Obstetric results of the multicenter, nationwide, scientific-educational program for pregnant women with gestational diabetes mellitus (GDM)

Objectives: The aim of the present study was to compare the obstetric results in women with GDM in a Polish population based on the criterion for the diagnosis of GDM. Material and methods: The study was a questionnaire study covering the data of 2853 patients with GDM treated in centers nationwide in the years 2011–2013. The principles of self-control, glycemic targets and treatment were based on the then-current PDA guidelines. Analysis of the collected data included an assessment of obstetric results based on the diagnostic criteria for GDM. Depending on the result of the glucose tolerance test, the patients were divided into subgroups. Results: 6.28% of births were preterm, and 47% were caesarean. A significant difference was observed in the number of preterm births between a subgroups: PDA(+) meeting only criterion 0’ and a PDA(+)meeting only criterion 120’ (16.67% vs. 5.83%); and between WHO(+) subgroup meeting only criterion 0’ with respect to the subgroup PDA(+) meeting only criterion 0’ (4.69% vs. 16.67%). Significant difference was found in the frequency of LGA between the WHO(-)PDA(+) and WHO(+)PDA(-) subgroups (6,57% vs. 14.93%), and between the WHO(-)PDA(+) group and a group of isolated hyperglycemia in 60’(6.57% vs. 12.5%). Also a significant positive correlation was observed between birth weight, the occurrence of LGA and macrosomia, and maternal weight and BMI before pregnancy. Conclusions: The results of the analysis indicate the new criteria have greater sensitivity in the prediction of prematurity and birth weight. However, it cannot be ruled out that the final results were affected by the therapeutic intervention employed

Analiza czynników matczynych i wyników położniczych u kobiet z cukrzycą ciążową. Wyniki programu naukowo-edukacyjnego „Dbamy o Mamy”

Aim. The aim of the study was to analyze maternal factors and obstetric outcomes in the women with gestational diabetes mellitus (GDM) in the polish population.Material and methods. The programme “We care for the Mothers” was a prospective, multicenter observational study that allowed to establish a database of 2853 patients with gestational diabetes treated between 2011 and 2013 in 42 diabetological departments in Poland. Diagnostic criteria, blood glucose self-control principles, glycemic targets and treatment principles were based on the guidelines of the Polish Diabetes Association 2011. The programme was based on the questionnaire, in which data concerning medical history (including obstetric data), anthropometric data, data concerning GDM treatment as well as the data concerning current pregnancy were gathered. All the data were then statistically analyzed.Results. 75 g OGTT result was available in 2497 women, of which GDM was ultimately diagnosed in 2408 patients. The mean age at the diagnosis was 30.59 ± 4.88 years (15.9% women > 35 years of age), BMI before conception was 24.75 kg/m2. The most frequent GDM risk factors were: history of pregnancy (61.46%), history of diabetes in the family (49.21) as well as overweight and obesity in the women (40.16%). At least one GDM risk factor was noted in 86.97% of the analyzed population. Insulin therapy was introduced in 23.83%; the higher BMI prior to conception the higher the frequency if insulin therapy was. Preterm delivery were observed in 6.36%, and 47% of deliveries was ended via cesarean section. Mean birth weight of the neonate was 3344 g; LGA and macrosomy rate was 8.59% and 9.77%, respectively. In the women with overweight or obesity, comparing to the group with normal weight, higher rate of LGA (p < 0.05) and higher neonatal birth weight (p < 0.001) was observed. No correlation between birth weight, LGA, SGA nor macrosomy of the neonates and gestational weight gain, fasting or postload glycemia in 75 g OGTT was observed. No significant differences in obstetric outcomes were noted as concerned GDM treatment, age and the number of previous pregnancies.Conclusions. The women that suffer from GDM in Poland are usually around 30 years old, with normal weight, history of pregnancy in the past and at leastone GDM risk factor. One in four women requires insulin therapy. Women with GDM usually give birth to a full-term newborn with normal birth weight, and in about 10% the neonate with excessive birth weight, significantly more often in overweight or obese mothers. Neither age of the women, OGTT result, nor the mode of treatment have the impact on obstetric outcomes.Wstęp. Celem badania była analiza czynników matczynych oraz wyników położniczych u kobiet z cukrzycą ciążową (GDM) w populacji polskiej.Materiał i metody. Program „Dbamy o Mamy” miał charakter prospektywnego, wieloośrodkowego badania obserwacyjnego, który pozwolił na stworzenie bazy danych 2853 pacjentek z cukrzycą ciążową leczonych w latach 2011–2013 w 42 ośrodkach diabetologicznych z całej Polski. Kryteria rozpoznania, zasady samokontroli, docelowe wartości glikemii oraz zasady leczenia pacjentek były oparte na zaleceniach Polskiego Towarzystwa Diabetologicznego z 2011 roku. Program opierał się na badaniu kwestionariuszowym, w którym zbierano dane z wywiadu ogólnego i położniczego, dane antropometryczne pacjentki, dane dotyczące sposobu leczenia GDM oraz dane położnicze dotyczące aktualnej ciąży. Uzyskane dane poddano analizie statystycznej.Wyniki. Wynik 75 g OGTT dostępny był u 2497 kobiet, z czego cukrzycę ciążową rozpoznano ostatecznie u 2408 pacjentek. Średni wiek w chwili rozpoznania wynosił 30,59 ± 4,88 roku (15,9% kobiet > 35. rż.), BMI przed ciążą wyniósł 24,75 kg/m2. Najczęstszymi czynnikami ryzyka GDM były wielorództwo (61,46%), rodzinne obciążenie cukrzycą (49,21%) oraz nadwaga i otyłość (40,16%). Przynajmniej jeden czynnik ryzyka GDM stwierdzono u 86,97% wszystkich badanych. Leczenie insuliną zastosowano u 23,83%, częstość insulinoterapii wzrastała wraz ze wzrostem BMI przed ciążą. Porody przedwczesne wystąpiły u 6,36%, a 47% zakończono drogą cięcia cesarskiego. Średnia masa urodzeniowa noworodka wyniosła 3344 g; częstość LGA i makrosomii to odpowiednio 8,59% i 9,77%. U kobiet z nadwagą lub otyłością zanotowano istotnie większą częstość LGA w porównaniu z grupą z prawidłową masą ciała (p < 0,05) oraz istotnie wyższą masę urodzeniową noworodka (p < 0,001). Nie stwierdzono natomiast korelacji pomiędzy masą urodzeniową, LGA, SGA i makrosomią noworodków a przyrostem masy ciała w okresie ciąży, glikemią na czczo i w 2. godzinie 75 g OGTT. Nie zanotowano istotnych różnic w zakresie wyników położniczych w zależności od sposobu leczenia GDM, wieku ani liczby przebytych ciąż.Wnioski. Na cukrzycę ciążową w Polsce chorują najczęściej kobiety około 30. roku życia, z prawidłową masą ciała, wieloródki, z przynajmniej jednym czynnikiem ryzyka wystąpienia GDM. Co czwarta ciężarna wymaga insulinoterapii. Kobiety z GDM zwykle rodzą noworodka donoszonego z prawidłową masą ciała, w niespełna 10% przypadków jest to noworodek z nadmierną masą urodzeniową, istotnie częściej w przypadku występowania nadwagi lub otyłości u kobiety przed ciążą. Wiek ciężarnych, wynik testu OGTT ani sposób leczenia nie wpływają na wyniki położnicze

Measurement report : effect of wind shear on PM10PM_{10} concentration vertical structure in the urban boundary layer in a complex terrain

The paper shows wind shear impact on $PM_{10}$ vertical profiles in Kraków, southern Poland. The data used consist of background data for two cold seasons (September 2018 to April 2019 and September 2019 to April 2020) and data for several case studies from November 2019 to March 2020. The data are composed of $PM_{10}$ measurements, model data, and wind speed and direction data. The background model data come from operational forecast results of the AROME model. $PM_{10}$ concentration in the vertical profile was measured with a sightseeing balloon. Significant spatial variability of the wind field was found. The case studies represent the conditions with much lower wind speed and a much higher $PM_{10}$ level than the seasonal average. The inversions were much more frequent than on average too. Wind shear turned out to be the important factor in terms of $PM_{10}$ vertical profile modification. It is generated due to the relief impact, i.e. the presence of a large valley, blocked on one side with the hills. The analysis of $PM_{10}$ profiles from all flights allows us to distinguish three vertical zones of potential air pollution hazards within the valley (about 100 m deep) and the city of Kraków: (1) up to about 60 m a.g.l. - the zone where during periods of low wind speed, air pollution is potentially the highest and the duration of such high levels is the longest, i.e. the zone with the worst aerosanitary conditions; (2) about 60-100 m a.g.l. - transitional zone where the large decrease in $PM_{10}$ levels with height is observed; (3) above 100-120 m a.g.l. - the zone where air quality is significantly better than in zone 1, either due to the increase in the wind speed or due to the wind direction change and advection of different, clean air masses

Monitoring of Greenhouse Gases in the Atmosphere – A Polish Perspective

An overview of systematic observations of the trace-gas composition of the atmosphere over southern Poland is presented, against the background of data available for other greenhouse gas (GHG) monitoring stations in Europe. The results of GHG monitoring for three major greenhouse gases (CO2, CH4, N2O) are discussed. Measurements were performed at two locations of contrasting characteristics, i.e. (i) the high-altitude mountain station of Kasprowy Wierch in the High Tatras, representing atmospheric conditions relatively free of local infl uences, and (ii) an urban station located in the Krakow agglomeration. The GHG data available for the Kasprowy Wierch station were compared with relevant data available for two marine reference stations (Mace Head, Ireland and Terceira Island, Azores), and two continental stations (Hohenpeissenberg, Germany and Pallas-Sammaltunturi, Finland). The growth rates for the CO2 mole fraction recorded at these fi ve stations reveal only small temporal changes that almost coincide, leading to a quasi-linear increase of the CO2 mixing ratio over the European continent over the past 20 years. While N2O observations also reveal a steady increase over this time period, the mole fraction accounted for by CH4 is increasing again, after a period of stagnation in the years 2001–2007. The impact of continental sources of CH4 and N2O is seen clearly in the Kasprowy Wierch records. The mean departure between the CH4 mixing ratios recorded at Kasprowy Wierch and at the marine reference stations in the period 1994–2014 is of 27.3 ppb, and stems from continental emissions of this gas originating mainly from anthropogenic activities (leaking natural-gas distribution networks, landfi lls and livestock). For N2O, a departure of 1 ppb was observed for the period 2009–2014. Comparison of quasi-continuous measurements of CO2, CH4 and N2O mixing ratios made in the urban atmosphere of Krakow and at the regional reference site Kasprowy Wierch (located approximately 100 km away), allows for a deeper insight into the mechanisms controlling daily variations in atmospheric mixing ratios of these gases at the two sites. The development of a nocturnal inversion layer in the atmosphere above the city leads to local enhancements of CO2, CH4 and N2O mole fractions in the Krakow atmosphere during the night hours, with these exceeding the baseline level signifi cantly

Monitoring of Greenhouse Gases in the Atmosphere – A Polish Perspective

An overview of systematic observations of the trace-gas composition of the atmosphere over southern Poland is presented, against the background of data available for other greenhouse gas (GHG) monitoring stations in Europe. The results of GHG monitoring for three major greenhouse gases (CO2, CH4, N2O) are discussed. Measurements were performed at two locations of contrasting characteristics, i.e. (i) the high-altitude mountain station of Kasprowy Wierch in the High Tatras, representing atmospheric conditions relatively free of local infl uences, and (ii) an urban station located in the Krakow agglomeration. The GHG data available for the Kasprowy Wierch station were compared with relevant data available for two marine reference stations (Mace Head, Ireland and Terceira Island, Azores), and two continental stations (Hohenpeissenberg, Germany and Pallas-Sammaltunturi, Finland). The growth rates for the CO2 mole fraction recorded at these fi ve stations reveal only small temporal changes that almost coincide, leading to a quasi-linear increase of the CO2 mixing ratio over the European continent over the past 20 years. While N2O observations also reveal a steady increase over this time period, the mole fraction accounted for by CH4 is increasing again, after a period of stagnation in the years 2001–2007. The impact of continental sources of CH4 and N2O is seen clearly in the Kasprowy Wierch records. The mean departure between the CH4 mixing ratios recorded at Kasprowy Wierch and at the marine reference stations in the period 1994–2014 is of 27.3 ppb, and stems from continental emissions of this gas originating mainly from anthropogenic activities (leaking natural-gas distribution networks, landfi lls and livestock). For N2O, a departure of 1 ppb was observed for the period 2009–2014. Comparison of quasi-continuous measurements of CO2, CH4 and N2O mixing ratios made in the urban atmosphere of Krakow and at the regional reference site Kasprowy Wierch (located approximately 100 km away), allows for a deeper insight into the mechanisms controlling daily variations in atmospheric mixing ratios of these gases at the two sites. The development of a nocturnal inversion layer in the atmosphere above the city leads to local enhancements of CO2, CH4 and N2O mole fractions in the Krakow atmosphere during the night hours, with these exceeding the baseline level signifi cantly