Iciek R

Multiple daily injections of insulin versus continuous subcutaneous insulin infusion for pregnant women with type 1 diabetes.

The aim was to evaluate the outcome of pregnancies with type 1 diabetes (T1DM) treated from the first trimester with continuous subcutaneous insulin infusion (CSII) or multiple daily injections (MDI).

Maternal serum placental growth factor and fetal SGA in pregnancy complicated by type 1 diabetes mellitus

Abstract Aim: To analyze the role of maternal placental growth factor (PlGF) in the prediction of small for gestational age (SGA) birth weight in pregnancy complicated by type 1 diabetes mellitus (T1DM). Methods: A prospective observational study on 59 normotensive T1DM pregnant women, assessing maternal PlGF concentrations between the 10th–14th and 22nd–25th weeks of gestation. Results: Number of SGA vs. non-SGA newborns was 11 (18.6%) vs. 48 (81.4%), respectively. First trimester PlGF serum concentrations (pg/mL) were similar between SGA vs. non-SGA groups [data given as median (interquartile range)]: 65.5 (35.58–159.20) vs. 68.23 (11.59–150.03), respectively; P=0.44. A trend for lower PlGF concentrations was observed in the second trimester in the SGA vs. non-SGA group: 63.34 (12.79–119.16) vs. 116.75 (33.93–235.82); P=0.07. In the SGA group, PlGF concentrations did not differ between the first and the second trimester: 65.5 (35.58–159.20) vs. 63.34 (12.79–119.16), respectively; P=0.36. In the non-SGA group, PlGF concentrations were significantly higher at the gestational age of 22–25 weeks compared to 10–14 weeks [116.75 (33.93–235.82) vs. 68.23 (11.59–150.03); P=0.03). Conclusions: Decreased PlGF serum concentration in mid-pregnancy, as well as a lack of physiological increase in PlGF levels between early and mid-gestation, may precede development of SGA in women with T1DM.

Concentrations of eNOS, VEGF, ACE and PlGF in maternal blood as predictors of impaired fetal growth in pregnancy complicated by gestational hypertension/preeclampsia.

Objectives: To investigate into an association between circulating levels of vascular factors (VF: ACE, eNOS, PlGF and VEGF) and impaired fetal growth measured as a small for gestational age newborn (SGA) in women with gestational hypertension/preeclampsia. Methods: A prospective observational trial in 46 patients in singleton pregnancies. Concentrations of VF were compared between participants who delivered SGA versus non-SGA newborns. Results: only low levels of ACE were associated with significantly increased risk for SGA (for a cut-off value, LR: 1.4–3.6). Conclusions: Circulating levels of VF are not sufficient predictors of SGA in pregnancies complicated by gestational hypertension/preeclampsia.