Anders E Åberg

Congenital malformations among infants whose mothers had gestational diabetes or preexisting diabetes

BACKGROUND Diabetes type 1 is associated with an increased risk for infant congenital malformations. It is debated whether this is true also at gestational diabetes. AIMS To study occurrence of congenital malformations in infants whose mothers had preexisting or gestational diabetes. STUDY DESIGN A register study covering over 1.2 million Swedish births in 1987-1997 based on the Swedish health registries. SUBJECTS We identified from the Medical Birth Registry 3864 infants born of women with preexisting diabetes and 8688 infants born of women with gestational diabetes. OUTCOMES MEASURES Congenital malformations identified in the Medical Birth Registry, the Registry of Congenital Malformations, and the Hospital Discharge Registry. The rates of congenital malformations among these infants was compared with the population rates. RESULTS At preexisting diabetes, the total malformation rate was 9.5% while the rate at gestational diabetes was similar to the population rate, 5.7%. At preexisting diabetes, certain conditions were more common than expected: orofacial clefts, cardiovascular defects, oesophageal/intestinal atresia, hypospadias, limb reduction defects, spine malformations, and polydactyly. For some of these conditions, an excess was found also for infants whose mothers had gestational diabetes. Infants with multiple malformations were in excess at preexisting diabetes but not at gestational diabetes but the specific type of malformations involved were similar in the two diabetes groups. CONCLUSIONS It is suggested that in the group of gestational diabetes exists a subgroup with an increased risk for a diabetes embryopathy, perhaps due to preexisting but undetected diabetes type 2.

Congenital malformations after the use of inhaled budesonide in early pregnancy

OBJECTIVE To study possible teratogenic risks with the use of an inhaled glucocorticoid, budesonide, in early pregnancy. METHODS Using the Swedish Medical Birth Registry, congenital malformations were studied in 2014 infants whose mothers had used inhaled budesonide for asthma in early pregnancy. The presence of congenital malformations was checked further with auxiliary registries. RESULTS No increase in the general rate of congenital malformations was observed: 3.8% (95% confidence interval [CI] 2.9, 4.6) of the infants had a congenital malformation diagnosed, which is similar to the population rate (3.5%). After exposure to budesonide, four infants were born with orofacial clefts; this also is similar to the expected number (3.3). CONCLUSION Even though a specific teratogenic effect of use of budesonide in early pregnancy cannot be ruled out, it is unlikely that a clinically significant teratogenic risk exists.

Asthma during pregnancy--a population based study.

To study delivery outcome in women with asthma, using Swedish health registers. Women with asthma were identified in two ways: by information in interviews performed by midwives at the pregnant womans first visit to antenatal care, and by linkage between a medical birth register and a hospital discharge register, identifying women who had been hospitalized for asthma and also had a delivery. Births between 1984 and 1995 were studied. An increased risk for preterm birth and low birth weight was seen, possibly co-varying with disease severity. Also a significant increase in pregnancies of more than 41 weeks duration was noticed. An increase in infant death but not in congenital malformations rate was observed. An association with preeclampsia, gestational diabetes, and infant hypoglycemia was verified. Maternal asthma appears to be a risk factor for preterm and postterm births and increases the risk for some pregnancy complications.

Acupuncture relieves pelvic and low‐back pain in late pregnancy

Background.  The study was designed to evaluate the analgesic effect and possible adverse effects of acupuncture for pelvic and low‐back pain during the last trimester of pregnancy.

Predictive factors of developing diabetes mellitus in women with gestational diabetes

Background.  To investigate which factors during gestational diabetes pregnancies correlate with the risk of developing impaired glucose tolerance or diabetes 1 year postpartum and to compare this risk in women with gestational diabetes and women with a normal oral glucose tolerance test during pregnancy.

Relationship between vitamin use, smoking, and nausea and vomiting of pregnancy

Background.  Nausea and vomiting in pregnancy (NVP) is a common complaint but risk factors for NVP are not well characterized.

Pregnancy outcome after maternal organ transplantation in Sweden

Objective  To study pregnancy outcome before and after organ transplantation.

Crystallization and preliminary X-ray analysis of the 9 kDa protein of the mouse signal recognition particle and the selenomethionyl-SRP9

Two different crystal forms of the 9 kDa protein of the signal recognition particle (SRP9) have been prepared by the hanging drop vapor diffusion technique using 28% (w/v) PEG8000 or 28% saturated ammonium sulphate as precipitant. The crystals are hexagonal bipyramids with average dimensions of 0.2 × 0.1 × 0.1 mm3 and they diffract to a resolution of 2.3 Å. They belong to the space groups P6222/P6422 or P3121/P3221 with cell dimensions . Crystals have also been grown from the selenomethionyl protein and multiwavelength data sets have been collected.

A simplified oral glucose tolerance test in pregnancy : compliance and results

Background. To describe a reliable method for a general oral glucose tolerance test (OGTT) during pregnancy, to evaluate adherence to the method, and to compare the frequency of reported gestational diabetes mellitus (GDM) and perinatal outcome in affected pregnancies in Skåne, using direct diagnostic OGTT, with those from a comparable area, Halmstad‐Ljungby‐Växjö (HLV), using random glucose measurements (RGM) to identify women for the OGTT. Methods. The OGTT program and quality assurance in Skåne is described. Antenatal records on deliveries in May 2003 were scrutinised to ascertain if OGTT had been performed. Frequencies of GDM, prematurity and large for gestational age (LGA) infants were estimated using a population‐based perinatal database (PRS). Results. OGTT was performed in 93% of pregnant women in Skåne. In 2000–2003 GDM frequency in Skåne was twice as high as in HLV (1.9 versus 1%), while the frequency of LGA and prematurity among infants of mothers who were diagnosed with GDM were similar. Conclusions. Decentralised general OGTT is a reliable and effective method to diagnose GDM. OGTT is twice as sensitive as RGM, and the severity of GDM in the cases identified with OGTT did not differ from the severity of those identified with RGM.

The crystal structure of the signal recognition particle Alu RNA binding heterodimer, SRP9/14

The mammalian signal recognition particle (SRP) is an 11S cytoplasmic ribonucleoprotein that plays an essential role in protein sorting. SRP recognizes the signal sequence of the nascent polypeptide chain emerging from the ribosome, and targets the ribosome–nascent chain–SRP complex to the rough endoplasmic reticulum. The SRP consists of six polypeptides (SRP9, SRP14, SRP19, SRP54, SRP68 and SRP72) and a single 300 nucleotide RNA molecule. SRP9 and SRP14 proteins form a heterodimer that binds to the Alu domain of SRP RNA which is responsible for translation arrest. We report the first crystal structure of a mammalian SRP protein, that of the mouse SRP9/14 heterodimer, determined at 2.5 Å resolution. SRP9 and SRP14 are found to be structurally homologous, containing the same α‐β‐β‐β‐α fold. This we designate the Alu binding module (Alu bm), an additional member of the family of small α/β RNA binding domains. The heterodimer has pseudo 2‐fold symmetry and is saddle like, comprising a strongly curved six‐stranded amphipathic β‐sheet with the four helices packed on the convex side and the exposed concave surface being lined with positively charged residues.