Medicine and Health Sciences Commons^™

Role Of Calbindin2 In Male Infertility With Oligozoospermia And Asthenoteratozoospermia, Ashraf H. A. Hassan, Adel A. E. Zalata, Sherif R. Ismail, Hebatullah Ahmed Elsayed

Mansoura Medical Journal

Introduction: Male infertility may account for almost half of all cases of infertility. This is commonly linked to compromised sperm characteristics, such as shape, concentration, and motility. Recent studies have suggested a role for calcium-binding proteins, including Calbindin 2 (CALB2), in spermatogenesis and male reproductive function. Aim: The purpose of this study was to assess the association between male infertility in cases of oligozoospermia and asthenoteratozoospermia and seminal Calbindin 2 levels. Patients and Methods: A case-control study was performed on 90 men (45 infertile, 45 fertile controls). Semen parameters, oxidative stress, hormone levels, DNA fragmentation, acrosin activity, and seminal CALB2 …

Clinical And Radiological Outcomes Of Posterior Malleolar Fractures Fixation Through Posterolateral Approach: A Prospective Case Series Study, Mohammed Abdulrafei Farag, Ahmed Elsayed Elhawary, Ahmed Salah-Eldeen Zaghloul

Mansoura Medical Journal

Background: Posterior malleolar fractures are frequently associated with other malleolar injuries and significantly affect ankle stability through the posterior tibiofibular ligament. CT imaging is vital for preoperative classification, fragment size measurement, and syndesmotic evaluation. Objective: To assess clinical and radiological outcomes of posterior malleolar fractures treated using the posterolateral approach. Methods: This prospective case series included 20 skeletally mature patients treated between March 2022 and January 2024. Preoperative evaluation included radiographs and CT scans for classification, fragment size, articular step-off, and syndesmotic injury. Postoperative reduction and alignment were assessed with X-ray and CT. Functional outcomes were evaluated at ≥6 months …

New Modifications Of The Loop Electrosurgical Excision Procedure (Leep) For The Management Of Cervical Lesions In The Low Resource Conditions, Amal Abdulrahman Al-Kbous, Rafik Ibrahim Barkat, Mohamed A. Elnegeri, Amany A. Makroum, Reda Abdelhadi Hemida Dr.Reda Hamida, Mohamed Elsayed Taman

Mansoura Medical Journal

Background: Cervical intraepithelial neoplasia (CIN) encompasses a range of abnormal changes within the cervical squamous epithelium and is regarded as a precursor to invasive squamous cell carcinoma of cervix. Management of CIN-1 generally involves follow-up with repeat testing after one year, while CIN-2 and higher lesions require treatment aimed at complete removal of the lesion and transformation zone using ablative or excisional methods such as Loop electrosurgical excision (LEEP), or cold-knife cone biopsy. This study aimed to test applying a new modification on LEEP to facilitate its use in the management of cervical lesions in the low resource conditions regarding …

Association Of Uric Acid Index And Cardiovascular Risk In Egyptian Patients With Type 2 Diabetes, Reem Fathallah, Talaat Abdelaaty, Hend Ghallab, Shimaa M. Elrahmany

Mansoura Medical Journal

Background The uric acid index (UAI) has recently gained recognition as a potential indicator for cardiovascular risk, particularly among middle-aged individuals. This research investigated the association between UAI levels and cardiovascular disease risk in Egyptian patients with type 2 diabetes (T2DM). Methods 200 individuals with T2DM were included in this cross-sectional analysis. The UAI was derived using the logarithmic formula: Ln [fasting triglycerides × fasting uric acid × fasting glucose ÷ 2]. To estimate the 10-year risk of cardiovascular events, the SCORE2-Diabetes was employed. Results The average serum uric acid level was 4.40 ± 1.48 mg/dL, and the mean UAI …

Oncologic Outcome Of Hemithyroidectomy For Low Risk Patients With Well Differentiated Thyroid Carcinoma, Yasser Sharaf El Din, Khaled Gaballa, Mohamed Attia, Mohamed A. Hegazy

Mansoura Medical Journal

Background: The incidence of well-differentiated thyroid cancer (WDTC) has increased in recent decades, yet most cases remain indolent and categorized as low-risk, typically associated with excellent prognoses. The rising identification of these tumors has led to continued discussion about optimal surgical management. In recent years, there has been a clear trend in the evolution of guidelines addressing surgical management of WDTC toward de-escalation, including hemithyroidectomy, for appropriately selected low-risk WDTC patients. Methods: We performed a retrospective case series included 24 individuals with an incidentally discovered and pathologically proven diagnosis of WDTC following hemithyroidectomy, over a five-year period (January 2018-December 2022) …

Evaluation Of Serum Zinc-To-Copper Ratio In Adults With Type 2 Diabetes And Its Association With Microvascular Complications, Magdy H. Megallaa, Shimaa M. Elrahmany, Rehab Safwat, Mohamed Zietoun

Mansoura Medical Journal

Background Zinc (Zn) and copper (Cu) are indispensable trace metals that contribute fundamentally to insulin biology, antioxidant defense, and vascular health. In this research, we sought to explore the association between the serum zinc-to-copper (Zn/Cu) ratio and microvascular complications among adults diagnosed with type 2 diabetes (T2DM). Methods For this case-control design, a total of 336 participants were selected and divided into two main groups: Group 1, comprising 224 patients with T2DM, and Group 2, consisting of 112 healthy subjects serving as controls. Group 1 was further stratified into two subgroups based on the presence of microvascular complications; Group 1A …

Treatment Of Xanthelasma Palpebrarum With Plasma Energy Device, Merna Azab, Fawzia A Saafan, Amal Wagdy

Mansoura Medical Journal

Background: Semisolid, yellowish deposits known as Xanthelasma palpebrarum (XP) may develop at the inner and outer corners of the eyelids. The goals of ideal XP treatment are complete clearance with no recurrence, ensuring safety, comfort, and affordability, with no or minimal undesirable side effects, including pigmentary changes or scarring. One non-ablative electrosurgical method is plasma sublimation therapy, which involves generating plasma from atmospheric gas using radio frequency energy. This process creates ionized and mixed chemicals, which then sublimate epidermal tissue. Aim: to evaluate the efficacy of plasma energy devices in treatment of xanthelasma palpebrarum. Patients and methods: The current study …

Vitamin D Status In Coronary Artery Disease, Yasmeen M. Zayed, Hamdy F Marzouk, Alshaimaa H. Abd-Elmaksoud, Ahmed H. Eladawy, Shereen A Mourad

Mansoura Medical Journal

Background: Vitamin D deficiency, dyslipidemia, and systemic inflammation are recognized contributors to coronary artery disease (CAD), so the aim of this study was to assess association of serum vitamin D (25(OH)D), traditional and nontraditional lipid indices, and neutrophil lymphocyte ratio (NLR) with CAD risk and severity, and to evaluate their predictive value using the Gensini score. Methods: A cross-sectional study included 55 CAD patients (group I) and 55 age- and sex-matched individuals (group II). lipid profiles, NLR, and serum 25(OH)D levels were measured. Nontraditional lipid indices, including Castelli’s Risk Indices and atherogenic coefficient were calculated. The severity of CAD was …

Low-Carbohydrate, Low-Fat, And Balanced Diets In Weight Reduction Among Obese Adolescents., Ashraf A. Elsharkawy, Gihan Fouad Ahmad, Ahmed El-Husseiny, Amany K. Elhawary, Ola Shawky Ahmed, Asmaa Taha Zaher Taha, Fatma El-Zahraa M. Hashish

Mansoura Medical Journal

Background: Obesity in adolescents is a major public health concern, leading to early onset of metabolic abnormalities. This study aimed to compare the effects of the Low- Carbohydrate Diet (LCD) and Low-Fat Diet (LFD) in comparison with the balanced calculated diet (BCD) on weight reduction in obese adolescents and their impact on metabolic health markers. Patients and methods: 75 obese adolescents aged less than 18 years were enrolled in this prospective, randomized, controlled study and were randomly assigned to either LCD group, LFD group, or BCD group. Anthropometric and laboratory measures were collected before and after a 10-week intervention. Results: …

Impact Of Insulin Resistance And Obesity Indices On Patients Received Recombinant Tissue Plasminogen Activator (R-Tpa) In Acute Ischemic Stroke, Manar Hamada Abou El-Wafa, Azza E. Elmongui, Ahmed Saad Almenshawy, Nada Abd Elhameed Elsaid

Mansoura Medical Journal

Background Insulin resistance (IR) and obesity may influence stroke outcomes after recombinant tissue plasminogen activator (r-TPA) therapy. The aim of this work was to analyze the potential impact of IR, body mass index (BMI) and relative fat mass on stroke prognosis in non-diabetic patients after intravenous thrombolytic therapy Methods This Cross-sectional observational study was conducted on 44 patients, with acute ischemic stroke (AIS) received r-TPA. Every single patient underwent routine laboratory examination in addition to serum insulin and assessment of insulin resistance (IR) by the HOMA-IR index (defined as HOMA-IR>2.5). Body mass (BMI), relative fat mass (RFM) indices and …

Sexual Dysfunction After Hysterectomy Based On Female Sexual Function, Elsayed M. Abd Elfattah, Amany A. Makroum, Mohamed A. Fekry, Mohamed Sayed Abdelhafez, Maher Shams, Ahmed El Mennayyer

Mansoura Medical Journal

Abstract Hysterectomy is the most common major gynecological surgical procedure. There are raised concerns regarding its impact on sexual function. Objective: This study aimed to assess the effects of vaginal, abdominal, and laparoscopic hysterectomy on women’s sexual functioning based on the female sexual function index (FSFI). Methods: This prospective Cohort study was conducted on 48 patients who underwent hysterectomy by different routes at the OB/GYN department at Mansoura University Hospitals, Mansoura, Egypt, aged between 25 and 49 years, from October 2024 to October 2025. The patients’ sociodemographic and clinical data were collected. The patients were asked to fill the FSFI …

Indications Of Hospitalization And Predictors Of Outcome Among Patients With Rheumatological Diseases Admitted To Mansoura Rheumatology And Immunology Unit, Hanan Mohamed Elberashi, Nibal Morad, Samar Tharwat

Mansoura Medical Journal

Background correction: Systemic autoimmune rheumatological diseases (SARDs) constitute a category of disorders that can affect several organs. SARDs are persistent, incapacitating illness characterized by significant morbidity and mortalityrates. Patients with SARDs necessitate hospitalization more frequently than the general population.

Aim: To determine the characteristics of patients hospitalized with SARDs at Mansoura University Hospital.

Materials and methods: This cross-sectional study was carried out on patients with different SARDs. The collected data

included patients’ sociodemographic data, autoimmune disease diagnoses, the onset and duration of the disease, rate of

readmission, the main cause of admission, the main organ affected at time of admission, …

Effect Of Autologous Nanofat Injection In Post-Traumatic Atrophic Scars: A Prospective Randomized Interventional Clinical Study, Ghada M. Hammad, Manar Sallam, Sherif R. Ismail, Ahmed M. Zenia, Shereen Ezzalregal Alashry

Mansoura Medical Journal

Background Post-traumatic scars continue to be a challenging issue for both patients and surgeons. Nanofat, a novel tool in regenerative medicine, relies primarily on adipose-derived stem cells (ADSCs). These cells aid in wound healing by promoting angiogenesis and secreting growth factors that help decrease inflammation and fibrous tissue formation. Aim of the study To assess the aesthetic results of autologous nanofat injection in post-traumatic atrophic scars. Patients and methods 30 cases with post-traumatic atrophic scars received a single session of nanofat injection. Evaluation was done 3 and 6 months after the session using the Vancouver scar scale. Results Our study …

Urinary Transferrin As A Marker For Diagnosis And Progression Of Diabetic Nephropathy: Short-Term Follow Up, Ghada El-Said Ahmed Ibrahim, Ibrahim Mohammed Adel Ibrahim Bakr, Amany Ragab Youssef Ahmed, Rasha Mahmoud Abdel Fattah

Mansoura Medical Journal

Background: One of the most serious and devastating effects of diabetes mellitus is diabetic nephropathy, which in many cases progresses to end-stage kidney disease (ESKD). Microalbuminuria is currently the gold standard biomarker for DN diagnosis. Microalbuminuria has a poor predictive value, though. Patients occasionally experienced progressive renal failure without microalbuminuria. A plasma protein called transferrin has a different ionic charge from albumin but is otherwise similar in weight. Aim: Our objectives were to evaluate urinary transferrin as a more accurate and earlier marker for the diagnosis of diabetic kidney disease and to investigate its relationship to the excretion of urinary …

Learning Dissemination Strategies: Lessons From The Covid-19 Pandemic In Training Healthcare Professionals In Disease Management, Kishan Vishanagra

Honors Undergraduate Theses

The COVID-19 pandemic presented many challenges for global healthcare systems, requiring rapid training and dissemination of disease management strategies among healthcare professionals. This study conducts a systematic review of 37 studies to examine the learning dissemination methods created and utilized during the COVID-19 pandemic, focusing on just-in-time training for disease management. This study identifies four core training topics: airway management, infection control, cardiopulmonary resuscitation, and patient triage. This study also categorizes delivery methods into in-situ simulation-based training, online e-learning platforms, online simulation-based training, and hybrid training models. Findings highlight that simulation-based training methods proved effective for invasive high-risk procedures, while …

Understanding Women's Access To And Utilization Of Syringe Service Programs, Annelisa E. Swiersz

Honors Undergraduate Theses

As of 2020, 138 million Americans ages 12 and over reported illicit drug use in their lifetime, with over 3 million of those people injecting drugs. There are risks for all people who use drugs, but people who inject drugs (PWID) pose specific risks such as hepatitis B, hepatitis C, and human immunodeficiency virus (HIV), with women who inject drugs (WWID) facing even more risks. WWID involved in sex work have a higher risk of HIV transmission and lack access to sterile injection devices and sexual and reproductive health services. To address these risks, syringe service programs (SSPs) were developed …

A Nurse-Led Transitional Care Intervention To Prevent Readmissions In A Low-Income-Serving Urban U.S. Hospital, Melissa Scollan-Koliopoulos

Nursing Faculty Publications

Background: Diabetes-related hospital readmissions within 30-days are costly and an indicator of suboptimal care resolution. Nurse-led transitional care interventions may improve glucose control and reduce emergency department recidivism following hospital discharge in very low-income populations.

Methods: An intention-to-treat design with randomization of participants (n = 108) compared conventional care to transitional care coordination that included diabetes specialty appointments, monthly support tele-phone calls, medication management, and tailored diabetes self-management education. Both the control and intervention group received a diabetes specialist and primary care appointment.

Results: There was a significant difference between the control and intervention groups (P = 0.018) from base-line …

Understanding Emergency Department Utilization By African Americans For Routine Diabetes Care: Are We Asking The Right Cultural Questions?, Melissa Scollan-Koliopoulos

Nursing Faculty Publications

Introduction: The emergency department is a source of routine care for many African Americans. Afrocentric cultural characteristics may serve as a better proxy than race for understanding preferences for emergency department use over primary care for diabetes management. Methods: A literature review was conducted including key terms related to transitional healthcare, emergency department recidivism, Afrocentric cultural characteristics, racism and health disparities, and diabetes in African Americans. An example of tailoring talking points using Afrocentric cultural characteristics is proposed using Jone’s TRIOS Model, a Afrocentric Self-enhancing and Protective Theory. Results: The literature includes evidence to support a complex explanation for emergency …

Librarian Partnerships In Dnp Education, Kerry A. Milner, Roy Brown, Janene Batten, Tami A. Hartzell, Ellen Fineout-Overholt

Nursing Faculty Publications

This is the sixth article in a new series designed to provide readers with insight into educating nurses about evidence-based decision-making (EBDM). It builds on AJN's award-winning previous series—Evidence-Based Practice, Step by Step and EBP 2.0: Implementing and Sustaining Change (to access both series, go to https://links.lww.com/AJN/A133). This follow-up series on EBDM will address how to teach and facilitate learning about the evidence-based practice (EBP) and quality improvement (QI) processes, and how they impact health care quality. This series is relevant for all nurses interested in EBP and QI, especially DNP faculty and students. The brief case scenario …

Letter To The Editor, Julee Waldrop, Kerry A. Milner, Jayne Jennings Dunlap, Staci Reynolds, Anne Derouin

Nursing Faculty Publications

No abstract provided.

Correlations Of Gait Kinematics And Cognitive Skills In Parkinson Disease, Joshua J. Lander, Matthew F. Moran, Hannah Alexanian

Physical Therapy Faculty Publications

Cognitive impairments and gait disturbances are often concurrent in Parkinson disease (PD), but the extent to which specific cognitive deficits relate to gait abnormalities remains unclear, especially in early-stage PD. To address this gap, we conducted an observational correlational study to determine if cognitive performance in distinct domains is associated with gait kinematics in PD. This study included a cohort of 19 individuals with early-stage PD who underwent gait analysis with a three-dimensional marker-less motion capture system (Theia Markerless Inc., Kingston, ON, CA) during three conditions: single-task walking, cognitive dual-task walking, and the Timed Up and Go (TUG) test. Cognitive …

Testing The Antigenic Potential Of Transmembrane Proteins To Develop A Thermostable Tuberculosis Mof-Liposomal Vaccine, Sneha Kumari, Jonathan Martinez-Garcia, Ryanne Nicole Ehrman, Wendy Tang, Joshua Miles, Priyanka Basak, Thomas Sinclair Howlett, Yalini Hansika Wijesundara, Ziqi Wang, Blanca I. Restrepo

School of Medicine Publications

Tuberculosis is one of the deadliest infectious diseases and continues to be a major health risk in many parts of the world. Even today, the century-old Bacillus Calmette-Guerin (BCG) vaccine is the only formulation on the market and is ineffective for several sections of the global population responsible for transmission. In the search for antigens that can mount a robust immune response, we have reported the recombinant expression and purification of two novel membrane proteins, the Cation transporter protein V (CtpV) and the Mycobacterial copper transporter B (MctB) present on the membrane surface of Mycobacterium tuberculosis. CtpV was tested …

Infants’ Resting-State Functional Connectivity And Event-Related Potentials: A Multimodal Approach To Investigating The Neural Basis Of Infant Novelty Detection, Dana Kanel, Santiago Morales, Kathryn Altman, John E. Richards, Anderson M. Winkler, Daniel Samuel Pine, Nathan A. Fox, Courtney A. Filippi

School of Medicine Publications

Individual differences in how the brain responds to novelty are present from infancy. A common method of studying novelty processing is through event-related potentials (ERPs). While ERPs possess millisecond precision, spatial resolution remains poor, especially in infancy. This study aimed to balance spatial and temporal precision by combining ERP data with functional magnetic resonance imaging (fMRI) data. Twenty-nine infants (15 female) underwent resting-state fMRI (Mage = 4.73 months) and electroencephalography (EEG) during a three-stimulus auditory oddball task (Mage = 5.19 months). The mismatch response (MMR) and P3 were computed from ERP data, and resting-state functional connectivity …

Clinical Criteria For Limbic-Predominant Age-Related Tdp-43 Encephalopathy, David A. Wolk, Peter T. Nelson, Liana Apostolova, Konstantinos Arfanakis, Patricia A. Boyle, Cynthia M. Carlsson, Nick Corriveau-Lecavalier, Penny Dacks, Bradford C. Dickerson, Gladys E. Maestre

School of Medicine Publications

Limbic predominant age-related TDP-43 encephalopathy neuropathologic change (LATE-NC) is highly prevalent in late life and a common co-pathology with Alzheimer's disease neuropathologic change (ADNC). LATE-NC is a slowly progressive, amnestic clinical syndrome. Alternatively, when present with ADNC, LATE-NC is associated with a more rapid course. With the emergence of anti-amyloid therapeutics, discrimination of LATE-NC from ADNC is critical and will lead to greater clinical recognition of amnestic patients without ADNC. Furthermore, co-pathology with LATE-NC may influence outcomes of these therapeutics. Thus there is a need to identify patients during life with likely LATE-NC. We propose criteria for clinical diagnosis of …

Autonomic Dysfunction In Gastroesophageal Reflux Disease. The Neurogastro-Cardiac Axis: Friend Or Foe?, Sergio Sobrino-Cossio, Jorge Cossío-Aranda, Elymir S. Galvis-García, Gualberto Mateos-Pérez, Óscar Teramoto-Matsubara, Jesús A. González-Hermosillo, Juan C. Lopez Alvarenga, Mustafa Azizoglu, José M. Remes-Troche

School of Medicine Publications

Gastroesophageal reflux disease (GERD) is a complex and highly prevalent entity. Impaired gut-brain communication is associated with autonomic dysfunction. Modulation of the autonomic nervous system controls gastrointestinal functions. In GERD, a decrease in vagal tone (parasympathetic activity) and an increase in sympathetic activity with autonomic balance shifted towards the sympathetic system have been reported. Clinical questionnaires and non-invasive measurement of heart rate variability may be useful in patients with GERD to detect autonomic dysfunction. Restoration of parasympathetic system activity (mainly neuromodulation), with subsequent improvement of parasympathetic activity, will reduce the intensity of autonomic symptoms and GERD, improving quality of life. …

Enhancing Bone Regeneration Using Kaempferol As An Osteoprotective Compound: Signaling Mechanisms, Delivery Strategies, And Potential Applications, Mojdeh Salehi Namini, Sanam Mohandesnezhad, Sadaf Mohandesnezhad, Vahid Mansouri, Lobat Tayebi, Nima Beheshtizadeh

Electrical & Computer Engineering Faculty Publications

Various plants, including fruits, vegetables, and spices, contain kaempferol, a bioflavonoid compound with diverse medicinal effects, such as antioxidant, antibacterial, and anti-inflammatory characteristics. Furthermore, this compound exhibits multiple health-promoting properties, including osteoprotection and osteogenesis, primarily by modulating various cell-signaling pathways. This review aims to illustrate the medical advantages of kaempferol and its role in regulating bone metabolism through cell signaling mechanisms. Numerous studies have demonstrated the bone-protective properties of kaempferol and its encapsulated form. Further research is needed to clarify the optimal dosages, toxicity, safety, and other potential mechanisms of action. This review demonstrates that several signaling pathways, including nuclear …

In Danger: Hiv Vaccine Research And Development In Europe, Roger Tatoud, Yves Lévy, Roger Le Grand, Jose Alcami, Giorgio Barbareschi, Christian Brander, Andrea Cara, Behazine Combadière, François Dabis, Sarah Fidler, Tomáš Hanke, Carolina Herrera, Gunilla B. Karlsson Hedestam, Hester Kuipers, Sheena Mccormack, Christiane Moog, Giuseppe Pantaleo, Laura Richert, Rogier W. Sanders, Robin Shattock, Hendrik Streeck, Rodolphe Thiebaut, Alexandra Trkola, Klaus Üeberla, Marit J. Van Gills, Ralf Wagner, Winfried Weissenhorn, Yazdan Yazdanpanah, Gabriella Scarlatti, Jean Daniel Lelièvre

Department of Obstetrics & Gynecology Faculty Publications

Highly effective antiretroviral-based HIV prevention plays an important role in ending the global HIV/AIDS epidemic. However, the sustainable control of the epidemic is hampered by unequal access to prevention options, including HIV testing, alongside with drug resistance and ongoing barriers to accessing sustainable HIV treatment. Therefore, an HIV vaccine, combined with effective prevention and treatment, remains an absolute necessity to control the epidemic. Yet, the recent discontinuation of four major vaccine efficacy studies is raising concerns about the future of HIV vaccine research and development globally, and particularly in the European region where funding for vaccine research and development has …

Disparities In Cardiovascular Disease Outcomes And Economic Burdens Among Minorities In Southeastern Virginia, Ismail El Moudden, Asra Amidi, Reem Sharaf Alddin, Michael Bittner, Qi Zhang

Department of Obstetrics & Gynecology Faculty Publications

Background

Cardiovascular diseases are the leading cause of mortality in the United States, presenting significant public health challenges and financial burdens, particularly in Southeastern Virginia, where African American and Hispanic (AA&H) populations are disproportionately affected.

Methods

This retrospective observational study analyzed data from 30,855 hospital discharges of AA&H patients across Southeastern Virginia from 2016 to 2020, focusing on individuals aged 18 to 85 with cardiovascular diseases. Utilizing the Virginia Health Information database, we examined demographic information, clinical data, and healthcare utilization patterns through hypothesis tests and regression models to explore associations between these variables and the economic impacts of cardiovascular …

Association Of Maternity Care Deserts With Maternal And Pregnancy-Related Mortality, Rula Atwani, Lindsay Robbins, George Saade

Department of Obstetrics & Gynecology Faculty Publications

OBJECTIVE:

To evaluate the association between the level of maternity care access and maternal and pregnancy-related mortality.

METHODS:

This was a cross-sectional analysis of county-level data in the United States from January 2018 to December 2021. Using the level of maternity care access, we categorized counties into desert, low access, moderate access, and full access. The primary outcome of interest was maternal mortality rate per 100,000 live births. A secondary outcome was pregnancy-related mortality rate per 100,000 live births. Absolute risk differences and adjusted incidence rate ratios were calculated for maternal mortality and pregnancy-related mortality with multivariable negative binomial mixed-effects …

Association Between The Intensity Of Exercise In The First Trimester And Early Second Trimester And The Risk Of Gestational Diabetes, Takaki Tanamoto, Misa Hayasaka, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

Objective

Although some studies show that exercise decreases the incidence of gestational diabetes mellitus (GDM), the optimal exercise intensity during pregnancy remains unclear. We examined GDM risk according to exercise intensity in pregnant individuals.

Methods

We analyzed data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers‐to‐Be (nuMoM2b), a prospective study enrolling nulliparous individuals in the first trimester. Participants with pregestational diabetes or delivery before 20 weeks were excluded. Exercise intensity during the first (6–13 weeks’ gestation) and early second (16–21 weeks’ gestation) trimesters was categorized by metabolic equivalent of task hours per week (MET‐hr/week) as none, low intensity (< 7.5), moderate intensity (7.5–14.9), or high intensity (≥ 15). The primary outcome was GDM; secondary outcomes included preeclampsia, gestational hypertension, preterm birth, small‐for‐gestational‐age birth, and stillbirth. Adjusted relative risks (aRRs) with 95% confidence intervals (CIs) were calculated using a generalized linear mixed‐effects model with a Poisson distribution and robust error variance, controlling for the random effects of individuals and potential confounders.

Results …