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  • Original Article

    Can genital infections alter the results of preterm birth predictive tests?

    Rev Bras Ginecol Obstet. 2015;37(1):10-15

    Summary

    Original Article

    Can genital infections alter the results of preterm birth predictive tests?

    Rev Bras Ginecol Obstet. 2015;37(1):10-15

    DOI 10.1590/SO100-720320140005202

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    PURPOSE:

    To determine if the presence of infectious agents in vaginal or cervical content can alter the results of the insulin-like growth factor binding protein-1 (phIGFBP-1) test and the measurement of cervical length (CC) by transvaginal ultrasonography.

    METHODS:

    A total of 107 pregnant women with a history of spontaneous preterm birth were submitted to the phIGFBP-1 test and to measurement of CC by transvaginal ultrasonography every 3 weeks, between 24 and 34 weeks of gestation. Genital infections were determined immediately before testing. The patients were distributed into four groups (GA, GB, GC, and GD) and the correlation between genital infection and changes in the tests was determined within each group based on the odds ratio (OR) and the Pearson correlation coefficient.

    RESULTS:

    In each group, over 50% of the patients had genital infections (GA 10/17; GB 28/42; GC 15/24; GD 35/53), with bacterial vaginosis being the main alteration of the vaginal flora. Positive results for phIGFBP-1(GA 10/10; GB 18/28; GC 15/15; GD 19/35) and CC≤20 mm (GA 10/10; GB 20/28; GC 10/15; GD 20/35) were obtained more frequently in patients with genital infection in all groups. Nonetheless, when applying the Pearson correlation coefficient we detected a poor correlation between genital infection and positivity for markers.

    CONCLUSION:

    The presence of changes in the vaginal flora and of other genital infections does not significantly alter the results of phIGFBP-1 and the measurement of cervical length when compared to cases without infection. However, more studies with larger samples are necessary to confirm these results.

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  • Original Article

    The influence of breastfeeding in postpartum oral glucose tolerance test in women with recent gestational diabetes mellitus

    Rev Bras Ginecol Obstet. 2015;37(12):565-570

    Summary

    Original Article

    The influence of breastfeeding in postpartum oral glucose tolerance test in women with recent gestational diabetes mellitus

    Rev Bras Ginecol Obstet. 2015;37(12):565-570

    DOI 10.1590/SO100-720320150005488

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    Abstract

    PURPOSE:

    To determine the influence of breastfeeding on the results of a postpartum oral glucose tolerance test in women recently diagnosed with gestational diabetes mellitus.

    METHODS:

    The data were obtained from the electronic medical records of the Endocrinopathy Sector during pregnancy, HCMED laboratory system ofHospital das Clínicas of São Paulo , and by telephone. According to the inclusion criteria adopted, 132 patients were eligible for the study. For statistical analysis, the patients were divided into two groups according to whether or not they breastfed. The results were analyzed by the Student t-test and by the Mann-Whitney, Chi-square and Fisher's exact tests, depending on the variable analyzed, with the level of significance set at p<0.05.

    RESULTS:

    Of the 132 patients included in the study, 114 breastfed and 18 did not. Most of the patients in both groups were overweight or obese. The breastfeeding group had a lower pre-pregnancy Body Mass Index than the non-breastfeeding group (p=0.006). Insulin was introduced earlier in the group that did not breastfeed (23.21±4.33 versus 28.84±6.17; p=0.04). The group that did not breastfeed had a higher mean postpartum fasting glucose value in the oral glucose tolerance test than the group that breastfed (91.3±8.7 versus 86.5±9.3; p=0.01). Breastfeeding acted as a protective factor against the development of glucose intolerance in the postpartum oral glucose tolerance test (OR=0.27; 95%CI 0.09-0.8). By logistic regression, breastfeeding was shown to be an independent protective factor.

    CONCLUSION:

    There was a statistically significant relationship between breastfeeding and a decreased risk of developing glucose intolerance. Breastfeeding should be encouraged because it is an effective, low cost intervention easily accessible to all patients during the postpartum period.

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    The influence of breastfeeding in postpartum oral glucose tolerance test in women with recent gestational diabetes mellitus

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