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Fulltext Outcome of pregnancy among Malaysian women with diabetes mellitus - a single centre experience

Nirmala Kampan, Hanis Azman, Izzat Hafiz, Hazwani Mohammad, Chuah, Su Yee, Nur Azurah Abd Ghani, et al.

Malaysian Journal of Public Health Medicine, 2013;13(2):1-10.
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To observe the maternal and neonatal outcomes among women with diabetes mellitus in pregnancy as compared to healthy control. A case-control study involving 400 women with DM who delivered between 2005 to 2009 was done with age-matched control group. A total of 305 women (76.25%) were gestational diabetes mellitus (GDM) on diet control, 79 (19.75%) were GDM on insulin and 16 (4%) were pre-existing DM. The mean body mass index of the women with diabetes was higher compared to the age-matched healthy women (p
Single nucleotide polymorphism for certain genes involved in gestational diabetes with risk factors and complications positive

NOR AZLIN MOHAMED ISMAIL, NORKHATIJAH MOHD ARIS, ZALEHA ABDULLAH MAHDY, SHUHAILA AHMAD, NORZILAWATI MOHD NAIM, HARLINA HARLIZAH SIRAJ, et al.

Sains Malaysiana, 2013;42:1613-1618.

Gestational Diabetes Mellitus (GDM) is associated with pregnancy complications, however its mechanism has not been fully understood. The aim of this study was to investigate the single nucleotide polymorphism (SNP) for identifying candidate genes involve in risk factors and complications of GDM. A total of 174 pregnant women with GDM and 114 healthy pregnant women were genotyped with 384 SNPs from 236 genes. The SNPs identified were rs10946398 (CDKAL1) in GDM risk factors; rs328 (LPL) and rs1042778 (OXTR) in complications of caesarean section; rs5404 (SLC2A2), rs5400 (SLC2A2) and rs13306465 (IRS1) for neonatal intensive care admission. Whereby SNPs rs12255372, rs7901695 and rs7903146 from TCF7L2 gene had six times higher risk (OR, 6.40-6.53) for T2DM at postpartum. In conclusion, although the above SNPs were identified with GDM risk factors and complications among pregnant Malaysian women with GDM, a larger study is needed to ascertain this candidate genes actual association.
Comparative study of two insulin regimes in pregnancy complicated by diabetes mellitus

Nor Azlin MI, Nor NA, Sufian SS, Mustafa N, Jamil MA, Kamaruddin NA

Acta Obstet Gynecol Scand, 2007;86(4):407-8.
PMID: 17486460
Fulltext Prevalence, Knowledge and Awareness of Pelvic Floor Disorder among Pregnant Women in a Tertiary Centre, Malaysia

Nur Farihan M, Ng BK, Phon SE, Nor Azlin MI, Nur Azurah AG, Lim PS

Int J Environ Res Public Health, 2022 Jul 07;19(14).
PMID: 35886170 DOI: 10.3390/ijerph19148314

Pelvic floor disorders are common and of concern, as the majority of maternity healthcare providers seldom discuss this issue with patients compared to other antenatal issues. The aim of this study is to determine the prevalence and to assess the knowledge and awareness of pelvic floor disorder (PFD) among pregnant women in a tertiary centre in Malaysia. We also aim to assess the association between women’s risk factors regarding their knowledge and awareness of pelvic floor disorder so that primary prevention strategies can be planned, initiated and implemented in the future. This is a cross-sectional study with a total of four hundred twenty-four pregnant women that were recruited over a 6-month duration from May to November 2017 in a tertiary centre in Malaysia. The Pelvic Floor Distress Inventory (PFDI-20) was used to evaluate pelvic floor distress symptoms during pregnancy, namely urinary incontinence, pelvic organ prolapse and faecal incontinence. A validated Prolapse and Incontinence Knowledge Questionnaire (PIKQ), which consists of 24 items, was used to assess respondents’ knowledge about urinary incontinence (UI) and pelvic organ prolapse (POP). A total of 450 participants were approached, but 424 participants agreed to participate, showing a response rate of 94.3%. The median age was 31.5 years old, and 33.3% were primiparity. Overall, 46.1% of pregnant women had at least one symptom of pelvic floor disorder during pregnancy. Of these, 62.3% experienced urinary incontinence, 41.1% experienced symptoms of pelvic organ prolapse, and 37.8% experienced symptoms of faecal incontinence. The overall median score of PIKQ was 12.0 (8.0, 17.0). The median score for PIKQ—UI was 7.0 (5.0, 9.0) and the median score for PIKQ—POP was 6.0 (4.0, 8.0). There were 341 (80.4%) pregnant women that had a low level of knowledge in UI, and 191 (45.0%) had a low level of knowledge in POP. Having a tertiary level of education and receiving antenatal specialist care were both associated with better proficiency in both the PIKQ—UI (p < 0.001) and PIKQ—POP (p < 0.001) subscales. Pelvic floor disorder during pregnancy was common. A knowledge of pelvic floor disorder was lacking among pregnant women in this study. Having a tertiary education and receiving antenatal specialist care were both associated with better knowledge proficiency. This study hopefully serves as a basic platform for future educational programs to bridge the knowledge gaps in PFD among pregnant women.
Fulltext Outcomes of Pregnancy in COVID-19-Positive Mothers in a Tertiary Centre

Subramaniam V, Ng BK, Phon SE, Muhammad Rafi'uddin H, Wira Sorfan AR, Siti Hajar AA, et al.

Life (Basel), 2023 Jun 30;13(7).
PMID: 37511865 DOI: 10.3390/life13071491

BACKGROUND: COVID-19 is an emerging global pandemic with potential adverse effects during pregnancy. This study aimed to determine the adverse maternal and foetal outcomes due to COVID-19 infection. We also compared maternal and neonatal outcomes with regard to the timing of diagnosis (first and second trimester vs. third and fourth trimester); early COVID-19 (stage I and II) vs. severe-stage COVID-19 (III, IV, and V); and lastly, women who were partially vaccinated vs. unvaccinated.
METHODS: This was a retrospective study conducted in HCTM from January 2021 to January 2022. All pregnant women admitted for COVID-19 infections were recruited. The patients' records were traced. Adverse maternal and neonatal outcomes were documented and analysed.
RESULTS: There were 172 pregnant women recruited into this study. We excluded twenty-four patients with incomplete data and nine women who delivered elsewhere. The final 139 patients were available for data analysis. The majority of women were in their third trimester of pregnancy (87.8%); however, only 5.0% and 7.2% were in the first and second trimesters, respectively. The study population had a median BMI of 29.1 kg/m2 and almost half of them had never received a COVID-19 vaccination. A sub-analysis of data concerning adverse maternal and foetal outcomes comparing early vs. severe stages of COVID-19 infection showed that severe-stage disease increased the risk of preterm birth (54.5% vs. 15.4%, p < 0.001) and preterm birth before 34 weeks (31.9% vs. 2.6%, p < 0.001) significantly. The severe-stage disease also increased NICU admission (40.9% vs. 15.4%, p = 0.017) with lower birth weight (2995 g vs. 2770 g, p = 0.017). The unvaccinated mothers had an increased risk of preterm birth before 34 weeks and this was statistically significant (11.6% vs. 2.9%, p = 0.048).
CONCLUSIONS: Adverse pregnancy outcomes such as ICU admission or patient death could occur; however, the clinical course of COVID-19 in most women was not severe and the infection did not significantly influence the pregnancy. The risk of preterm birth before 34 weeks was higher in a more severe-stage disease and unvaccinated mother. The findings from this study can guide and enhance antenatal counselling of women with COVID-19 infection, although they should be interpreted with caution in view of the very small number of included cases of patients in the first and second trimesters.