Hyper-Hypo study: A Retrospective Observational Study of Neonatal Hypoglycemia Related to Maternal Hypertension

Objective The study aims to identify and evaluate the relationships between unmodifiable and potentially modifiable factors in hypoglycemic neonates with hypertensive mothers.  Design This was a retrospective observational analysis of routinely collected anonymized data related to neonatal hypoglycaemia and maternal hypertension.  Method The study was carried out at the tertiary Neonatal Intensive Care Unit (112 beds) of the Women’s Wellness and Research Center of Hamad Medical Corporation, Doha, Qatar. This study included all neonates admitted into the NICU diagnosed with neonatal hypoglycemia with a maternal history of antihypertensive therapy use during pregnancy. This research described the prevalence of neonatal hypoglycaemia related to use of antihypertensive drugs for maternal hypertension. The identified modifiable risks can be used to improve neonatal practice and support future policy developments to ensure optimal neonatal outcomes.  Results We examined 1197 out of 1199 neonates admitted into NICU with a diagnosis of hypoglycemia. About 78% (n=862) of the neonates were admitted primarily due to hypoglycemia, with a mean initial blood glucose reading of 1.9 ± 0.8 mmol\L upon admission. About 28.3% of neonates(n=339) were born to mothers with hypertensive disorders in pregnancy, and 49.0% neonates of diabetic mothers (IDM). Neonates of hypertensive women were significantly more preterm, had lower birth weight and part of multiple pregnancies. These neonates were exposed to either single or combined antihypertensive therapy. The most commonly used antihypertensive medications were labetalol 82% (n= 273/333), magnesium sulphate 21%, (n= 70/333) methyldopa 16.5% (n= 55/333) and nifedipine 14%; (n= 47/333). There was no significant difference in the mean initial blood glucose between neonates in the hypertensive versus non-hypertensive groups of mothers (1.7 vs 1.6 mmol/L). However, a sub-group comparison of neonates (with initial blood glucose Conclusions This retrospective study demonstrated that neonates of hypertensive mothers have significant differences in gestational age at birth, birthweight, occurrence of respiratory distress and prematurity. Hypoglycemia were more prevalent among neonates of non-hypertensive mothers. On the other hand, neonates of hypertensive mothers administered with methyldopa showed a significant decrease of initial blood glucose reading.</p

The Study of Maternal Factors and Their Association with Risk of Preterm Birth

Objective The objective is to study maternal factors and their association with preterm birth (PTB). We hypothesize that certain maternal factors increase the risk of PTBs. Design A retrospective study recruiting women in labor at WWRC from June 2022 until February 2023. Method A cohort of 163 cases of which 59 (36.2%) were PTB (gestational age: Clinical and demographic data of patients such as age, BMI, glycemic status, blood pressure (BP) status, and Group B streptococcal (GBS) infection status were collected via Cerner, the hospital’s electronic medical records. Results For maternal age, 9 PTBs (15.3%) and 5 TBs (5%) were born to mothers aged ≤25years, 39 PTBs (66.1%) and 71 TBs (70.3%) were born to mothers aged >25- ≤35 years, and 11 (18.6%) PTBs and 25 TBs (24.8%) were born to mothers aged >35 years. In terms of BMI, 2 PTBs (3.4%) and 4 TBs (3.9%) were born to underweight mothers (BMI: 25). For glycemic status, 40 PTBs (67.8%) and 71 TBs (70.3%) were born to non-diabetic mothers, 8 PTBs (13.6%) and 24 TBs (23.7%) were born to mothers with gestational diabetes mellitus (GDM), 8 PTBs (13.6%) and 2 TBs (2%) were born to mothers with type 1/type 2 diabetes mellitus (DMI/DMII), and 3 PTBs (5.1%) and 4 TBs (4%) were of unknown diabetes status. As for blood pressure (BP) status, 55 PTBs (93.2%) and 98 TBs (97%) were born to mothers with normal BP range ( For GBS status, 18 PTBs (30.5%) and 20 TBs (19.6%) were born to GBS-positive mothers, 33 PTBs (55.9%) and 78 TBs (77.2%) were born to GBS-negative mothers, and 8 PTBs (13.6%) and 3 TBs (3%) were of unknown GBS status. Conclusion Our current data suggests that maternal age, BMI, and GBS status are the most likely maternal factors associated with PTB. However, a larger sample size is necessary to support such findings. Future studies aim to recruit further cases including additional maternal factors such as preterm history, ethnicity, and presence of chorioamnionitis.</p

Nurses and Physicians Interprofessional Collaboration during COVID-19 Pandemic in a Maternity Outpatient Department: A Mixed Method Approach

Objective The investigators aim to conduct mixed-method research to explore the Interprofessional Collaboration or IPC experience of both nurses and doctors in Women’s Wellness and Research Center or WWRC during the COVID-19 Pandemic. The IPC in OPD has made novel and dramatic changes in order to continue its operations during the pandemic; thus, new adaptive strategies were implemented which are worth exploring in this research.  Design Sequential Mixed-Method Research Design.  Method Using the Jefferson Scale of Attitude toward Interprofessional Collaboration (JeffSATIC), a cross-sectional online survey was conducted. The instrument is applicable to all health professions and allows group comparisons in different professional specialties. The tool comprises 20 items across two factors including working relationship and accountability. Seventy-five nurses and 83 doctors made up the 158 respondents who were drawn from a tertiary maternity facility in Doha, Qatar. The team also conducted series of Focused Group Discussions using open-ended questions to gain more in-depth understanding about their experience. The SPSS Version 26 was used to examine the data that were exported from SurveyMonkey, and multiple regression analysis was used to identify the predictors. Thematic analysis was done for the qualitative data. Both findings from the statistical and thematic analyst were mixed to gain provide comprehensive description and insights about IPC. Results The results show the IPC mean score for physicians (M= 103.56) was higher than nurses (M=63.00) including matters on working relationship (M= 60.86) and accountability (M= 42.71). Comparably, the reported IPC mean score (M= 84.21) during pandemic was lower than data from Australia (M=114) and USA (M= 119) without pandemic. Moreover, both Clinical Experience and Educational Attainment are the significant predictors (p-value Conclusions The attitude of both nurses and doctors toward IPC during a pandemic is predicted by knowledge gained through training and education, and duration of clinical experience. The IPC strengthen their partnership as care providers despite of the challenges and new ways of delivering patient care. Based on the findings, strategic planning about enhancing knowledge, clinical skills, and strengthening partnerships with IPC towards better maternity care outcomes during pandemic is recommended.</p

Nurses and Physicians Interprofessional Collaboration during COVID-19 Pandemic in a Maternity Outpatient Department: A Mixed Method Approach

Objective The investigators aim to conduct mixed-method research to explore the Interprofessional Collaboration or IPC experience of both nurses and doctors in Women’s Wellness and Research Center or WWRC during the COVID-19 Pandemic. The IPC in OPD has made novel and dramatic changes in order to continue its operations during the pandemic; thus, new adaptive strategies were implemented which are worth exploring in this research.  Design Sequential Mixed-Method Research Design. Method: Using the Jefferson Scale of Attitude toward Interprofessional Collaboration (JeffSATIC), a cross-sectional online survey was conducted. The instrument is applicable to all health professions and allows group comparisons in different professional specialties. The tool comprises 20 items across two factors including working relationship and accountability. Seventy-five nurses and 83 doctors made up the 158 respondents who were drawn from a tertiary maternity facility in Doha, Qatar. The team also conducted series of Focused Group Discussions using open-ended questions to gain more in-depth understanding about their experience. The SPSS Version 26 was used to examine the data that were exported from SurveyMonkey, and multiple regression analysis was used to identify the predictors. Thematic analysis was done for the qualitative data. Both findings from the statistical and thematic analyst were mixed to gain provide comprehensive description and insights about IPC. Results The results show the IPC mean score for physicians (M= 103.56) was higher than nurses (M=63.00) including matters on working relationship (M= 60.86) and accountability (M= 42.71). Comparably, the reported IPC mean score (M= 84.21) during pandemic was lower than data from Australia (M=114) and USA (M= 119) without pandemic. Moreover, both Clinical Experience and Educational Attainment are the significant predictors (p-value Conclusions The attitude of both nurses and doctors toward IPC during a pandemic is predicted by knowledge gained through training and education, and duration of clinical experience. The IPC strengthen their partnership as care providers despite of the challenges and new ways of delivering patient care. Based on the findings, strategic planning about enhancing knowledge, clinical skills, and strengthening partnerships with IPC towards better maternity care outcomes during pandemic is recommended.</p

Association of single nucleotide polymorphisms with dyslipidemia and risk of metabolic disorders in the State of Qatar

Background: Dyslipidemia is recognized as one of the risk factors of cardiovascular diseases (CVDs), type 2 diabetes mellitus (T2DM), and non-alcoholic fatty liver disease (NAFLD). Objective: The study aimed to investigate the association between selected single nucleotide polymorphisms (SNPs) with dyslipidemia and increased susceptibility risks of CVD, NAFLD, and/or T2DM in dyslipidemia patients in comparison with healthy control individuals from the Qatar genome project. Methods: A community-based cross-sectional study was conducted among 2933 adults (859 dyslipidemia patients and 2074 healthy control individuals) from April to December 2021 to investigate the association between 331 selected SNPs with dyslipidemia and increased susceptibility risks of CVD, NAFLD and/or T2DM, and covariates. Results: The genotypic frequencies of six SNPs were found to be significantly different in dyslipidemia patients subjects compared to the control group among males and females. In males, three SNPs were found to be significant, the rs11172113 in over-dominant model, the rs646776 in recessive and over-dominant models, and the rs1111875 in dominant model. On the other hand, two SNPs were found to be significant in females, including rs2954029 in recessive model, and rs1801251 in dominant and recessive models. The rs17514846 SNP was found for dominant and over-dominant models among males and only the dominant model for females. We found that the six SNPs linked to gender type had an influence in relation to disease susceptibility. When controlling for the four covariates (gender, obesity, hypertension, and diabetes), the difference between dyslipidemia and the control group remained significant for the six variants. Finally, males were three times more likely to have dyslipidemia in comparison with females, hypertension was two times more likely to be present in the dyslipidemia group, and diabetes was six times more likely to be in the dyslipidemia group. Conclusion: The current investigation provides evidence of association for a common SNP to coronary heart disease and suggests a sex-dependent effect and encourage potential therapeutic applications. Keywords: Qatar genome project (QGP); cardiovascular disease (CVD); coronary artery disease (CAD); diabetes; dyslipidemia; hypertension; metabolic; non-alcoholic fatty liver disease (NAFLD); single nucleotide polymorphism (SNP). © 2023 The Authors. Molecular Genetics & Genomic Medicine published by Wiley Periodicals LLC

Maternal and Neonatal Outcomes Post Bariatric Surgery: A Population-Based Study

Objectives  This study had two primary objectives. First, to evaluate the incidence, risk factors, and maternal and neonatal outcomes among pregnant women post-BS (the exposed group). Second, to evaluate these outcomes among pregnant women without a history of BS, these include women who are obese, overweight, and with normal weight (non-exposed groups). Design This population-based study was conducted using 12-month retrospective registry data from the PEARL-Peristat Study at the Women's Wellness and Research Center (WWRC) in Qatar. Methods: We examined 6,212 parturient women and their offspring. Participants were classified into exposed (post-BS) (N=315) and non-exposed (N=5897). Statistical analysis was conducted using SPSS 28 software. We analyzed the risk factors and outcomes using univariate and multivariable regression. Results were reported as odds ratios (cOR) and adjusted aOR with 95% confidence intervals (CI), while incidences were reported as percentages. P value was regarded as significant at Results Qatari, advanced maternal age, Parity >1, diabetes, and hypertension were found to be significant risk factors for women with post-BS. In addition, women in the post-BS group were found to be significantly more likely to have a cesarean delivery (37.5% vs. 24%, aOR=1.59, CI 1.18-2.14), preterm babies (10% vs. 7%, aOR=1.66, CI 1.06-2.59), and stillbirth (1.6% vs. 0.4%, aOR=4.53, CI 1.33-15.50) compared to the normal weight women group. Moreover, post-BS women had a higher risk of low-birth-weight neonates than obese (15% vs. 8%, aOR= 1.77, CI 1.153-2.73), overweight (15% vs. 7%, aOR=1.63, CI:1.09-2.43), and normal weight (15% vs. 8%, aOR=1.838, CI 1.23-2.75) women. Finally, women in the post-BS group were more likely to have low-birth weight neonates ( In contrast, post-BS had a lower risk of gestational diabetes than obese (19% vs. 40%, aOR=0.39, CI: 0.29-0.54) overweight (19% vs. 32%, aOR= 0.57, CI 0.42-0.79) women. Similarly, compared to the overweight group, post-BS had a lower incidence and risk of assisted birth (4% vs. 9%, aOR=0.46, CI 0.21-0.99). On the other hand, obesity significantly increased the risk of gestational diabetes, cesarean deliveries, and labor induction in comparison to the other groups. Conclusion  Pregnancies with post-BS should be considered a high-risk group for some outcomes and should be monitored closely. These findings may guide the future clinical decisions of antenatal and postnatal follow-up for post-BS women. </p