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Fulltext Association between Perceived Oral Symptoms and Presence of Clinically Diagnosed Oral Diseases in a Sample of Pregnant Women in Malaysia

Yunita Sari E, Saddki N, Yusoff A

Int J Environ Res Public Health, 2020 10 08;17(19).
PMID: 33049972 DOI: 10.3390/ijerph17197337

The integration of oral health into primary health care denotes the important role of medical counterparts as the front liners in antenatal care to help screen mothers for oral symptoms and refer them to dentists accordingly. However, the validity of self-perceived oral health status is inconclusive. This study determined the association between self-perceived oral symptoms and the presence of clinically diagnosed oral diseases in a sample of pregnant women. A total of 192 pregnant women participated in this cross-sectional study. Clinical oral examinations were performed to record dental caries experience, gingival health and periodontal health. The women were also asked about their oral symptoms. Most women had at least one oral symptom (84.9%): cavitated tooth (62.0%), bad breath (38.5%), bleeding gums (28.6%), and toothache (22.9%). About half of the women had untreated dental caries (58.9%), and the odds were significantly higher in women who complained of having cavitated tooth. About half of the women had moderate to severe gingivitis (53.7%), and the odds were significantly higher in women who complained of bleeding gums. About half had periodontal pockets (46.3%), and the odds were higher in women who complained of bleeding gums and bad breath although lower in women who complained of swollen gums. In conclusion, the prevalence of dental caries and periodontal disease among pregnant women in this study were relatively high. The presence of untreated dental caries, moderate and severe gingivitis, and periodontal pockets were significantly associated with their corresponding oral symptoms.

Matched MeSH terms: Pregnancy
Fulltext Tocotrienols and oxidative stress in ocytes and developing embryos

Yuhaniza Shafinie Kamsani, Mohd Hamim Rajikin

Journal of Clinical and Health Sciences, 2017;2:8-18.

This review summarizes the impact of tocotrienols (TCTs) as antioxidants in minimizing
oxidative stress (OS), particularly in embryos exposed to OS causing agents. OS level is
increased, for example, by nicotine, a major alkaloid content in cigarette, which is also a source
of exogenous reactive oxygen species (ROS). Increased nicotine-induced OS increases cell
stress response, which is a common trigger leading to embryonic cell death. Having more
profound anti-oxidative stress effects than its counterpart tocopherol, TCTs improve blastocyst
implantation, foetal growth, pregnancy outcome and survival of the neonates affected by
nicotine. In reversing cell developmental arrest caused by nicotine-induced OS, TCTs enhances
PDK-1 expression in the P13K/Akt pathway and permit embryonic development beyond the 4-
cell stage with the production of more morulae. At the cytoskeletal level, TCTs increase the
number of nicotine-induced apoptotic cells, through caspase 8 activation in the mitochondria.
TCTs facilitate rough endoplasmic reticulum (rER) stress-mediated apoptosis and autophagy,
resulting from nicotine-induced OS. Reduced vesicular population in TCT supplemented
oocytes on the other hand may suggest reduced secretion of apoptotic cell bodies thus probably
minimizing vesicular apoptosis during oocyte maturation. Further extensive research is
required to develop TCTs as a tool in specific therapeutic approaches to overcome the
detrimental effects of OS.

Matched MeSH terms: Pregnancy; Pregnancy Outcome
Fulltext Tocotrienols and oxidative stress in ocytes and developing embryos

Yuhaniza Shafinie Kamsani, Mohd Hamim Rajikin

Journal of Clinical and Health Sciences, 2017;2(2):8-18.
MyJurnal

This review summarizes the impact of tocotrienols (TCTs) as antioxidants in minimizing oxidative stress (OS), particularly in embryos exposed to OS causing agents. OS level is increased, for example, by nicotine, a major alkaloid content in cigarette, which is also a source of exogenous reactive oxygen species (ROS). Increased nicotine-induced OS increases cell stress response, which is a common trigger leading to embryonic cell death. Having more profound anti-oxidative stress effects than its counterpart tocopherol, TCTs improve blastocyst implantation, foetal growth, pregnancy outcome and survival of the neonates affected by nicotine. In reversing cell developmental arrest caused by nicotine-induced OS, TCTs enhances PDK-1 expression in the P13K/Akt pathway and permit embryonic development beyond the 4-cell stage with the production of more morulae. At the cytoskeletal level, TCTs increase the number of nicotine-induced apoptotic cells, through caspase 8 activation in the mitochondria. TCTs facilitate rough endoplasmic reticulum (rER) stress-mediated apoptosis and autophagy, resulting from nicotine-induced OS. Reduced vesicular population in TCT supplemented oocytes on the other hand may suggest reduced secretion of apoptotic cell bodies thus probably minimizing vesicular apoptosis during oocyte maturation. Further extensive research is required to develop TCTs as a tool in specific therapeutic approaches to overcome the detrimental effects of OS.

Matched MeSH terms: Pregnancy; Pregnancy Outcome
Prevention of respiratory distress syndrome

Yu, Victor Y.H.

Malaysian Journal of Child Health, 1993;5(1):3-8.
MyJurnal

ANTENATAL CORTICOSTEROID THERAPY. Benefits. In 1969, the first study was published which showed that prematurely delivered lambs exposed prenatally to corticosteroids survived longer than placebo-treated control animals.' A randomised clinical trial (RCT) followed which demonstrated that antenatal corticosteroid therapy significantly reduced the incidence of respiratory distress syndrome (RDS) in infants born before 2 weeks gestation and reduced mortality in those born before 37 weeks.2 A meta-analysis has been published on 12 RCTs involving over 3000 women in preterm labour, using primarily 24mg of betamethasone or dexamethasone given in 2-6 divided doses over a 48-hour period.' It showed that antenatal corticosteroid therapy is associated with a significant reduction in the risk of RDS (a) if the infant is born > 24 hours or < 7 days of the treatment, (b) in both male and female infants and (c) even in infants < 31 weeks gestation. It also significantly reduces mortality rate and morbidity such as intraventricular haemorrhage (IVH) and necrotising enterocolitis (NEC), shortens the duration of hospitalisation and reduces treatment costs. The improvement in survival rate in infants born

Matched MeSH terms: Pregnancy
MPA given orally during the first trimester for threatened miscarriage carries no specific risk for foetal abnormalities albeit the rate is higher than non-threatened pregnancies

Yovich JL, Mariappen U, Hinchliffe PM, Dhaliwal SS, Keane KN

Reprod Biol, 2020 Sep;20(3):424-432.
PMID: 32389607 DOI: 10.1016/j.repbio.2020.03.008

This observational study examines the outcomes of pregnancies arising in women referred for infertility, where those who experienced threatened miscarriage were treated with medroxyprogesterone acetate (MPA) tablets. The 14-year study period covers comprehensive real-time data entries into the validated electronic database including details of the infertility management, pregnancy outcomes and any foetal anomalies among the infants, each being tracked and recorded. Of 4057 clinical pregnancies, 1343 received MPA for threatened miscarriage; 934 (69.6 %) of which continued to livebirths. These were compared with the remaining 2714 clinical pregnancies without threatened miscarriage or MPA and which resulted in 2075 (76.5 %) livebirths. There were 134 developmental abnormalities recorded among the 3009 livebirths of which 78 (2.6 %) were categorised appropriate for the Western Australian Developmental Abnormalities Register; WARDA. These comprised 55 in the MPA group, 36 of which were categorised as serious (being 2.7 % of clinical pregnancies and 3.9 % of births). In the group without MPA, there were 79 abnormalities, of which 42 were categorised as serious (being 1.7 % of clinical pregnancies and 2.2 % of births). Specifically, there were no cases of androgenisation noted among the female infants. The abnormality rates were low overall and well within the annual WARDA ranges. We cautiously suggest that oral MPA can be considered for studies throughout pregnancy including the early first trimester to assess a potential role in reducing miscarriage, as well as advanced pregnancies to evaluate a potential role in reducing stillbirths and preterm delivery.

Matched MeSH terms: Pregnancy; Pregnancy Outcome; Pregnancy, Multiple
Fulltext Anti-G with concomitant anti-C and anti-D: A case report in a pregnant woman

Yousuf R, Mustafa AN, Ho SL, Tang YL, Leong CF

Asian J Transfus Sci, 2017 3 21;11(1):62-64.
PMID: 28316444 DOI: 10.4103/0973-6247.200770

The G antigen of Rh blood group system is present in almost all D-positive or C-positive red cells but absent from red cells lacking D and C antigens. The differentiation of anti-D and anti-C from anti-G is not necessary for routine transfusion; however, during pregnancy, it is important because anti-G can masquerade as anti-D and anti-C with initial antibody testing. The false presence of anti-D will exclude the patient from receiving anti-D immunoglobulin (RhIG) when the patient actually is a candidate for RhIG prophylaxis. Moreover, patients with positive anti-D or anti-G are at risk of developing hemolytic disease of the fetus and newborn and need close monitoring. Thus, proper identification allows the clinicians to manage patients properly. This case report highlights a rare case of anti-G together with anti-D and anti-C in a pregnant woman. This report disseminates knowledge on identification of anti-G and its importance in pregnant women.

Matched MeSH terms: Pregnancy
Zinc Content in Cord Blood Is Associated with Maternal Age and Parity

Youssof AL, Kassim NL, Rashid SA, De Ley M, Rahman MT

Biol Trace Elem Res, 2017 Jan;175(1):17-26.
PMID: 27250493 DOI: 10.1007/s12011-016-0760-x

At childbirth (parturition), zinc (Zn) homeostasis in cord blood (CB) can be affected by a number of factors: Zn in maternal blood, parturition related stress as well as metallothionein (MT). Both Zn and stress are known inducers of MT which is primarily involved in Zn homeostasis. This study analyzed Zn concentration [Zn], in CB components and MT-2A transcription in CB mononuclear cells (MNC) in relation to primiparous and multiparous childbirth. [Zn] in CB (n = 47) plasma, erythrocytes, and MNCs were measured by atomic absorption spectrophotometry (λ = 213.9 nm). The MT-2A transcription in CB-MNC was quantified using real-time PCR. Significant correlations (Pearson r) were found between: plasma-[Zn] and erythrocyte-[Zn] (p = 0.002); [Zn] and MT-2A messenger RNA (mRNA) (p = 0.000) in CB-MNC. Student's t tests showed higher levels of MT-2A mRNA and MNC-[Zn] in CB of older (≥25 years) compared to younger mothers (≤24 years) (p = 0.043 and p = 0.016, respectively). Significantly higher [Zn] was found in CB plasma (p = 0.017) and MNC (p = 0.041) of older primiparous compared to the younger primiparous and older multiparous mothers respectively. MT-2A mRNA in CB-MNC was significantly lower in CB of younger primiparous mothers compared to their older counterparts (p = 0.001). Path analysis showed that MNC-[Zn] (β = 0.83; p = 0.000) had a greater influence on MT-2A mRNA expression, compared to parity (β = -0.14; p = 0.033). Higher [Zn] in CB of primiparous mothers could be linked to higher stress during parturition, however, might be beneficial for the growth and development of the child. Together MNC-[Zn] and parity contributed ~70 % of the MT-2A transcription in CB-MNC.

Matched MeSH terms: Pregnancy
Obesity: how much does it matter for female pelvic organ prolapse?

Young N, Atan IK, Rojas RG, Dietz HP

Int Urogynecol J, 2018 08;29(8):1129-1134.
PMID: 28914337 DOI: 10.1007/s00192-017-3455-8

INTRODUCTION AND HYPOTHESIS: The objective was to determine the association between body mass index (BMI) and symptoms and signs of female pelvic organ prolapse (POP).
METHODS: An observational cross-sectional study of 964 archived datasets of women seen for symptoms and signs of lower urinary tract and pelvic organ dysfunction between September 2011 and February 2014 at a tertiary urogynaecology centre in Australia was carried out. An in-house standardised interview, the International Continence Society Pelvic Organ Prolapse Quantification (ICS POP-Q) and 4-D translabial ultrasound, followed by analysis of ultrasound volumes for pelvic organ descent and hiatal area on Valsalva, were performed, blinded against other data.
RESULTS: There is a positive association between BMI and posterior compartment prolapse on clinical examination and ultrasound imaging, but not for the anterior and central compartments. There was no association with prolapse symptom bother and a negative association with symptoms of prolapse.
CONCLUSIONS: In this observational study, we found a strong association between all tested measures of posterior compartment descent and BMI, both clinical and on imaging.

Matched MeSH terms: Pregnancy
Fulltext Variations in medical practice of retinopathy of prematurity among 8 Asian countries from an international survey

Youn YA, Kim SY, Cho SJ, Chang YS, Miyake F, Kusuda S, et al.

Sci Rep, 2023 Sep 20;13(1):15602.
PMID: 37730731 DOI: 10.1038/s41598-023-42432-3

Advances in perinatal care have led to the increased survival of preterm infants with subsequent neonatal morbidities, such as retinopathy of prematurity (ROP). This study aims to compare the differences of neonatal healthcare systems, resources, and clinical practice concerning ROP in Asia with review of current literature. An on-line survey at the institutional level was sent to the directors of 336 neonatal intensive care units (NICU) in 8 collaborating national neonatal networks through the Asian Neonatal Network Collaboration (AsianNeo). ROP screening was performed in infants born at

Matched MeSH terms: Pregnancy
Introducing external cephalic version in a Malaysian setting

Yong SP

Hong Kong Med J, 2007 Feb;13(1):40-5.
PMID: 17277391

To assess the outcome of external cephalic version for routine management of malpresenting foetuses at term.

Matched MeSH terms: Pregnancy; Pregnancy Outcome
Fulltext Hyperkalaemic periodic paralysis in pregnancy

Yong SL, Sin TH, Tang EB, Chai MC

BMJ Case Rep, 2018 Jun 04;2018.
PMID: 29866669 DOI: 10.1136/bcr-2017-223588

Hyperkalaemic periodic paralysis is a rare skeletal muscle disorder which is characterised by episodic muscle paralysis associated with hyperkalaemia. Although it is an autosomal-dominant disease, cases of de novo mutations have been reported. We report the case of a 30-year-old woman, gravida 5 para 3+1, who was planned for an elective repeated caesarean section at 38 weeks and 3 days of pregnancy. She developed recurrent episodes of hyperkalaemic periodic paralysis after receiving corticosteroids. Intravenous calcium gluconate was administered to normalise potassium levels (from 6.3 mmol/L to 4.1 mmol/L). Extra anaesthetic precautions were taken during the caesarean delivery. Postoperatively, she was well and discharged from the ward. She encountered similar symptoms in her third pregnancy, and there was no family history of muscle weakness which suggested a de novo mutation. Pregnancy seemed to result in vulnerability to hyperkalaemic attacks as she was never symptomatic outside pregnancy.

Matched MeSH terms: Pregnancy; Pregnancy Complications/diagnosis*; Pregnancy Complications/drug therapy; Pregnancy Complications/metabolism
Impact of late pregnancy haemoglobin A1c at 29-30 weeks' gestation on adverse pregnancy outcomes among women with pre-existing diabetes: a retrospective analysis

Yong SL, Ng BK, Mohd Yassin MAJ, Syed Zakaria SZ, Mohamed Ismail NA

J Obstet Gynaecol, 2018 May;38(4):461-465.
PMID: 29390907 DOI: 10.1080/01443615.2017.1372397

This study was to assess the relationship between late pregnancy haemoglobin A1C (HbA1C) at 29-30 weeks of gestation and adverse pregnancy outcomes (APOs) in 272 pregnant women with pre-existing diabetes. HbA1C ≥6.1% was associated with significantly increased risk of preterm delivery, Caesarean section, large for gestational age (LGA), neonatal respiratory distress, neonatal hypoglycaemia, and composite adverse neonatal outcome (p 5.6% (p = .039). Reduction of HbA1C cut-off from 6.1% to 5.6% improved the sensitivity but reduced the specificity for prediction of APOs. Overall, the receiver operating characteristic (ROC) curves demonstrated the moderate predictive value of late pregnancy HbA1C for APOs. In conclusion, elevated late pregnancy HbA1C levels at 29-30 gestational weeks had a negative impact on APOs in pregnant women with pre-existing diabetes. However, HbA1C cut-off levels of neither ≥6.1% nor >5.6% were ideal for predicting APOs. Impact statement What is already known on this subject: Poorly controlled diabetes is associated with adverse pregnancy outcomes (APOs). Periconceptual haemoglobin A1C (HbA1C) correlates well with the risk of foetal anomaly but is not predictive of APOs at time of delivery. New evidence suggested that late pregnancy HbA1C is predictive of APOs but the definitions of a late pregnancy gestational week and target HbA1C cutpoint remain in doubt. What the results of this study add: This study investigated the relationship between late pregnancy HbA1C levels at 29-30 weeks of gestation and the APOs among pregnant women with pre-existing diabetes. Late pregnancy HbA1C ≥ 6.1% correlated with the risk of APOs but the increased risk of pre-eclampsia only became significant at the lower cut-off of >5.6%. Reducing HbA1C cut-off from 6.1% to 5.6% improved the sensitivity but reduced the specificity for prediction of APOs. Overall, late pregnancy HbA1C had a moderate predictive value for APOs. What the implications are of these findings for clinical practice and/or further research: HbA1C cut-off levels of neither ≥6.1% nor >5.6% were ideal in predicting APOs among pregnant women with pre-existing diabetes. As HbA1C levels tend to drop in pregnancy, caution should be taken when interpreting HbA1C in pregnancy. More multi-centred studies are required to explore the respective glycaemic target for each APO and to determine the ideal timing for late pregnancy HbA1C measurement.

Matched MeSH terms: Pregnancy; Pregnancy in Diabetics/blood*; Pregnancy in Diabetics/epidemiology; Pregnancy Outcome/epidemiology*; Pregnancy Trimester, Third/blood*
Pre-pregnancy body mass index, height and physical activity are associated with rate of gestational weight gain among Malaysian mothers

Yong HY, Mohd Shariff Z, Koo SJ, Binti Sa'ari NS

J Obstet Gynaecol Res, 2016 Sep;42(9):1094-101.
PMID: 27226139 DOI: 10.1111/jog.13039

AIM: Both inadequate and excessive weight gain during pregnancy can have immediate and long-term health risks for women and infants. This study investigated rate of gestational weight gain (GWG) and its associated factors in Malaysian pregnant women.
METHODS: This cross-sectional study was conducted at maternal and child health clinics in Selangor and Negeri Sembilan between November 2010 and April 2012. A pre-tested questionnaire was used to obtain sociodemographic, obstetric, dietary intake and physical activity information. Current weight and height were measured using standard procedures. GWG rate was calculated as the average weekly weight gain in that particular trimester of pregnancy and further categorized according to the Institute of Medicine (IOM) recommendations.
RESULTS: Mean GWG rate for all pre-pregnancy BMI categories in the second and third trimesters was higher than the IOM recommendations. Overweight women (adjusted OR, 4.26; 95%CI: 1.92-9.44) and women <153 cm tall (adjusted OR, 1.96; 95%CI: 1.21-3.18) tend to have inadequate GWG rate. Women with high pre-pregnancy body mass index (BMI; ≥25.0 kg/m(2) ; overweight: adjusted OR, 3.88; 95%CI: 2.12-7.09; obese: adjusted OR, 2.34; 95%CI: 1.28-4.29) and low physical activity (adjusted OR, 1.74; 95%CI: 0.77-3.97) were two-threefold more likely to have excessive GWG.
CONCLUSION: Both inadequate and excessive GWG can have detrimental effects on the health of mothers and infants. Pre-pregnancy BMI, height and physical activity should be emphasized in prenatal care to ensure that women have adequate GWG rate.
Study site: maternal and child health clinics (Klinik Kesihatan), Selangor and Negeri Sembilan, Malaysia

Matched MeSH terms: Pregnancy; Pregnancy Complications/epidemiology*; Pregnancy Trimester, Second; Pregnancy Trimester, Third
Fulltext Pre-Pregnancy BMI Influences the Association of Dietary Quality and Gestational Weight Gain: The SECOST Study

Yong HY, Mohd Shariff Z, Mohd Yusof BN, Rejali Z, Tee YYS, Bindels J, et al.

Int J Environ Res Public Health, 2019 10 04;16(19).
PMID: 31590213 DOI: 10.3390/ijerph16193735

Poor diet quality in pregnancy could impact gestational weight gain (GWG) and consequently fetal growth and development. But today there is limited data available on gestational diet quality. This study investigated the association between diet quality in each pregnancy trimester and GWG in Malaysian women. Diet quality was assessed using the modified Healthy Eating Index for Malaysians (HEI). Total GWG was defined as the difference between measured weight at last prenatal visit and pre-pregnancy weight. About one-fourth of women (23.3%) had excessive total GWG. There were significant differences in the HEI component score across trimesters, except for fruits. Overall, overweight/obese women had lower total HEI score (51.49-55.40) during pregnancy compared to non-overweight/obese women (53.38-56.50). For non-overweight/obese women, higher total HEI scores in the second and third trimesters were significantly associated with lower risk of inadequate GWG (aOR = 0.97, 95% CI = 0.95-0.99, p = 0.01) and higher risk of excessive GWG (aOR = 1.04, 95% CI = 1.01-1.07, p = 0.03), respectively. Overweight/obese women with higher total HEI scores in the second (aOR = 1.04, 95% CI = 1.01-1.07, p = 0.02) and third trimester (aOR = 1.04, 95% CI = 1.01-1.08, p = 0.02) were significantly at higher risk for excessive GWG. Pregnant women had relatively low diet quality throughout pregnancy. Diet quality and GWG association differed according to pre-pregnancy BMI with excessive GWG more likely to be associated with higher total HEI scores in the third trimester.

Matched MeSH terms: Pregnancy; Pregnancy Trimesters
Fulltext Higher Parity, Pre-Pregnancy BMI and Rate of Gestational Weight Gain Are Associated with Gestational Diabetes Mellitus in Food Insecure Women

Yong HY, Mohd Shariff Z, Mohd Yusof BN, Rejali Z, Tee YYS, Bindels J, et al.

Int J Environ Res Public Health, 2021 03 07;18(5).
PMID: 33800084 DOI: 10.3390/ijerph18052694

Food insecurity may exacerbate adverse maternal health outcomes during pregnancy, however, this association has not been well established, particularly in the context of developing countries. This study aimed to identify the associations between household food insecurity and gestational diabetes mellitus (GDM) risk among urban pregnant women. Household food insecurity was assessed using the translated 10-item Radimer/Cornell hunger scale. Logistic regression models were used to estimate the associations between food insecurity status and GDM risk. About 35.6% of women experienced food insecurity, with 25.2% reported household food insecurity, 8.0% individual food insecurity, and 2.4% child hunger. Food insecure women were at significantly higher risk of developing GDM compared to food secure women (AOR = 16.65, 95% CI = 6.17-24.98). The significant association between food insecurity and GDM risk was influenced by pre-pregnancy BMI, parity and rate of GWG at second trimester. Food insecure women with parity ≥ 2 (AOR = 4.21, 95% CI = 1.98-8.92), overweight/obese BMI prior to pregnancy (AOR = 12.11, 95% CI = 6.09-24.10) and excessive rate of GWG in the second trimester (AOR = 9.66, 95% CI = 4.27-21.83) were significantly more likely to develop GDM compared to food secure women. Food insecurity showed strong association with GDM risk in that the association was influenced by maternal biological and physical characteristics. Multipronged interventions may be necessary for food insecure pregnant women who are not only at risk of overweight/obesity prior to pregnancy but also may have excessive gestational weight gain, in order to effectively reduce GDM risk.

Matched MeSH terms: Pregnancy
Fulltext High physical activity and high sedentary behavior increased the risk of gestational diabetes mellitus among women with excessive gestational weight gain: a prospective study

Yong HY, Mohd Shariff Z, Mohd Yusof BN, Rejali Z, Bindels J, Tee YYS, et al.

BMC Pregnancy Childbirth, 2020 Oct 07;20(1):597.
PMID: 33028258 DOI: 10.1186/s12884-020-03299-8

BACKGROUND: Although physical activity (PA) in pregnancy benefits most women, not much is known about pregnancy-related changes in PA and its association with gestational diabetes mellitus (GDM) risk. The aim of this study was to identify the trajectory of PA during pregnancy and possible associations with the risk of GDM.
METHODS: This was a prospective cohort study of 452 pregnant women recruited from 3 health clinics in a southern state of Peninsular Malaysia. PA levels at the first, second, and third trimester were assessed using the Pregnancy Physical Activity Questionnaire. GDM was diagnosed at 24-28 weeks of gestation following the Ministry of Health Malaysia criteria. Group-based trajectory modeling was used to identify PA trajectories. Three multivariate logistic models were used to estimate the odds of trajectory group membership and GDM.
RESULTS: Two distinct PA trajectories were identified: low PA levels in all intensity of PA and sedentary behavior (Group 1: 61.1%, n = 276) and high PA levels in all intensity of PA as well as sedentary behavior (Group 2: 38.9%, n = 176). Moderate and high intensity PA decreased over the course of pregnancy in both groups. Women in group 2 had significantly higher risk of GDM in two of the estimated logistic models. In all models, significant associations between PA trajectories and GDM were only observed among women with excessive gestational weight gain in the second trimester.
CONCLUSIONS: Women with high sedentary behavior were significantly at higher risk of GDM despite high PA levels by intensity and this association was significant only among women with excessive GWG in the second trimester. Participation in high sedentary behavior may outweigh the benefit of engaging in high PA to mitigate the risk of GDM.

Matched MeSH terms: Pregnancy; Pregnancy Trimester, Second; Pregnancy Trimester, Third
Fulltext Beverage Intake and the Risk of Gestational Diabetes Mellitus: The SECOST

Yong HY, Mohd Shariff Z, Mohd Yusof BN, Rejali Z, Tee YYS, Bindels J, et al.

Nutrients, 2021 Jun 27;13(7).
PMID: 34199062 DOI: 10.3390/nu13072208

The contribution and impact of beverage intake to total nutrient and energy intake may be substantial. Given the link between lifestyle, diet, and the risk of pregnancy complications, this study investigated the association between the quantity and types of beverages with gestational diabetes mellitus (GDM) risk. The study included 452 women from the Seremban Cohort Study (SECOST). The mean energy by beverage intake was 273 ± 23.83 kcal/day (pre-pregnancy), 349 ± 69.46 kcal/day (first trimester) and 361 ± 64.24 kcal/day (second trimester). Women significantly increased intake of maternal milks and malted drinks, but significantly reduced the intake of carbonated drinks and other drinks from before until the second trimester of pregnancy. For chocolate drinks, carbonated drinks, and soy milk, women increased intake from pre-conception to the first trimester, but reduced their intake from the first to the second trimester. While higher intake of cultured-milk drinks was associated with an increased risk of GDM, higher fruit juice intake was associated with a lower risk of GDM. However, these associations were only observed for intake prior to pregnancy and during the first trimester. Further research is needed to corroborate these findings and investigate the contributions of different beverages to overall diet quality as well as adverse health outcomes during pregnancy.

Matched MeSH terms: Pregnancy
Fulltext The association between dietary patterns before and in early pregnancy and the risk of gestational diabetes mellitus (GDM): Data from the Malaysian SECOST cohort

Yong HY, Mohd Shariff Z, Mohd Yusof BN, Rejali Z, Appannah G, Bindels J, et al.

PLoS One, 2020;15(1):e0227246.
PMID: 31923230 DOI: 10.1371/journal.pone.0227246

Generally, dietary patterns (DP)s have been linked to the risk of diabetes mellitus, however, only few studies examined the associations between DPs in early pregnancy and the risk of gestational diabetes mellitus (GDM). This study aims to determine the association between DPs before and during pregnancy and risk of GDM in Malaysian pregnant women. DPs were derived using principal component analysis of consumed 126 food and beverage items assessed using a validated semi-quantitative food frequency questionnaire collecting data retrospectively for pre-pregnancy, but prospectively for the first and second trimester. Three different DPs were identified at each time point and labelled as DP 1-3 (pre-pregnancy), DP 4-6 (first trimester), and DP 7-9 (second trimester). About 10.6% (n = 48) of pregnant women were diagnosed with GDM in our cohort. Women with high adherence (HA) to DP 2 (adjusted OR: 0.45, 95% CI: 0.20-0.91) and DP 5 (adjusted OR: 0.28, 95% CI: 0.11-0.68) showed a significantly reduced risk of GDM compared to women with low adherence (LA). Other DPs were not significantly associated with GDM risk. Compared to women with GDM, non-GDM women showed HA scores for all DPs throughout pregnancy. Overall, a relative low percentage of women with GDM was found in this cohort. The risk was lower in women with HA to a relatively unhealthy dietary pattern, i.e. DP 2 and DP 5. The lower body mass index (BMI) status and energy intake of women showing a HA to DP 2 in the first trimester may underlie the observed association with a lower GDM risk. Additionally, genetic variance might explain the less susceptibility to GDM despite HA to unhealthy DPs among non-GDM women.

Matched MeSH terms: Pregnancy; Pregnancy Trimester, First*; Pregnancy Trimester, Second*
Fulltext Seremban Cohort Study (SECOST): a prospective study of determinants and pregnancy outcomes of maternal glycaemia in Malaysia

Yong HY, Mohd Shariff Z, Rejali Z, Mohd Yusof BN, Yasmin F, Palaniveloo L

BMJ Open, 2018 01 21;8(1):e018321.
PMID: 29358431 DOI: 10.1136/bmjopen-2017-018321

INTRODUCTION: Both gestational diabetes mellitus (GDM) and hyperglycaemia less severe than GDM are associated with risk of adverse pregnancy outcomes. We describe the study design of a prospective cohort of pregnant women recruited in early pregnancy with follow-ups of mothers and infants up to 2 years after birth. The primary aim of the study was to identify the determinants and outcomes of maternal glycaemia.
METHODS AND ANALYSIS: Seremban Cohort Study (SECOST) is an ongoing prospective cohort study in which eligible pregnant women in first trimester (<10 weeks of gestation) are recruited from Maternal and Child Health clinics in Seremban District, Negeri Sembilan with seven follow-ups during pregnancy through 2 years postnatally. Infants are followed up every 6 months after birth until 2 years old. A standard 75 g oral glucose tolerance test is performed between 24 and 32 of weeks of gestation and as close to 28 weeks of gestation. Pregnancy and birth information are obtained from medical records. Sociodemographic, anthropometric, biochemical, dietary, physical activity, smoking, depression, child feeding and other data of mothers and infants are obtained at follow-ups.
ETHICS AND DISSEMINATION: This study is approved by the Medical Research Ethics Committee (MREC), Universiti Putra Malaysia (UPM/FPSK/100-9/2-MJKEtika) and MREC, Ministry of Health Malaysia (KKM/NIHSEC/08/0804/P12- 613). Permission to conduct this study is also obtained from the Head of Seremban District Health Office. All participants are required to provide written informed consent prior to data collection. The research findings will be disseminated at journals and conference presentations.
Study name: Seremban Cohort Study (SECOST)

Matched MeSH terms: Pregnancy; Pregnancy Complications/epidemiology*; Pregnancy Outcome*
Early pregnancy hemoglobin is associated with the risk of gestational diabetes mellitus: a retrospective cohort study

Yong HY, Mohd Shariff Z, Mohd Yusof BN, Rejali Z, Tee YYS, Bindels J, et al.

Br J Nutr, 2022 Dec 14;128(11):2097-2104.
PMID: 35139935 DOI: 10.1017/S000711452100502X

This study aimed to determine the association between hemoglobin (Hb) concentration and Hb change, during early to mid-pregnancy with the risk of gestational diabetes mellitus (GDM). This was a clinic-based retrospective cohort study of 1951 healthy pregnant women (18-45 years old) with a singleton gestation attending antenatal care at government health clinics. Hb concentration at first prenatal visit and each trimester was extracted from the antenatal cards. Hb changes from first prenatal visit to first and second trimester as well as from second to third trimester were calculated. Multivariate logistic regression was used with adjustment for covariates. Women with GDM had significantly higher Hb concentrations (Hb 1) at first prenatal visit (< 12 weeks) compared with non-GDM women (11·91 g/dl v.11·74 g/dl). Hb 1 and Hb changes (Hb change 2) from first prenatal visit to the second trimester (23-27th weeks) were significantly associated with GDM risk, with an adjusted OR of 1·14 (95 % CI 1·01, 1·29) and 1·25 (95 % CI 1·05, 1·49), respectively. The significant associations between Hb 1 and Hb change 2 with the risk of GDM were found among non-Malays, overweight/obese and women aged 35 years and above. Women with higher Hb concentrations in early pregnancy were at higher risk of GDM, and such association was significant among women aged 35 years and above, non-Malays and overweight/obese. This raises a potential concern for elevated Fe status in early pregnancy as a risk factor of GDM among Fe-replete women.

Matched MeSH terms: Pregnancy

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