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Share Cannabidiol Exposure During Gestation Leads To Adverse Cardiac Outcomes Early In Postnatal Life In Male Rat Offspring., Daniel B. Hardy, Steven R. Laviolette, Kendrick Lee, David Rc Natale

Physiology and Pharmacology Publications

Introduction: Studies indicate that *7% of pregnant individuals in North America consume cannabis in pregnancy. Pre-clinical studies have established that maternal exposure to D9-tetrahydrocannabinol (THC; major psychoactive component in cannabis) leads to fetal growth restriction and impaired cardiac function in offspring. However, the effects of maternal exposure to cannabidiol (CBD; major non-euphoric constituent) on cardiac outcomes in offspring remain unknown. Therefore, our objective is to investigate the functional and underlying molecular impacts in the hearts of offspring exposed to CBD in pregnancy. Methods: Pregnant Wistar rats were exposed to either 3 or 30mg/kg CBD or vehicle control i.p. daily from …

Cannabidiol Exposure During Rat Pregnancy Leads To Labyrinth-Specific Vascular Defects In The Placenta And Reduced Fetal Growth, Daniel B. Hardy, David R C Natale, Kendrick Lee

Physiology and Pharmacology Publications

Introduction: Cannabis use is increasing among pregnant people, and cannabidiol (CBD), a constituent of cannabis, is often perceived as ‘‘natural’’ and ‘‘safe’’ as it is non-intoxicating. In utero, cannabis exposure is associated with negative health outcomes, including fetal growth restriction (FGR). The placenta supplies oxygen and nutrients to the fetus, and alterations in placental development can lead to FGR. While there has been some investigation into the effects of D9-THC, there has been limited investigation into the impacts of in utero gestational CBD exposure on the placenta. Methods: This study used histological and transcriptomic analysis of embryonic day (E)19.5 rat …

Prenatal And Postpartum Maternal Mental Health And Neonatal Motor Outcomes During The Covid-19 Pandemic, Alissa Papadopoulos, Emily S. Nichols, Yalda Mohsenzadeh, Isabelle Giroux, Michelle F. Mottola, Ryan J. Van Lieshout, Emma G. Duerden

Neuroscience Institute Publications

Background: Rates of prenatal and postpartum stress and depression in pregnant individuals have increased during the COVID-19 pandemic. Perinatal maternal mental health has been linked to worse motor development in offspring, with motor deficits appearing in infancy and early childhood. We aimed to evaluate the relationship between prenatal and postpartum stress and depression and motor outcome in infants born during the COVID-19 pandemic. Methods: One hundred and seventeen participants completed an online prospective survey study at two timepoints: during pregnancy and within 2 months postpartum. Depression was self-reported using the Edinburgh Perinatal/Postpartum Depression Scale (EPDS), and stress via the Perceived …

Highlighting The Mechanistic Relationship Between Perinatal Depression And Preeclampsia: A Scoping Review, Mei Yuan, Samantha Bedell, Barbra De Vrijer, Genevieve Eastabrook, Jefferson C. Frisbee, Stephanie J. Frisbee

Obstetrics & Gynaecology Publications

Background: Although there is scientific literature supporting an association between depression and preeclampsia (PE), little is known about the underlying mechanistic pathways that may explain these observed associations. Thus, this study aimed to outline the relationship between depression and PE, and to highlight the underlying cardiovascular and metabolic risk factors that are common to both. Methods: A scoping review of the literature was conducted in Medline, Scopus, and Web of Science. Results: From 706 articles initially identified, 23 articles met the inclusion criteria and were included in this review. Although some studies reported a positive association between PE and postpartum …

Sex Differences In The Behavioural Outcomes Of Prenatal Nicotine And Tobacco Exposure, Anita Sikic, Jude A. Frie, Jibran Y. Khokhar, Jennifer E. Murray

Neuroscience Institute Publications

Smoking remains the leading cause of preventable death worldwide. A combination of biological and environmental risk factors make women especially vulnerable to nicotine addiction, making it harder for them to quit smoking. Smoking during pregnancy, therefore, is still a major health concern, with epidemiological data suggesting a role for gestational nicotine exposure in the development of several behavioural disorders. Given there are significant sex-specific behavioural outcomes related to smoking in adolescence and adulthood, it is probable that the behavioural outcomes following gestational nicotine or tobacco exposure are similarly sex-dependent. This is an especially relevant topic as the current landscape of …

Be Healthy In Pregnancy (Bhip): A Randomized Controlled Trial Of Nutrition And Exercise Intervention From Early Pregnancy To Achieve Recommended Gestational Weight Gain, Stephanie A. Atkinson, Atherai Maran, Kendra Dempsey, Maude Perreault, Thuva Vanniyasingam, Stuart M. Phillips, Eileen K. Hutton, Michelle F. Mottola

Paediatrics Publications

A randomized two-arm prospective superiority trial tested the efficacy of a novel structured and monitored nutrition (bi-weekly counselling for individualized energy and high dairy protein diet) and exercise program (walking goal of 10,000 steps/day) (intervention) compared to usual care (control) in pregnant women to achieve gestational weight gain (GWG) within current recommendations. Women recruited in communities in southern Ontario, Canada were randomized at 12–17 weeks gestation with stratification by site and pre-pregnancy BMI to intervention (n = 119) or control (n = 122). The primary outcome was the proportion of women who achieved GWG within the Institute of Medicine recommendations. …

Myasthenia Gravis In Pregnancy: Systematic Review And Case Series, Harrison Banner, Kirsten M. Niles, Michelle Ryu, Mathew Sermer, Vera Bril, Kellie E. Murphy

Paediatrics Publications

Background: Myasthenia gravis is an autoimmune disease which can impact pregnancy. Methods: Six databases were systematically searched for studies with at least five subjects reporting pregnancy outcomes for women with myasthenia gravis in pregnancy. Assessment of bias was performed for all included studies. Forty-eight cases from our own centre were also included in the analysis. Results: In total, 32 publications met inclusion criteria for systematic review, for a total of 33 unique data sets including 48 cases from our institution. Outcome data was available for 824 pregnancies. Spontaneous vaginal delivery occurred in 56.3% of pregnancies. Overall risk of myasthenia gravis …

Acetone Ingestion Mimics A Fasting State To Improve Glucose Tolerance In A Mouse Model Of Gestational Hyperglycemia, Sandra Szlapinski, Brenda Strutt, Madeline Deane, Edith Arany, Jamie Bennett, David J. Hill

Paediatrics Publications

Gestational diabetes mellitus results, in part, from a sub‐optimal β‐cell mass (BCM) during pregnancy. Artemisinins were reported to increase BCM in models of diabetes by α‐ to β‐cell conversion leading to enhanced glucose tolerance. We used a mouse model of gestational glucose intolerance to compare the effects of an artemisinin (artesunate) on glycemia of pregnant mice with vehicle treatment (acetone) or no treatment. Animals were treated daily from gestational days (GD) 0.5 to 6.5. An intraperitoneal glucose tolerance test was performed prior to euthanasia at GD18.5 or post‐partum. Glucose tolerance was significantly improved in both pregnant and non‐pregnant mice with …

Influence Of A Virtual Exercise Program Throughout Pregnancy During The Covid-19 Pandemic On Perineal Tears And Episiotomy Rates: A Randomized Clinical Trial, Cristina Silva-Jose, Miguel Sánchez-Polán, Ángeles Díaz-Blanco, Tirso Pérez-Medina, Vanessa Carrero Martínez, Irune Alzola, Rubén Barakat, Ignacio Refoyo, Michelle F. Ferlisi, Naveen Poonai

Paediatrics Publications

The complications associated with COVID-19 confinement (impossibility of grouping, reduced mobility, distance between people, etc.) influence the lifestyle of pregnant women with important associated complications regarding pregnancy outcomes. Therefore, perineal traumas are the most common obstetric complications during childbirth. The aim of the present study was to examine the influence of a supervised virtual exercise program throughout pregnancy on perineal injury and episiotomy rates during childbirth. A randomized clinical trial design (NCT04563065) was used. Data were collected from 98 pregnant women without obstetric contraindications who attended their prenatal medical consultations. Women were randomly assigned to the intervention (IG, N = …

Roles Of Two Small Leucine-Rich Proteoglycans Decorin And Biglycan In Pregnancy And Pregnancy-Associated Diseases, Chidambra D. Halari, Michael Zheng, Peeyush K. Lala

Paediatrics Publications

Two small leucine-rich proteoglycans (SLRP), decorin and biglycan, play important roles in structural–functional integrity of the placenta and fetal membranes, and their alterations can result in several pregnancy-associated diseases. In this review, we briefly discuss normal placental structure and functions, define and classify SLRPs, and then focus on two SLRPs, decorin (DCN) and biglycan (BGN). We discuss the consequences of deletions/mutations of DCN and BGN. We then summarize DCN and BGN expression in the pregnant uterus, myometrium, decidua, pla-centa, and fetal membranes. Actions of these SLRPs as ligands are then discussed in the context of multiple binding partners in the …

Time Mating Guinea Pigs By Monitoring Changes To The Vaginal Membrane Throughout The Estrus Cycle And With Ultrasound Confirmation, Rebecca L. Wilson, Kristin Lampe, Brad J. Matushewski, Timothy R.H. Regnault, Helen N. Jones

Paediatrics Publications

One of the greatest challenges to the development and implementation of pregnancy therapeutics is the ability to rigorously test treatments in clinically relevant animal models. Guinea pigs offer a unique advantage in studying the placenta, fetal development, and reproductive health as they have similar developmental milestones to humans, both throughout gestation and following birth. Tracking the guinea pig estrus cycle is imperative to ensuring appropriately timed mating and can be performed by monitoring the guinea pig vaginal membrane. Here, we describe a methodology to efficiently and accurately time mate guinea pigs, and provide a picture representation of changes to the …

Risk Associated With Valvular Regurgitation During Pregnancy, Birgit Pfaller, Angelo Dave Javier, Jasmine Grewal, Nadia Gabarin, Jack Colman, Marla Kiess, Rachel M. Wald, Mathew Sermer, Samuel C. Siu, Candice K. Silversides

Paediatrics Publications

Background: Pregnancies in women with regurgitant valve lesions are generally considered low risk, but this has not been well studied. Objectives: This study determined the frequency of adverse cardiac events (CEs) in pregnant women with moderate or severe regurgitant valve lesions. Methods: Maternal and fetal outcomes in women with moderate or severe chronic valve regurgitation enrolled in a prospective multicenter study on pregnancy outcomes were examined. Adverse CEs included heart failure, sustained arrhythmias, cardiac arrest, or death. A multivariate logistic regression model was used to identify determinants of CEs in women at the highest risk. Results: Outcomes of 430 pregnancies …

Translating Developmental Origins Of Health And Disease In Practice: Health Care Providers' Perspectives., Monica L Molinaro, Marilyn Evans, Timothy Regnault, Barbra De Vrijer

Paediatrics Publications

Currently, there is limited knowledge on how health care providers perceive and understand the Developmental Origins of Health and Disease (DOHaD), which may impact how they inform patients and their families throughout the perinatal period. This qualitative descriptive study explored if and how health care providers counsel on in utero programming and future health outcomes with parents, both preconception and during pregnancy. One-on-one, semi-structured interviews were conducted with 23 health care providers from varying health disciplines including obstetrics and gynaecology, midwifery, paediatrics, endocrinology and internal medicine. Audiotaped interviews were transcribed verbatim and analysed using inductive thematic analysis. Three themes were …

The Application Of In Utero Magnetic Resonance Imaging In The Study Of The Metabolic And Cardiovascular Consequences Of The Developmental Origins Of Health And Disease, Stephanie A. Giza, Simran Sethi, Lauren M. Smith, Mary Ellen E.T. Empey, Lindsay E. Morris, Charles A. Mckenzie

Paediatrics Publications

Observing fetal development in utero is vital to further the understanding of later-life diseases. Magnetic resonance imaging (MRI) offers a tool for obtaining a wealth of information about fetal growth, development, and programming not previously available using other methods. This review provides an overview of MRI techniques used to investigate the metabolic and cardiovascular consequences of the developmental origins of health and disease (DOHaD) hypothesis. These methods add to the understanding of the developing fetus by examining fetal growth and organ development, adipose tissue and body composition, fetal oximetry, placental microstructure, diffusion, perfusion, flow, and metabolism. MRI assessment of fetal …

Impact Of Obesity On Outcomes Of Pregnancy In Women With Heart Disease, Birgit Pfaller, Samuel C. Siu, Rohan D'Souza, Barbara Wichert-Schmitt, Govind Krishna Kumar Nair, Kim Haberer, Cynthia Maxwell, Candice K. Silversides

Paediatrics Publications

Background: Women with heart disease are at risk for complications during pregnancy. This study sought to examine the effect of maternal obesity on pregnancy complications in women with heart disease. Objectives: The objective was to determine the incidence of adverse cardiac events (CE) in pregnant women with heart disease and obesity. Methods: Adverse CE during pregnancy were examined in a prospective cohort of women with heart disease. CE were a composite of the following: cardiac death/arrest, arrhythmias, heart failure, myocardial infarction, stroke, aortic dissection, and thromboembolic events. Pre-eclampsia and post-partum hemorrhage were also studied. Outcomes were examined according to body …

Maternal And Cord Blood Hemoglobin As Determinants Of Placental Weight: A Cross-Sectional Study, Ferrante S. Gragasin, Maria B. Ospina, Jesus Serrano-Lomelin, Su Hwan Kim, Matthew Kokotilo, Andrew G. Woodman, Stephen J. Renaud, Stephane L. Bourque

Paediatrics Publications

Background: Both high and low placental weights are associated with adverse pregnancy outcomes. Maternal hemoglobin levels can influence placental weight, but the evidence is conflicting. Since maternal hemoglobin does not invariably correlate with fetal/neonatal blood hemoglobin levels, we sought to determine whether cord blood hemoglobin or maternal hemoglobin status more closely associates with placental weight in women undergoing elective cesarean section at term. Methods: This was a cross-sectional study conducted at the Royal Alexandra Hospital, Edmonton, Canada, involving 202 women with term singleton pregnancies undergoing elective cesarean section. Maternal blood and mixed cord blood hemoglobin levels were analyzed using a …

Increased Alpha And Beta Cell Mass During Mouse Pregnancy Is Not Dependent On Transdifferentiation, Sandra K. Szlapinski, Jamie Bennett, Brenda J. Strutt, David J. Hill

Paediatrics Publications

Maternal pancreatic beta-cell mass (BCM) increases during pregnancy to compensate for relative insulin resistance. If BCM expansion is suboptimal, gestational diabetes mellitus can develop. Alpha-cell mass (ACM) also changes during pregnancy, but there is a lack of information about α-cell plasticity in pregnancy and whether α- to β-cell transdifferentiation can occur. To investigate this, we used a mouse model of gestational glucose intolerance induced by feeding low-protein (LP) diet from conception until weaning and compared pregnant female offspring to control diet-fed animals. Control and LP pancreata were collected for immunohistochemical analysis and serum glucagon levels were measured. In order to …

Long-Term Cardiovascular Outcomes After Pregnancy In Women With Heart Disease, Samuel C. Siu, Douglas S. Lee, Mohammed Rashid, Jiming Fang, Peter C. Austin, Candice K. Silversides

Paediatrics Publications

BACKGROUND: Women with heart disease are at risk for pregnancy complications, but their long-term cardiovascular outcomes after pregnancy are not known. METHODS AND RESULTS: We examined long-term cardiovascular outcomes after pregnancy in 1014 consecutive women with heart disease and a matched group of 2028 women without heart disease. The primary outcome was a composite of mortality, heart failure, atrial fibrillation, stroke, myocardial infarction, or arrhythmia. Secondary outcomes included cardiac procedures and new hypertension or diabetes mellitus. We compared the rates of these outcomes between women with and without heart disease and adjusted for maternal and pregnancy characteristics. We also determined …

Adrenal Cushing Syndrome Diagnosed During Pregnancy: Successful Medical Management With Metyrapone, Alescia Azzola, Genevieve Eastabrook, Doreen Matsui, Amanda Berberich, Rommel G. Tirona, Daryl Gray, Patricia Gallego, Stan Van Uum

Paediatrics Publications

Adrenal Cushing syndrome during pregnancy is rare, and there is limited information on the effect and safety of metyrapone treatment both for mother and fetus. We present a 24-year-old woman diagnosed with adrenal Cushing syndrome at the end of the second trimester. We elected treatment with metyrapone titrated to 250 mg 3 times daily, resulting in good clinical response and maternal serum and saliva cortisol levels in the upper half of the normal pregnancy range. A healthy male infant was born at 35 weeks' gestation, with no clinical signs of adrenal insufficiency, this despite a low cortisol of 5 nmol/L …

Adrenal Cushing Syndrome Diagnosed During Pregnancy: Successful Medical Management With Metyrapone, Alescia Azzola, Genevieve Eastabrook, Doreen Matsui, Amanda Berberich, Rommel G. Tirona, Daryl Gray, Patricia Gallego, Stan Van Uum

Paediatrics Publications

Adrenal Cushing syndrome during pregnancy is rare, and there is limited information on the effect and safety of metyrapone treatment both for mother and fetus. We present a 24-year-old woman diagnosed with adrenal Cushing syndrome at the end of the second trimester. We elected treatment with metyrapone titrated to 250 mg 3 times daily, resulting in good clinical response and maternal serum and saliva cortisol levels in the upper half of the normal pregnancy range. A healthy male infant was born at 35 weeks' gestation, with no clinical signs of adrenal insufficiency, this despite a low cortisol of 5 nmol/L …

Drug Therapy During Pregnancy., Dongmei Sun, Janine R. Hutson, Facundo Garcia-Bournissen Md Phd

Paediatrics Publications

No abstract provided.

Maternal Obesity Reduces Placental Autophagy Marker Expression In Uncomplicated Pregnancies, Matthew Cohen, Emily Guo, Aidan Pucchio, Barbra De Vrijer, Trevor G Shepherd, Genevieve Eastabrook

Obstetrics & Gynaecology Publications

AIM: Obesity has been associated with changes in autophagy and its increasing prevalence among pregnant women is implicated in higher rates of placental-mediated complications of pregnancy such as pre-eclampsia and intrauterine growth restriction. Autophagy is involved in normal placentation, thus changes in autophagy may lead to impaired placental function and development. The aim of this study was to investigate the connection between obesity and autophagy in the placenta in otherwise uncomplicated pregnancies.

METHODS: Immunohistochemistry and western blot analysis were done on placental and omental samples from obese (body mass index [BMI] ≥30 kg/m

RESULTS: As pre-pregnancy BMI increased, there was …

Temporal Relationships Between Maternal Metabolic Parameters With Neonatal Adiposity In Women With Obesity Differ By Neonatal Sex: Secondary Analysis Of The Dali Study, Rodrigo A. Lima, Gernot Desoye, David Simmons, Roland Devlieger, Sander Galjaard, Rosa Corcoy, Juan M. Adelantado, Fidelma Dunne

Paediatrics Publications

Objectives: To investigate the importance of time in pregnancy and neonatal sex on the association between maternal metabolic parameters and neonatal sum of skinfolds. Methods: This was a longitudinal, secondary analysis of the vitamin D and lifestyle intervention for gestational diabetes mellitus study, conducted in nine European countries during 2012 to 2015. Pregnant women with a pre-pregnancy body mass index (BMI) of ≥29 kg/m2 were invited to participate. We measured 14 maternal metabolic parameters at three times during pregnancy: <20 weeks, 24 to 28 weeks, and 35 to 37 weeks of gestation. The sum of four skinfolds assessed within 2 days after birth was the measure of neonatal adiposity. Results: In total, 458 mother-infant pairs (50.2% female infants) were included. Insulin resistance (fasting insulin and HOMA-index of insulin resistance) in early pregnancy was an important predictor for boys' sum of skinfolds, in addition to fasting glucose and maternal adiposity (leptin, BMI and neck circumference) throughout pregnancy. In girls, maternal lipids (triglycerides and fatty acids) in the first half of pregnancy were important predictors of sum of skinfolds, as well as fasting glucose in the second half of pregnancy. Conclusions: Associations between maternal metabolic parameters and neonatal adiposity vary between different periods during pregnancy. This time-dependency is different between sexes, suggesting different growth strategies.

Transient Hyponatremia Of Prematurity Caused By Mild Bartter Syndrome Type Ii: A Case Report., Subhrata Verma, Rahul Chanchlani, Victoria Mok Siu, Guido Filler

Paediatrics Publications

BACKGROUND: Bartter syndrome subtypes are a group of rare renal tubular diseases characterized by impaired salt reabsorption in the tubule, specifically the thick ascending limb of Henle's loop. Clinically, they are characterized by the association of hypokalemic metabolic alkalosis, hypercalciuria, nephrocalcinosis, increased levels of plasma renin and aldosterone, low blood pressure and vascular resistance to angiotensin II. Bartter syndrome type II is caused by mutations in the renal outer medullary potassium channel (ROMK) gene (KCNJ1), can present in the newborn period and typically requires lifelong therapy.

CASE PRESENTATION: We describe a case of a prematurely born female infant presenting with …

Maternal Immune Activation Alters Fetal Brain Development And Enhances Proliferation Of Neural Precursor Cells In Rats, Kelly J. Baines, Dendra M. Hillier, Faraj L. Haddad, Nagalingam Rajakumar, Susanne Schmid, Stephen J. Renaud

Brain and Mind Institute Researchers' Publications

Maternal immune activation (MIA) caused by exposure to pathogens or inflammation during critical periods of neurodevelopment is a major risk factor for behavioral deficits and psychiatric illness in offspring. A spectrum of behavioral abnormalities can be recapitulated in rodents by inducing MIA using the viral mimetic, PolyI:C. Many studies have focused on long-term changes in brain structure and behavioral outcomes in offspring following maternal PolyI:C exposure, but acute changes in prenatal development are not well-characterized. Using RNA-Sequencing, we profiled acute transcriptomic changes in rat conceptuses (decidua along with nascent embryo and placenta) after maternal PolyI:C exposure during early gestation, which …

Maternal Exposure To Δ9-Tetrahydrocannabinol Impairs Female Offspring Glucose Homeostasis And Endocrine Pancreatic Development In The Rat., Ryan Gillies, Kendrick Lee, Sebastian Vanin, Steven R Laviolette, Alison C Holloway, Edith Arany, Daniel B Hardy

Physiology and Pharmacology Publications

Recent reports indicate that 7% of pregnant mothers in North America use cannabis. This is concerning given that in utero exposure to Δ9-tetrahydrocannabinol (Δ9-THC), the main psychoactive component in cannabis, causes fetal growth restriction and may alter replication and survival of pancreatic β-cells in the offspring. Accordingly, we hypothesized that maternal exposure to Δ9-THC during pregnancy will impair postnatal glucometabolic health of offspring. To test this hypothesis, pregnant Wistar rats were treated with daily intraperitoneal injections of either 3 mg/kg Δ9-THC or vehicle from gestational day 6 to birth. Offspring were subsequently challenged with glucose and insulin at 5 months …

Preventing Complications In Pregnant Women With Cardiac Disease, Birgit Pfaller, Gnalini Sathananthan, Jasmine Grewal, Jennifer Mason, Rohan D'Souza, Danna Spears, Marla Kiess, Samuel C. Siu, Candice K. Silversides

Paediatrics Publications

Background: Pregnancy can lead to complications in women with heart disease, and these complications can be life threatening. Understanding serious complications and how they can be prevented is important. Objectives: The primary objectives were to determine the incidence of serious cardiac events (SCEs) in pregnant women with heart disease, whether they were preventable, and their impact on fetal and neonatal outcomes. Serious obstetric events were also examined. Methods: A prospectively assembled cohort of 1,315 pregnancies in women with heart disease was studied. SCEs included cardiac death or arrest, ventricular arrhythmias, congestive heart failure or arrhythmias requiring admission to an intensive …

Development Of A Core Outcome Set For Studies On Cardiac Disease In Pregnancy (Coscarp): A Study Protocol, Rohan D'Souza, Chelsea Hall, Mathew Sermer, Samuel Siu, Candice Silversides

Paediatrics Publications

Background: Clinical studies looking at interventions to optimize pregnancy and long-term outcomes for women with cardiac disease and their babies are inconsistent in their reporting of clinical outcomes, making it difficult to compare results across studies and draw meaningful conclusions. The development of a core outcome set (COS) - a standardized, minimum set of outcomes that must be collected and reported in all studies - is a practical solution to this problem. Methods/design: We will follow a five-step process in developing a COS for studies on pregnant women with cardiac disease. First, a systematic literature review will identify all reported …

A Core Outcome Set For Studies Of Gestational Diabetes Mellitus Prevention And Treatment, Aoife M Egan, Delia Bogdanet, Tomás P Griffin, Oratile Kgosidialwa, Mila Cervar-Zivkovic, Eugene Dempsey, John Allotey, Fernanda Alvarado, Cheril Clarson, Shamil D Cooray, Harold W De Valk, Sander Galjaard, Mary R Loeken, Michael J A Maresh, Angela Napoli, Paula M O'Shea, Ewa Wender-Ozegowska, Mireille N M Van Poppel, Shakila Thangaratinam, Caroline Crowther, Linda M Biesty, Declan Devane, Fidelma P Dunne

Paediatrics Publications

AIMS/HYPOTHESIS: The aim of this systematic review was to develop core outcome sets (COSs) for trials evaluating interventions for the prevention or treatment of gestational diabetes mellitus (GDM).

METHODS: We identified previously reported outcomes through a systematic review of the literature. These outcomes were presented to key stakeholders (including patient representatives, researchers and clinicians) for prioritisation using a three-round, e-Delphi study. A priori consensus criteria informed which outcomes were brought forward for discussion at a face-to-face consensus meeting where the COS was finalised.

RESULTS: Our review identified 74 GDM prevention and 116 GDM treatment outcomes, which were presented to stakeholders …

Labour Progression In Obese Women: Are Women With Increased Body Mass Index Having Unnecessary Cesarean Sections?, Caroline Shenouda, Aloka Wijesooriya, Amanda Toufeili, Michael R Miller, Debbie Penava, Barbra De Vrijer

Obstetrics & Gynaecology Publications

OBJECTIVE: This study sought to determine whether obese pregnant women undergo cesarean sections without an adequate trial of labour. This may affect future birth and pregnancy outcomes.

METHODS: A retrospective analysis was done on 526 parturients at Victoria Hospital in London, Ontario. Women were categorized according to parity and pre-pregnancy body mass index (BMI; normal weight, BMI 18.5-24.9 kg/m

RESULTS: Obese class II and III primiparous women required an additional 1.62 and 2.67 hours (P = 0.012), respectively, to reach a dilation of 10 cm compared with their normal weight counterparts; obese class II and III multiparous women required an …