitna Doklestic
- Emergency Department, University Clinical Centre of Serbia, 11000 Belgrade, Serbia;
| | - Radmila Cerovic
- Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia; (M.G.); (A.S.); (K.S.); (S.V.-P.); (M.P.); (M.M.); (S.B.); (R.C.)
| | | | - Stefan Dugalic
- Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia; (M.G.); (A.S.); (K.S.); (S.V.-P.); (M.P.); (M.M.); (S.B.); (R.C.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (A.J.); (L.L.); (T.M.); (N.L.); (K.L.); (M.S.); (T.S.)
- Correspondence:
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Cirkovic A, Stanisavljevic D, Milin-Lazovic J, Rajovic N, Pavlovic V, Milicevic O, Savic M, Kostic Peric J, Aleksic N, Milic N, Stanisavljevic T, Mikovic Z, Garovic V, Milic N. Preeclamptic Women Have Disrupted Placental microRNA Expression at the Time of Preeclampsia Diagnosis: Meta-Analysis. Front Bioeng Biotechnol 2022; 9:782845. [PMID: 35004644 PMCID: PMC8740308 DOI: 10.3389/fbioe.2021.782845] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/22/2021] [Indexed: 12/18/2022] Open
Abstract
Introduction: Preeclampsia (PE) is a pregnancy-associated, multi-organ, life-threatening disease that appears after the 20th week of gestation. The aim of this study was to perform a systematic review and meta-analysis to determine whether women with PE have disrupted miRNA expression compared to women who do not have PE. Methods: We conducted a systematic review and meta-analysis of studies that reported miRNAs expression levels in placenta or peripheral blood of pregnant women with vs. without PE. Studies published before October 29, 2021 were identified through PubMed, EMBASE and Web of Science. Two reviewers used predefined forms and protocols to evaluate independently the eligibility of studies based on titles and abstracts and to perform full-text screening, data abstraction and quality assessment. Standardized mean difference (SMD) was used as a measure of effect size. Results: 229 publications were included in the systematic review and 53 in the meta-analysis. The expression levels in placenta were significantly higher in women with PE compared to women without PE for miRNA-16 (SMD = 1.51,95%CI = 0.55-2.46), miRNA-20b (SMD = 0.89, 95%CI = 0.33-1.45), miRNA-23a (SMD = 2.02, 95%CI = 1.25-2.78), miRNA-29b (SMD = 1.37, 95%CI = 0.36-2.37), miRNA-155 (SMD = 2.99, 95%CI = 0.83-5.14) and miRNA-210 (SMD = 1.63, 95%CI = 0.69-2.58), and significantly lower for miRNA-376c (SMD = -4.86, 95%CI = -9.51 to -0.20). An increased level of miRNK-155 expression was found in peripheral blood of women with PE (SMD = 2.06, 95%CI = 0.35-3.76), while the expression level of miRNA-16 was significantly lower in peripheral blood of PE women (SMD = -0.47, 95%CI = -0.91 to -0.03). The functional roles of the presented miRNAs include control of trophoblast proliferation, migration, invasion, apoptosis, differentiation, cellular metabolism and angiogenesis. Conclusion: miRNAs play an important role in the pathophysiology of PE. The identification of differentially expressed miRNAs in maternal blood creates an opportunity to define an easily accessible biomarker of PE.
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Affiliation(s)
- Andja Cirkovic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Dejana Stanisavljevic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Jelena Milin-Lazovic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Nina Rajovic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vedrana Pavlovic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ognjen Milicevic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marko Savic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Jelena Kostic Peric
- Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Belgrade, Serbia
| | - Natasa Aleksic
- Center for Molecular Biology, University of Vienna, Vienna, Austria
| | - Nikola Milic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Zeljko Mikovic
- Clinic for Gynecology and Obstetrics Narodni Front, Belgrade, Serbia
| | - Vesna Garovic
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, United States
| | - Natasa Milic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, United States
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Rajovic T, Todorovic N, Vracevic M, Rajovic N, Pavlovic A, Pavlovic V, Grbic I, Sapic R, Krsmanovic S, Vukmirovic M, Stanisavljevic T, Markovic K, Mostic T, Stanisavljevic D, Milic N. From Burden to Depressive Symptoms in Informal Caregivers during the COVID-19 Pandemic: A Path Analysis. Int J Environ Res Public Health 2021; 18:9577. [PMID: 34574500 PMCID: PMC8468340 DOI: 10.3390/ijerph18189577] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/03/2021] [Accepted: 09/04/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND The objective of this study was to assess the complex relationship between the multiple determinants of the caregiving process, the caregiver burden, and depression during the COVID-19 pandemic in Serbia. METHODS A cross-sectional study was conducted on a nationally representative sample (n = 798) during the COVID-19 pandemic in Serbia from March to September 2020. A nine-section questionnaire designed for this study included the characteristics of caregivers, characteristics of care and care recipients, COVID-19 related questions, and the following standardized instruments: 12-Item Short-Form Health Survey, Fatigue Severity Scale, Activities of Daily Living Scale and Instrumental Activities of Daily Living Scale, Zarit Caregiver Burden Scale, and Beck Depression Inventory. Path analysis was used for the simultaneous assessment of the direct and indirect relationships of all determinants. RESULTS More than two thirds (71.9%) of informal caregivers experienced a burden, and more than one quarter (27.1%) had depression symptomatology. Self-rated physical health, need for psychosocial support, and caregiver burden were the main direct predictors of depression. Multiple determinants of the caregiving process had indirect effects on depressive symptomatology via the caregiver burden as a mediating factor. CONCLUSIONS The subjective burden presented a significant risk factor for depressive symptoms in caregivers during the COVID-19 pandemic. The provision of psychosocial support was identified as an important opportunity to reduce depressive risk in informal caregivers.
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Affiliation(s)
- Tatjana Rajovic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (T.R.); (N.R.); (V.P.); (D.S.)
| | | | | | - Nina Rajovic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (T.R.); (N.R.); (V.P.); (D.S.)
| | - Andrija Pavlovic
- Department of Humanities, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Vedrana Pavlovic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (T.R.); (N.R.); (V.P.); (D.S.)
| | - Igor Grbic
- Department for Neurology and Psychiatry, Faculty of Medicine, 38220 Kosovska Mitrovica, Serbia;
| | - Rosa Sapic
- Department of Occupational Therapy, College for Social Work, 11000 Belgrade, Serbia;
| | - Slavica Krsmanovic
- Medical School, Academy of Applied Studies Belgrade, 11000 Belgrade, Serbia;
| | - Marijana Vukmirovic
- Center for Informatics and Biostatistics Belgrade, Public Health Institute, 11000 Belgrade, Serbia;
| | | | - Ksenija Markovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (T.S.); (K.M.)
| | - Tanja Mostic
- Department of Anesthesiology, Clinical Center of Serbia, 11000 Belgrade, Serbia;
| | - Dejana Stanisavljevic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (T.R.); (N.R.); (V.P.); (D.S.)
| | - Natasa Milic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (T.R.); (N.R.); (V.P.); (D.S.)
- Department of Internal Medicine, Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55902, USA
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