Risk Factors for Gestational Diabetes in Women with Polycystic Ovarian Syndrome

We aimed to compare the pre-gestational metabolic states of the women who were previously diagnosed with policystic ovarian syndrome and had gestational diabetes mellitus in the subsequent pregnancy and who did not have gestational diabetes mellitus in subsequent pregnancy and to determine the independent variables that predict the gestational diabetes mellitus risk for policystic ovarian syndrome patients in the subsequent pregnancy. Between the dates 2007 and 2012, the patients who were diagnosed with policystic ovarian syndrome in our outpatient gynecology clinic were searched retrospectively. Then these patients were called for pregnancy states. All of these patients have pregnancy spontaneously. The patients pre-gestational mean age, body mass index, metabolic and hormonal profiles and pregnancy outcomes were compared between policystic ovarian syndrome cases who developed gestational diabetes mellitus or not. We found some differences in pregestational metabolic states between the policystic ovarian syndrome patients who developed gestational diabetes mellitus in pregnancy or not. The mean age, body mass index, very low density lipoprotein, triglyceride, fasting insulin, fasting c-peptide levels, 1st and 2nd hour glucose levels in 75 gr oral glucose tolerance test, homeostatsis model assessment insulin resistance measures and neonates birth weights were higher in gestational diabetes mellitus group than non-gestational diabetes mellitus group. But high density lipoprotein was lower in gestational diabetes mellitus group than non- gestational diabetes mellitus group. There were no differences between the mean levels C- reactive protein, hormonal profile, mean fasting glucose, low density lipoprotein cholesterol, total cholesterol levels and mode of delivery. Glucose intolerance was significantly higher in the gestational diabetes mellitus group (%74,07 vs %6,66). With the multipl logistic regression analysis we found the body mass index as the strongest independent predictor of gestational diabetes mellitus in policystic ovarian syndrome patients (OR: 2,831, %95 CI: 1,234-6,495). The second independent predictor was the high 2nd hour glucose level in oral glucose tolerance test(OR: 1,119, %95 CI: 1,026-1,221). The pre-gestational metabolic variables including the age, body mass index, lipid profile, and glucose metabolism are significantly different in the gestational diabetes mellitus group than the non-gestational diabetes mellitus group. The obesity and glucose intolerance are the independent predictors of gestational diabetes mellitus in policystic ovarian syndrome cases. [Med-Science 2016; 5(1.000): 179-90

Germline cells in ovarian surface epithelium of mammalians: a promising notion

<p>Abstract</p> <p>It is a long held doctrine in reproductive biology that women are born with a finite number of oocytes and there is no oogenesis during the postnatal period. However, recent evidence challenges this by showing the presence of germ line stem cells in the human ovarian surface epithelium (OSE), which can serve as a source of germ cells, and differentiate into oocyte like structures. Postnatal renewal of oocytes may have enormous therapeutic potential especially in women facing the risk of premature ovarian failure idiopathically or iatrogenically after exposure to gonadotoxic chemotherapy and radiation for cancer therapy.</p> <p>This article reviews current knowledge on germ line stem cells in human OSE.</p

Maternal and fetal serum orexin-A levels in gestational diabetes mellitus

Aim: Evidence suggests that orexin regulates food consumption, glucose metabolism and insulin secretion. Orexin may have a role in the pathogenesis of type II diabetes mellitus, however its role in gestational diabetes mellitus is not known. We aimed to assess maternal serum and cord blood orexin-A (OXA) concentrations in pregnant women with gestational diabetes mellitus (GDM). Material and Methods: Thirty-five pregnant women with GDM and 35 gestational-age-matched healthy pregnant subjects participated in the study. Maternal serum and cord blood OXA levels were measured with enzyme immunoassay at the time of birth. The correlations between maternal serum and cord blood OXA levels, anthropometric and metabolic parameters were also assessed. Results: The mean maternal and cord serum OXA (1.16 +/- 0.37 and 1.35 +/- 0.20 ng/mL, respectively) in the GDM group were significantly different from those of the controls (1.58 +/- 0.59 and 1.25 +/- 0.21 ng/mL, respectively). The mean maternal fasting-glucose-to-OXA ratio was significantly higher in the GDM group. In the GDM group, the mean maternal serum OXA levels were similar in the insulin (n = 24) and diet (n = 11) treated cases, respectively (1.13 +/- 0.36 ng/mL and 1.21 +/- 0.41 ng/mL). Maternal serum OXA levels positively correlated with fetal serum OXA and maternal glucose levels. OXA concentrations in maternal serum were negatively correlated with the fasting glucose, fasting insulin and homeostasis model assessment insulin resistance index. Conclusions: Maternal serum OXA levels decrease, and fetal serum OXA levels increase in women with GDM

A comparative study on oxidative and antioxidative markers of serum and follicular fluid in GnRH agonist and antagonist cycles

OBJECTIVE: To determine whether concentrations of oxidative stress markers of follicular fluid and serum are different in GnRH agonist protocol from GnRH antagonist protocol. MATERIAL AND METHOD: This was a cross-sectional study. Eighty-four women undergoing controlled ovarian stimulation with either GnRH agonist (n = 39) or GnRH antagonist protocols (n = 45) for IVF/ICSI treatment were assigned by a physician. Blood was obtained at the time of oocyte retrieval, and follicular fluid (FF) from the mature follicles of each ovary was centrifuged and frozen until analysis. Malondialdehyde (MDA), nitric oxide (NO), protein carbonyl (PC), hydroxyl proline (OH-P), sodium oxide dismutase (SOD), reduced glutathione (GSH), glutathione peroxidase (GSH-Px), adenosine deaminase (ADA) and xanthine oxidase (XO) were assessed in the serum and follicular fluid of each participants. RESULTS: The mean serum concentrations of GSH-Px, GSH and MDA were lower in the GnRH antagonist group compared to GnRH agonist group, but mean serum SOD was higher in the GnRH antagonist group. The mean follicular SOD, ADA and NO were higher in GnRH antagonist group than GnRH agonist group. The IVF/ICSI outcomes were similar in both groups. CONCLUSION(S): GnRH antagonist protocol is associated with increased oxidative stress. The relation of GnRH analogues with oxidative stress and its implication in follicular growth needs to be addressed in further studies

Maternal and perinatal outcomes in high compared to low risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection (phase 2): the World Association of Perinatal Medicine working group on coronavirus disease 2019

Background: It has still to be ascertained whether severe acute respiratory syndrome coronavirus 2 infection in pregnancy is associated with worse maternal and fetal outcomes compared to low risk gestations. Objective: This study aimed to evaluate maternal and perinatal outcomes in high- and low-risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection. Study design: This was a multinational retrospective cohort study involving women with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection from 76 centers from 25 countries in Europe, the United States, South America, Asia, and Australia from April 4, 2020, to October 28, 2020. The primary outcome was a composite measure of maternal mortality and morbidity, including admission to the intensive care unit, use of mechanical ventilation, or death. The secondary outcome was a composite measure of adverse perinatal outcome, including miscarriage, fetal loss, neonatal and perinatal death, and admission to the neonatal intensive care unit. All outcomes were assessed in high- and low-risk pregnancies. Pregnancies were considered high risk in case of either preexisting chronic medical conditions in pregnancy or obstetrical disorders occurring in pregnancy. The Fisher exact test and logistic regression analysis were used to analyze the data. Results: A total of 887 singleton pregnancies who tested positive for severe acute respiratory syndrome coronavirus 2 infection using reverse transcription-polymerase chain reaction of nasal and pharyngeal swab specimens were included in the study. The risk of composite adverse maternal outcomes was higher in high-risk pregnancies than in low-risk pregnancies (odds ratio, 1.52; 95% confidence interval, 1.03-2.24; P=.035). In addition, women carrying high-risk pregnancies were at higher risk of hospital admission (odds ratio, 1.48; 95% confidence interval, 1.07-2.04; P=.002), presence of severe respiratory symptoms (odds ratio, 2.13; 95% confidence interval, 0.41-3.21; P=.001), admission to the intensive care unit (odds ratio, 2.63; 95% confidence interval, 1.42-4.88), and invasive mechanical ventilation (odds ratio, 2.65; 95% confidence interval, 1.19-5.94; P=.002). When exploring perinatal outcomes, high-risk pregnancies were at high risk of adverse perinatal outcomes (odds ratio, 1.78; 95% confidence interval, 0.15-2.72; P=.009). However, such association was mainly because of the higher incidence of miscarriage in high-risk pregnancies compared with that in low-risk pregnancies (5.3% vs 1.6%, P=.008); furthermore, there was no difference in other explored outcomes between the 2 study groups. At logistic regression analysis, maternal age (odds ratio, 1.12; 95% confidence interval, 1.02-1.22; P=.023) and high-risk pregnancy (odds ratio, 4.21; 95% confidence interval, 3.90-5.11; P&lt;.001) were independently associated with adverse maternal outcomes. Conclusion: High-risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection were at higher risk of adverse maternal outcomes than low-risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection