1,720,983 research outputs found
Maternal weight and gestational diabetes impacts on child health
No full textPurpose of review To review recent evidence linking maternal body mass index and gestational diabetes mellitus (GDM) with offspring health outcomes.Recent findings It is now established that the rising prevalences of maternal obesity and GDM are both making substantial contributions to the growing burden of childhood obesity and associated disorders. Strengthening evidence also links maternal obesity with increased offspring risks of cardiovascular disease, nonalcoholic fatty liver disease, lower respiratory tract infections during infancy, wheezing illnesses, asthma and attention deficit hyperactivity disorder during childhood, and with higher risks of psychiatric disorders and colorectal cancer in adulthood. GDM has been associated with increased offspring risks of cardiovascular disease, childhood wheeze/asthma (but not allergic sensitization), and with high refractive error, attention deficit hyperactivity and psychiatric disorders from childhood onwards.Summary The long-term consequences of maternal obesity and GDM for the offspring in childhood and later adult life present major challenges for public health across the life course and for future generations. Tackling these challenges requires a systems-based approach to support achieving a healthy weight in young people prior to conception, alongside new insights into population based preventive measures against gestational diabetes
Higher maternal serum concentrations of nicotinamide and related metabolites in late pregnancy are associated with a lower risk of offspring atopic eczema at age 12 months
No full textSummary - Background Evidence that atopic eczema partly originates in utero is increasing, with some studies linking the risk of developing the condition with aspects of maternal diet during pregnancy. Nicotinamide, a naturally occurring nutrient that is maintained through the dietary intakes of vitamin B3 and tryptophan, has been used in the treatment of some skin conditions including atopic eczema. Objective To examine the relation of maternal serum concentrations of nicotinamide and related tryptophan metabolites to the risk of atopic eczema in the offspring. Methods Within the UK Southampton Women Survey, infantile atopic eczema at ages 6 and 12 months was ascertained (modified UK Working Party Criteria for the Definition of Atopic Dermatitis). Maternal serum levels of kynurenine, kynurenic acid, anthranilic acid, tryptophan, nicotinamide and N1-methylnicotinamide were measured in late pregnancy by mass spectrometry (n = 497) and related to the odds ratio of infantile atopic eczema. Results Maternal nicotinamide and related metabolite concentrations were not associated with offspring atopic eczema at age 6 months. Higher concentrations of nicotinamide and anthranilic acid were, however, associated with a lower risk of eczema at age 12 months (odds ratios 0.69, 95% CI 0.53–0.91/SD change, P = 0.007 and 0.63, 0.48–0.83, P = 0.001, respectively). The associations were robust to adjustment for potentially confounding variables. Conclusion and clinical relevance This is the first study linking maternal serum concentrations of nicotinamide and related metabolites to the risk of atopic eczema in the offspring. The findings point to potentially modifiable maternal influences on this complex and highly prevalent conditio
A retained pulmonary artery catheter fragment incidentally found lodged in the right heart 16 years after its insertion
No full textSixteen years after a long admission for a serious occupational accident, a 38-year-old man presented with intermittent atypical chest pain. Upon investigations a retained fragment of a pulmonary artery catheter was found in the right ventricle. Throughout the years between his accident and the current presentation he did not have any symptoms or signs of complications associated with the retained catheter such as arrhythmia, sepsis or thromboembolism. Upon presenting his case at the medical/surgical multidisciplinary meeting it was decided that the probability of complications occurring at this stage was low as the catheter fragment would have endothelialised and the risk of retrieval would outweigh the benefits. This scenario highlighted the importance of understanding the possible long-term complications of retained catheter fragments, the importance of being aware of the limitation of these devices and the need to be more vigilant in the emergency setting.</p
Early life exposure to antibiotics and laxatives in relation to infantile atopic eczema.
No full textTransgenerational and early-life nutrition, epigenetics, and prevention of obesity.
No full textChildhood obesity and associated noncommunicable diseases (NCDs) have increased at alarming rates, such that NCDs now account for 60% of deaths globally. Preventing obesity requires the identification of the underlying risk factors and the mediating molecular and physiological mechanisms. There is now substantial observational and experimental evidence indicating that transgenerational maternal and paternal nutritional exposures modulate epigenetic processes, which lead to phenotypic alterations and influence the later risk of obesity and other NCDs. The epigenetic processes involved include DNA methylation, covalent modifications of histones, and noncoding RNAs. Such epigenetic changes are induced during development function at the level of individual Cytosine-phosphate-Guanine (CpG) dinucleotides in both gene promoter and intergenic regions. Elucidation of these epigenetic processes may permit perinatal identification of individuals most at risk of later obesity and other NCDs and aid identification of preventive, early mitigation and novel therapeutic strategies
High early pregnancy plasma <i>myo</i>-inositol associates with increased post-prandial glycemia later in pregnancy: secondary analyses of the NiPPeR randomized controlled trial
No full textAim: myo-inositol supplementation from ~13 weeks' gestation reportedly improves glycaemia regulation in metabolically at-risk women, with speculation that earlier supplementation might bring further improvement. However, the NiPPeR trial of a myo-inositol-containing supplement starting preconception did not lower gestational glycaemia in generally healthy women. We postulated that the earlier timing of supplementation influences the maternal metabolic adaptation for gestational glycaemia regulation.Methods: in total, 585 women were recruited from Singapore, UK and New Zealand for the NiPPeR study. We examined associations of plasma myo-inositol concentrations at 7 and 28 weeks' gestation with 28 weeks plasma glucose (PG; fasting, and 1 h and 2 h in 75 g oral glucose tolerance test) and insulin indices using linear regression adjusting for covariates.Results: higher 7-week myo-inositol, but not 28-week myo-inositol, associated with higher 1 h PG [βadj (95% confidence intervals) 0.05 (0.01, 0.09) loge mmol/L per loge μmol/L, p = .022] and 2 h PG [0.08 (0.03, 0.12), p = .001]; equivalent to 0.39 mmol/L increase in 2 h PG for an average 7-week myo-inositol increase of 23.4 μmol/L with myo-inositol supplementation. Higher 7-week myo-inositol associated with a lower 28-week Stumvoll index (first phase), an approximation of insulin secretion [-0.08 (-0.15, -0.01), p = .020] but not with 28-week Matsuda insulin sensitivity index. However, the clinical significance of a 7-week myo-inositol-related increase in glycaemia was limited as there was no association with gestational diabetes risk, birthweight and cord C-peptide levels. In-silico modelling found higher 28-week myo-inositol was associated with lower gestational glycaemia in White, but not Asian, women after controlling for 7-week myo-inositol effects.Conclusion: to our knowledge, our study provides the first evidence that increasing first trimester plasma myo-inositol may slightly exacerbate later pregnancy post-challenge glycaemia, indicating that the optimal timing for starting prenatal myo-inositol supplementation needs further investigation.</p
Do human milk oligosaccharides protect against infant atopic disorders and food allergy?
No full textAtopic disorders (AD), often coexistent with food allergy (FA), start developing in early life and have lifelong health consequences. Breastfeeding is thought to be protective against AD and FA, but the data are controversial, and mechanisms are not well understood. Human milk oligosaccharides (HMOs) are complex carbohydrates that are abundant in human milk. These are thought to contribute to the development of the infant immune system by (i) promoting healthy microbiome, (ii) inhibiting pathogen binding to gut mucosa and (iii) modulating the immune system. Differences in microbiome composition between allergic and healthy infants have been observed, regardless of breastfeeding history. To date, limited studies have examined the preventive effects of HMOs on AD and FA in infants and current data relies on observation studies as trials of varying HMO intake through randomising individuals to breastfeeding are unethical. There is evidence for beneficial e ects of breastfeeding on lowering the risks of FA, eczema and asthma but there are inconsistencies amongst studies in the duration of breastfeeding, diagnostic criteria for AD and the age at which the outcome was assessed. Furthermore, current analytical methods primarily used today only allow detection of 16–20 major HMOs while more than 100 types have been identified. More large-scale longitudinal studies are required to investigate the role of HMO composition and the impact of changes over the lactation period in preventing AD and FA later in life.</p
- …
