Abstract:
OBJECTIVE:The purpose of this study was to examine the association between gestational age (GA) at the time of treatment initiation for gestational diabetes mellitus (GDM) and maternal and perinatal outcomes. STUDY DESIGN:We conducted a secondary analysis of a multicenter randomized treatment trial of mild GDM in which women with mild GDM were assigned randomly to treatment vs usual care. The primary outcome of the original trial, as well as this analysis, was a composite perinatal adverse outcome that included neonatal hypoglycemia, hyperbilirubinemia, hyperinsulinemia, and perinatal death. Other outcomes that were examined included the frequency of large for GA, birthweight, neonatal intensive care unit admission, gestational hypertension/preeclampsia, and cesarean delivery. The interaction between GA at treatment initiation (stratified as 24-26, 27, 28, 29, and ≥30 weeks of gestation) and treatment group (treated vs routine care), with the outcomes of interest, was used to determine whether GA at treatment initiation was associated with outcome differences. RESULTS:Of 958 women whose cases were analyzed, those who initiated treatment at an earlier GA did not gain an additional treatment benefit compared with those who initiated treatment at a later GA (probability value for interaction with the primary outcome, .44). Similarly, there was no evidence that other outcomes were improved significantly by earlier initiation of GDM treatment (large for GA, P = .76; neonatal intensive care unit admission, P = .8; cesarean delivery, P = .82). The only outcome that had a significant interaction between GA and treatment was gestational hypertension/preeclampsia (P = .04), although there was not a clear cut GA trend where this outcome improved with treatment. CONCLUSION:Earlier initiation of treatment of mild GDM was not associated with stronger effect of treatment on perinatal outcomes.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Palatnik A,Mele L,Landon MB,Reddy UM,Ramin SM,Carpenter MW,Wapner RJ,Varner MW,Rouse DJ,Thorp JM Jr,Sciscione A,Catalano P,Saade GR,Caritis SN,Sorokin Y,Eunice Kennedy Shriver National Institute of Child Health and Human Dedoi
10.1016/j.ajog.2015.06.022subject
Has Abstractpub_date
2015-10-01 00:00:00pages
560.e1-8issue
4eissn
0002-9378issn
1097-6868pii
S0002-9378(15)00605-5journal_volume
213pub_type
杂志文章,随机对照试验abstract:OBJECTIVE:The purpose of this study was to evaluate the effect of N-acetylcysteine on the activity and secretion of the matrix metalloproteinases in the decidua, amnion, and chorion and the secretion of the tissue inhibitor of matrix metalloproteinase-1. STUDY DESIGN:Samples from eight nonlaboring women were taken at ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(03)00847-0
更新日期:2003-12-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to determine the accuracy of clinical assessment of paravaginal defects in women with anterior vaginal wall prolapse. STUDY DESIGN:A retrospective chart review of all women undergoing surgery for anterior vaginal wall prolapse during the years of 1994 to 1996 identified operat...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(99)70440-0
更新日期:1999-07-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to determine the amniotic fluid soluble intercellular adhesion molecule-1 concentrations in women with preterm labor in relation to intra-amniotic infection. STUDY DESIGN:Amniotic fluids from 125 women with preterm labor (78 with preterm delivery and 47 with term deliveries) we...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2006.05.020
更新日期:2006-12-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to analyze the correlation between the genetic constitution and the phenotype in triploid pregnancies. STUDY DESIGN:One hundred fifty-eight triploid pregnancies were identified in hospitals in Western Denmark from April 1986 to April 2010. Clinical data and karyotypes were colle...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2014.03.039
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine whether thickness, fiber count, and density of urethral circular smooth muscle (CSM) differ in young and old women. STUDY DESIGN:Mid urethral hemiaxial sections from female cadavers aged 20-39 years (n = 12) and 70-89 years (n = 16) were stained for smooth muscle al...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.03.009
更新日期:2008-05-01 00:00:00
abstract::A randomized controlled study was carried out at three medical centers to compare the efficacy and side effects of ethanol and ritodrine in the treatment of threatened premature labor. One hundred and thirty-five patients judged to be between the twentieth and thirty-sixth week of gestation and presenting with clinic...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-9378(77)90115-6
更新日期:1977-04-15 00:00:00
abstract:OBJECTIVE:We sought to determine if genetic polymorphisms in the aryl hydrocarbon receptor signaling pathway are associated with menopausal hot flashes via hormone levels. STUDY DESIGN:Women (n = 639) aged 45-54 years completed a study survey and provided blood for genetic and hormone analyses. The associations were a...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2012.05.019
更新日期:2012-09-01 00:00:00
abstract::The treatment of primary spasmodic dysmenorrhea with prostaglandin synthetase/receptor site inhibitors such as mefenamic acid (Ponstel) is becoming accepted. Recent improvements in intrauterine pressure recording have made the acquisition of reliable, physiologic data possible. These data have been used to provide obj...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1982-06-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to evaluate the effects on peripheric pulmonary vessel muscularization by tracheal occlusion (TO) performed at different gestational ages in fetal rabbits with surgically induced diaphragmatic hernia. STUDY DESIGN:In 23 New Zealand white does, both ovarian end fetuses underwent surg...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.01.006
更新日期:2004-09-01 00:00:00
abstract::This document builds upon recommendations from peer organizations and outlines a process for identifying maternal cases that should be reviewed. Severe maternal morbidity is associated with a high rate of preventability, similar to that of maternal mortality. It also can be considered a near miss for maternal mortalit...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2016.07.050
更新日期:2016-09-01 00:00:00
abstract::A new colposcopic sign (sharpness of peripheral margins) was graded into three objective categories representing subclinical papillomaviral infection, lower grade dysplasia, and grade 3 cervical intraepithelial neoplasia. Colposcopic features were prospectively recorded in 72 women and then correlated with histologic ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(85)80244-1
更新日期:1985-11-15 00:00:00
abstract:OBJECTIVES:Extraperitoneal approaches to removal of lymph nodes for staging in cervical cancer patients are numerous, and each has disadvantages. We developed a supraumbilical transverse incision to initiate irradiation within days of cervical cancer staging. STUDY DESIGN:Twenty patients with advanced stage IIB or III...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(93)90080-3
更新日期:1993-08-01 00:00:00
abstract::Serial hemodynamic investigations were performed in 10 women with twin pregnancies at 20, 24, 28, 32, and 36 weeks' gestation and at 6 months after delivery. Cardiac output was measured by Doppler and cross-sectional echocardiography at the aortic, pulmonary, and mitral valves. Cardiac chamber size and ventricular fun...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(89)90682-0
更新日期:1989-11-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to critically review the indications, outcomes, complications, and costs of laparoscopically assisted vaginal hysterectomy in comparison with abdominal and vaginal hysterectomy. STUDY DESIGN:The operating room log was reviewed to determine the number and route of hysterectomie...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(93)90679-d
更新日期:1993-06-01 00:00:00
abstract::Maternal heart rate (MHR), blood pressure (BP), the differential index (DI) describing the short-term component of fetal heart rate (FHR) variability, and the interval index (II) describing the long-term component were measured in eight subjects in the midtrimester before, during, and after the mothers smoked a standa...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(83)91013-x
更新日期:1983-07-15 00:00:00
abstract::Vitamin D is an essential fat soluble vitamin and a key modulator of calcium metabolism in children and adults. Because calcium demands increase in the third trimester of pregnancy, vitamin D status becomes crucial for maternal health, fetal skeletal growth, and optimal maternal and fetal outcomes. Vitamin D deficienc...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2009.09.002
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVE:Our aim was to examine the effect of the nitric oxide donor isosorbide mononitrate on the uterine cervix at term and to evaluate possible adverse effects of this treatment. STUDY DESIGN:Term pregnant women were randomly selected to receive either 40 mg vaginally administered isosorbide mononitrate or placebo...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0002-9378(03)00865-2
更新日期:2003-12-01 00:00:00
abstract:OBJECTIVE:This study compared myoendometrial versus placental radial uterine arteries from late-pregnant rats to evaluate differences in passive mechanical properties and arterial wall hyperplasia. STUDY DESIGN:Myoendometrial and placental radial uterine arteries were dissected from late-pregnant (day 17-19) Sprague-D...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.06.094
更新日期:2005-01-01 00:00:00
abstract::Epidermal inclusion cysts are a late complication of female genital circumcision, which is a practice that affects 125 million women primarily from Africa and the Middle East. A 30-year-old woman, gravida 4, para 1, presented to our clinic with an 8-year history of a slowly enlarging periclitoral mass. The patient had...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2016.03.026
更新日期:2016-06-01 00:00:00
abstract::The primary source of estrogen, ovarian 17 beta-estradiol, is normally converted to estrone and estriol, both of which are metabolized to their sulfate and glucuronide forms, as well as oxidated to nonestrogens. In postmenopausal women, the primary sources of estrogen are nonovarian, including the production of andros...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(87)90166-9
更新日期:1987-05-01 00:00:00
abstract::We have previously demonstrated in pregnant sheep that ritodrine infusion for 24 hours reduces myometrial beta-adrenergic receptor density and isoproterenol-stimulated adenylate cyclase activity. These receptor-associated changes were accompanied by an increasing inability of ritodrine to inhibit uterine contractility...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(88)90575-3
更新日期:1988-12-01 00:00:00
abstract::Evidence suggests an increased risk of ovarian cancer with asbestos exposure. Ovaries and corresponding fallopian tubes were studied by analytic electron microscopy. There was 71.4% agreement between tube and ovary for presence-type of asbestos. The fallopian tube can provide useful information regarding asbestos expo...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(99)70559-4
更新日期:1999-08-01 00:00:00
abstract:OBJECTIVE:Recent developments permit the use of pulse oximetry to evaluate fetal oxygenation in labor. We tested the hypothesis that the addition of fetal pulse oximetry in the evaluation of abnormal fetal heart rate patterns in labor improves the accuracy of fetal assessment and allows safe reduction of cesarean deliv...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1067/mob.2000.110632
更新日期:2000-11-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to compare the effects of exposure to repeated courses of antenatal steroids with those of a single course on hypothalamic-pituitary-adrenal axis function. STUDY DESIGN:Women at risk of premature delivery were assessed for entry into a randomized controlled trial of repeated courses...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ajog.2007.02.015
更新日期:2007-07-01 00:00:00
abstract::Pancervicovaginal (Papanicolaou) smears exhibiting pseudomycilial-like clumps of organisms obtained from 35 women employing IUD's were studied by direct immunofluorescent technique for identification of A. israelii and A. naeslundi. In every case the specific fluorescence was achieved with species-specific antiserum a...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(78)90604-x
更新日期:1978-06-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to determine the incidence of catheter-associated infection after radical hysterectomy and to evaluate the role of prophylactic antibiotics in these patients. STUDY DESIGN:A 4-year retrospective review of 102 women undergoing radical hysterectomy for cervical or endometrial cancer w...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/s0002-9378(03)00696-3
更新日期:2003-08-01 00:00:00
abstract::This case report describes the antenatal diagnosis of a fetal pulmonary anomaly. Early detection afforded detailed parental counseling and prompt neonatal diagnosis and treatment. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(85)90433-8
更新日期:1985-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the long-term neurodevelopmental outcome in fetuses with severe tachy- or bradyarrhythmia. STUDY DESIGN:This was a follow-up study to assess the neurologic, mental, and psychomotor development in cases with fetal cardiac arrhythmia. RESULTS:A total of 44 fetuses we...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2009.02.002
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVE:This study reports the gynecologic conditions in postmenopausal women (intact uterus on enrollment) in the National Surgical Adjuvant Breast and Bowel Project (NSABP) study of tamoxifen and raloxifene (STAR)/P-2 trial. STUDY DESIGN:This study, with a median follow-up period of 81 months, evaluated the incide...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2011.06.067
更新日期:2011-12-01 00:00:00
abstract::Single-agent chemotherapy of advanced and recurrent squamous carcinoma of the female genital tract has been largely ineffective. Combination-drug therapy which has augmented the efficacy of chemotherapy in numerous solid and nonsolid human tumors is usually attended by a degree of toxicity that has discouraged its use...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(75)90500-1
更新日期:1975-12-01 00:00:00