Impact of gestational diabetes mellitus on the duration of breastfeeding in primiparous women : an observational cohort study

Background The impact of gestational diabetes mellitus (GDM) on the duration of breastfeeding varies between shortening and no impact. Breastfeeding seems to reduce both maternal and offspring risk for type 2 diabetes and offspring risk for overweight or obesity later in life. The aim of our study was to evaluate in primiparous women whether GDM had an influence on the duration of breastfeeding, and further, to evaluate the factors that influenced on the duration of breastfeeding. Methods The study cohort (N = 1089) consisted of all primiparous women with a Finnish background excluding women with pre-existing diabetes mellitus who lived in the city of Vantaa, Finland, gave birth to a singleton living child between 2009 and 2015, and with valid data on breastfeeding available. The diagnosis of GDM was based on a standard 75 g 2-h oral glucose tolerance test. Data were obtained from Finnish national registers and from the medical records of the city of Vantaa. Results No differences were observed in the duration of breastfeeding between women diagnosed with GDM and without GDM, 7.5 (Standard Deviation [SD] 3.7) months versus 7.9 (SD 3.5) months (p = 0.17). Women diagnosed with GDM breastfed boys for a longer duration than girls (maternal age, pre-pregnancy body mass index, marital status, educational attainment, duration of pregnancy, and smoking habits adjusted p = 0.042). Women who breastfed <6 months were younger, were more likely smokers, had shorter education, and higher pre-pregnancy body mass index than women who breastfed over 6 months (p <0.001 for linearity). Conclusions In primiparous women GDM did not influence breastfeeding duration. The positive health effects of breastfeeding should be emphasized especially in young, overweight and less educated women in order to minimize the risk of obesity and type 2 diabetes for themselves and their offspring.Peer reviewe

Impact of sunshine on the risk of gestational diabetes mellitus in primiparous women

ABSTRACTThere is a lack of data about the influence of sunshine hours on the prevalence for gestational diabetes mellitus (GDM). The aim of this study was to evaluate whether the prevalence of GDM varied according to hours of daily sunshine during the first trimester. The study cohort (N = 6189) consists of all primiparous women with a Finnish background who delivered between 2009 and 2015 living in Vantaa city, Finland. Data on births and maternal characteristics were obtained from National Health Registers. Data on sunshine hours were obtained from the Finnish Meteorological Institute. Individual daily sunshine hours during the first trimester of pregnancy were calculated for each woman. Diagnosis of GDM was based on a standard 75-g 2-h glucose tolerance test (OGTT). No relationship was observed between month of conception and GDM. Daily sunshine hours during the first trimester and GDM showed a U-shaped association (adjusted p-value 0.019). In OGTT, a U-shaped association was observed between 0-h glucose value and daily sunshine hours during the first trimester (p = 0.039) as well as with the 1-h glucose value (p = 0.012), respectively. In primiparous women daily sunshine hours during the first trimester showed a U-shaped association with the prevalence of GDM independent of pre-pregnancy risk factors.Abbreviations: BMI: body mass index; GDM: gestational diabetes mellitus; OGTT: standard 75 g 2-h glucose tolerance test; SD: standard deviationPeer reviewe

Drug purchases prior to conception and the risk of gestational diabetes mellitus

Publisher Copyright: © The Author(s) 2022.Objective: Some drugs have adverse effects on glucose metabolism, but it is unknown whether prescription drugs used prior to conception influence the future risk of gestational diabetes mellitus (GDM). Our study evaluated whether the purchase of prescription drugs 6 months prior to conception was associated with the occurrence of GDM. Methods: This cohort study enrolled women with a Finnish background who delivered between 2009 and 2015 in the city of Vantaa, Finland (N = 10,455). Data on maternal characteristics and prescription drug purchases were obtained from national health registers. The use of a unique personal identification number enabled us to combine the register data on an individual level. Results: Six months prior to conception, women who had pregnancies complicated by GDM purchased more prescription drugs than women without GDM (1.38 ± 2.04 vs. 1.11 ± 1.80). The GDM risk was higher in women with higher numbers of prescription purchases and those with more than three deliveries. Conclusions: Multiparous women who purchase several prescription drugs should be given personalized counseling to prevent GDM.Peer reviewe

Impact of smoking on gestational diabetes mellitus and offspring birthweight in primiparous women

Introduction Smoking has been shown to affect glucose homeostasis and increase the risk for type 2 diabetes mellitus. Further, gestational diabetes mellitus (GDM) and smoking are known to influence offspring birthweight. The effect of smoking on glucose homeostasis in pregnancy is less studied and the findings are inconsistent. The aim of this study was to evaluate the effect of smoking on risk for GDM and to evaluate the impact of smoking and GDM on offspring birthweight. Material and methods This is an observational cohort study encompassing 4111 Finnish primiparous women from the city of Vantaa, Finland, who delivered a singleton child between 2009 and 2015. Data were obtained from Finnish national registers. Study participants had complete oral glucose tolerance test results and were divided into three groups according to smoking status: non-smokers (I), smokers who quit during first trimester (II), and smokers who continued after first trimester (III). Results Prevalence of GDM was 19.8%, 24.3%, and 26.6% in non-smokers, those who quit, and those who continued after the first trimester, respectively (P = .004 for differences between groups). The odds ratio for GDM in smokers who continued after the first trimester compared with non-smokers was 1.65 (95% CI 1.09-2.57) after adjustments for age, prepregnancy body mass index, education, and cohabitation. In women without GDM, offspring birthweight was lowest in those who continued smoking after the first trimester (P = .010 for differences between groups). In women with GDM, smoking status did not influence offspring birthweight. Conclusions Smoking during pregnancy is associated with an increased risk for GDM. Offspring birthweight is lowest in women who continue smoking after the first trimester. If pregnancy is complicated by GDM, offspring birthweight is not influenced by smoking.Peer reviewe

Impact of maternal height and gestational diabetes mellitus on offspring birthweight

Aims: To evaluate the impact of gestational diabetes mellitus (GDM) and maternal height on offspring birthweight. Methods: This is an observational cohort study, encompassing 4 111 Finnish primiparous women from Vantaa city, Finland, with singleton deliveries between 2009 and 2015. Data were obtained from the Finnish Medical Birth Register. The study population was divided into five groups according to maternal height. Cut-offs for height levels were I = 173 cm. The main outcome measure was offspring birthweight, expressed as Z-scores according to sex and gestational age. Results: Independently, both maternal height and GDM increased offspring birthweight (p <0.001 for height and GDM). When studying the interaction, a significant increase in offspring birthweight was noted only in extreme height categories; group I = 173 cm (p <0.001) and the impact was similar in both sexes. Maternal height had no impact on offspring ponderal index (p = 0.20 for trend). Conclusions: In extreme height categories, short and tall primiparous women with GDM are at risk for delivering larger offspring compared to women without GDM of similar height. (C) 2019 Elsevier B.V. All rights reserved.Peer reviewe

Preconception Mental Health, Socioeconomic Status, and Pregnancy Outcomes in Primiparous Women

Background:One in four women of childbearing age has some degree of mental disorders and are, therefore, prone to both pregnancy complications and adverse health outcomes in their offspring. We aimed to evaluate the impact of preconception severe mental disorders on pregnancy outcomes in primiparous women. MethodsThe study cohort was composed of 6,189 Finnish primiparous women without previously diagnosed diabetes, who delivered between 2009 and 2015, living in the city of Vantaa, Finland. Women were classified to have a preconception severe mental disorder if they had one or more outpatient visits to a psychiatrist or hospitalization with a psychiatric diagnosis 1 year before conception. Data on pregnancies, diagnoses, and pregnancy outcomes were obtained from national registers at an individual level. ResultsPrimiparous women with preconception severe psychiatric diagnosis were younger, more often living alone, smokers, and had lower educational attainment and lower taxable income than women without psychiatric diagnosis (for all p < 0.001). Of all women, 3.4% had at least one psychiatric diagnosis. The most common psychiatric diagnoses were depression and anxiety disorders. The most common comorbidity was the combination of depression and anxiety disorders. There were no differences in the need for respiratory treatments, admissions to the neonatal intensive care unit, or antibiotic treatments between the offspring's groups. ConclusionAlthough primiparous women had severe mental disorders, the well-being of newborns was good. The most common severe mental health disorders were depression and anxiety disorders, and psychiatric comorbidity was common. Women with severe mental disorders more often belonged to lower socioeconomic groups.Peer reviewe

Varhaiskasvatuksen koulutusten kehittämissuositusten toimeenpanosuunnitelma

Vuosina 2019–2020 toiminut Varhaiskasvatuksen koulutusten kehittämisfoorumi selvitti varhaiskasvatuksen koulutusten nykytilaa ja laati varhaiskasvatuksen koulutusten kehittämisohjelman. Kyseiseen kehittämisohjelmaan sisältyneiden koulutuksen kehittämissuositusten jatkotyöstämistä varten perustettiin alkuvuodesta 2021 asiantuntijatyöryhmä, jonka tehtävänä oli laatia näihin suosituksiin pohjautuva toimeenpanosuunnitelma. Asiantuntijaryhmä luovutti tässä julkaisussa esitellyn toimeenpanosuunnitelmaehdotuksensa opetus- ja kulttuuriministeriölle huhtikuussa 2021. Toimeenpanosuunnitelmassa eritellään kehittämissuositusten toteuttamisen tavat, esitetään kunkin toimenpide-ehdotuksen kohdalla sen toteuttamisen vastuutaho/vastuutahot ja tavoiteltava aikataulu. Lisäksi tehdään ehdotus myöhemmin vuonna 2021 asetettavan uuden Varhaiskasvatuksen koulutusten kehittämisfoorumin tavoitteista, tehtävistä, rakenteesta, toiminnasta ja tarvittavista resursseista

Genomförandeplan för rekommendationerna för utveckling av utbildningarna inom småbarnspedagogik

Utvecklingsforumet för utbildningarna inom småbarnspedagogik, som var verksamt 2019–2020, utredde nuläget för utbildningarna inom småbarnspedagogik och utarbetade ett program för utveckling av utbildningarna. I början av 2021 tillsattes det en expertgrupp för att fortsätta arbetet med utvecklingsprogrammets rekommendationer för utveckling av utbildningarna. Gruppens uppgift var att utarbeta en genomförandeplan som grundar sig på dessa rekommendationer. Expertgruppen överlämnade sitt förslag till genomförandeplan till undervisnings- och kulturministeriet i april 2021. Genomförandeplanen presenteras i den här publikationen. I planen redogörs det för sätt att genomföra utvecklingsrekommendationerna och anges också en ansvarig aktör/ansvariga aktörer och en tidsplan för varje föreslagen åtgärd. Dessutom innehåller planen förslag till mål, uppgifter, struktur, verksamhet och behövliga resurser för det nya Utvecklingsforumet för utbildningarna inom småbarnspedagogik som tillsätts 2021