LIVIVO - The Search Portal for Life Sciences

zur deutschen Oberfläche wechseln
Advanced search

Search results

Result 1 - 10 of total 38

Search options

  1. Article ; Online: REduced-Carbohydrate intervention for managing Obesity and Reduction of gestational Diabetes (RECORD): A randomized controlled feasibility trial.

    Michalopoulou, Moscho / Jebb, Susan A / MacKillop, Lucy H / Dyson, Pamela / Hirst, Jane E / Zhu, Sufen / Wire, Amy / Astbury, Nerys M

    Diabetes, obesity & metabolism

    2024  Volume 26, Issue 4, Page(s) 1407–1420

    Abstract: Aim: To test the feasibility and acceptability of a reduced-carbohydrate dietary program, intended to reduce the risk of gestational diabetes.: Materials and methods: Fifty-one pregnant women at <20 weeks' gestation, with body mass index ≥30 kg/m: ... ...

    Abstract Aim: To test the feasibility and acceptability of a reduced-carbohydrate dietary program, intended to reduce the risk of gestational diabetes.
    Materials and methods: Fifty-one pregnant women at <20 weeks' gestation, with body mass index ≥30 kg/m
    Results: Forty-nine of 51 participants attended the follow-up OGTT, a retention rate of 96% (95% confidence interval [CI] 86.8%-98.9%). In the intervention group, carbohydrate intake at follow-up was 190.4 (95% CI 162.5-215.6) g/day, a reduction of -24.6 (95% CI -51.5-2.4) g/day from baseline. Potentially favourable effects of the intervention on glucose control, weight gain and blood pressure were observed, but the study was not powered to detect significant differences in these. Participants found the intervention acceptable, and were content with the study processes, but some reported barriers to sustained adherence, mainly pertaining to competing priorities.
    Conclusions: Retention was high, suggesting the study processes are feasible, but the carbohydrate reduction in the intervention group was small, and did not meet progression criteria, limiting the likelihood of achieving the desired goal to prevent gestational diabetes.
    Trial registration number: ISRCTN16235884.
    MeSH term(s) Infant, Newborn ; Pregnancy ; Female ; Humans ; Diabetes, Gestational/prevention & control ; Feasibility Studies ; Obesity/complications ; Obesity/therapy ; Weight Gain ; Carbohydrates ; Diet, Carbohydrate-Restricted
    Chemical Substances Carbohydrates
    Language English
    Publishing date 2024-01-16
    Publishing country England
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 1454944-x
    ISSN 1463-1326 ; 1462-8902
    ISSN (online) 1463-1326
    ISSN 1462-8902
    DOI 10.1111/dom.15442
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  2. Article: Standardising the assessment of caesarean birth using an oxford caesarean prediction score for mothers with gestational diabetes.

    Lu, Huiqi / Hirst, Jane / Yang, Jenny / Mackillop, Lucy / Clifton, David

    Healthcare technology letters

    2022  Volume 9, Issue 1-2, Page(s) 1–8

    Abstract: Mothers with gestational diabetes are at increased risk of giving birth by caesarean section. A standardised assessment method may help to guide in recommendations in planning caesarean birth. We analysed 203 women with gestational diabetes managed in a ... ...

    Abstract Mothers with gestational diabetes are at increased risk of giving birth by caesarean section. A standardised assessment method may help to guide in recommendations in planning caesarean birth. We analysed 203 women with gestational diabetes managed in a single centre and developed an aggregate heuristic risk score. Among 155 women who had not had a previous caesarean birth, five risk factors (previous birth, weight gain during pregnancy, mother's height, and glycated haemoglobin and fasting blood glucose results at the beginning of pregnancy) were found associated with primary caesarean birth. Risk of primary caesarean birth in low-risk women (score 0-1) was 13.8%, medium-risk (score 2-3) 24.5% and high risk (score ≥ 4) 66.7%. The area under the receiver operating characteristic (AUROC) for primary caesarean birth prediction is 0.726 ± 0.003. Machine learning models were then deployed on 97 patients to explore the role of temporal blood glucose in predicting caesarean birth, achieving an AUROC of 0.857 ± 0.008. In conclusion, Oxford caesarean prediction score could help clinicians counselling women with gestational diabetes about their individual risk of primary caesarean birth. Temporal blood glucose measurements may improve the prediction subject to further validation.
    Language English
    Publishing date 2022-03-13
    Publishing country England
    Document type Journal Article
    ZDB-ID 2782924-8
    ISSN 2053-3713
    ISSN 2053-3713
    DOI 10.1049/htl2.12022
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  3. Article ; Online: Development and testing of a reduced carbohydrate intervention for the management of obesity and reduction of gestational diabetes (RECORD): protocol for a feasibility randomised controlled trial.

    Michalopoulou, Moscho / Jebb, Susan A / MacKillop, Lucy H / Dyson, Pamela / Hirst, Jane E / Wire, Amy / Astbury, Nerys M

    BMJ open

    2022  Volume 12, Issue 9, Page(s) e060951

    Abstract: Introduction: Previous trials of dietary interventions to prevent gestational diabetes mellitus (GDM) have yielded only limited success. Low-carbohydrate diets have shown promise for the treatment of type 2 diabetes, but there is no evidence to support ... ...

    Abstract Introduction: Previous trials of dietary interventions to prevent gestational diabetes mellitus (GDM) have yielded only limited success. Low-carbohydrate diets have shown promise for the treatment of type 2 diabetes, but there is no evidence to support their use in pregnancy. The aim of this study is to explore the feasibility of a moderately reduced-carbohydrate dietary intervention delivered from mid-pregnancy alongside routine antenatal care.
    Methods and analysis: This is a feasibility randomised controlled trial (RCT) with embedded qualitative study. Sixty women who are pregnant <20 weeks' gestation, with body mass index ≥30 kg/m
    Ethics and dissemination: This trial was reviewed and approved by the South-Central Oxford B Research Ethics Committee NHS National Research Ethics Committee and the Health Research Authority (Reference: 20/SC/0442). The study results will inform whether to progress to a full-scale RCT to test the clinical effectiveness of the RECORD programme to prevent GDM in women at high risk. The findings will be published in peer-reviewed journals and presented at conferences.
    Trial registration number: ISRCTN16235884.
    MeSH term(s) Pregnancy ; Infant, Newborn ; Female ; Humans ; Diabetes, Gestational/prevention & control ; Feasibility Studies ; Obesity/prevention & control ; Obesity/epidemiology ; Diet, Carbohydrate-Restricted ; Dietary Carbohydrates ; Randomized Controlled Trials as Topic
    Chemical Substances Dietary Carbohydrates
    Language English
    Publishing date 2022-09-01
    Publishing country England
    Document type Clinical Trial Protocol ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2022-060951
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  4. Article ; Online: Development and testing of a reduced carbohydrate intervention for the management of obesity and reduction of gestational diabetes (RECORD)

    Pamela Dyson / Susan A Jebb / Nerys M Astbury / Jane E Hirst / Lucy H MacKillop / Moscho Michalopoulou / Amy Wire

    BMJ Open, Vol 12, Iss

    protocol for a feasibility randomised controlled trial

    2022  Volume 9

    Abstract: Introduction Previous trials of dietary interventions to prevent gestational diabetes mellitus (GDM) have yielded only limited success. Low-carbohydrate diets have shown promise for the treatment of type 2 diabetes, but there is no evidence to support ... ...

    Abstract Introduction Previous trials of dietary interventions to prevent gestational diabetes mellitus (GDM) have yielded only limited success. Low-carbohydrate diets have shown promise for the treatment of type 2 diabetes, but there is no evidence to support their use in pregnancy. The aim of this study is to explore the feasibility of a moderately reduced-carbohydrate dietary intervention delivered from mid-pregnancy alongside routine antenatal care.Methods and analysis This is a feasibility randomised controlled trial (RCT) with embedded qualitative study. Sixty women who are pregnant <20 weeks’ gestation, with body mass index ≥30 kg/m2 at their antenatal booking appointment, will be randomised 2:1 intervention or control (usual care) and followed up until delivery. The intervention is a moderately reduced-carbohydrate diet (~130–150 g total carbohydrate/day), designed to be delivered alongside routine antenatal appointments. Primary outcomes are measures of adoption of the diet and retention of participants. Secondary outcomes include incidence of GDM, change in markers of glycaemic control, gestational weight gain, total carbohydrate and energy intake. Process outcomes will examine resources and management issues. Exploratory outcomes include further dietary changes, quality of life, maternal and neonatal outcomes, and qualitative measures.Ethics and dissemination This trial was reviewed and approved by the South-Central Oxford B Research Ethics Committee NHS National Research Ethics Committee and the Health Research Authority (Reference: 20/SC/0442). The study results will inform whether to progress to a full-scale RCT to test the clinical effectiveness of the RECORD programme to prevent GDM in women at high risk. The findings will be published in peer-reviewed journals and presented at conferences.Trial registration number ISRCTN16235884.
    Keywords Medicine ; R
    Subject code 170
    Language English
    Publishing date 2022-09-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    More links

    Kategorien

  5. Article ; Online: Improving diagnostic accuracy in pregnancy with individualised, gestational age-specific reference intervals.

    Dockree, Samuel / Shine, Brian / Impey, Lawrence / Mackillop, Lucy / Randeva, Harpal / Vatish, Manu

    Clinica chimica acta; international journal of clinical chemistry

    2022  Volume 527, Page(s) 56–60

    Abstract: Background and aims: Investigations in pregnancy should be interpreted using pregnancy-specific reference intervals (RIs). However, because of the progressive nature of pregnancy, even pregnancy-specific RIs may not be equally representative at ... ...

    Abstract Background and aims: Investigations in pregnancy should be interpreted using pregnancy-specific reference intervals (RIs). However, because of the progressive nature of pregnancy, even pregnancy-specific RIs may not be equally representative at different gestations. We proposed that gestational age-specific RIs may increase diagnostic accuracy over those with fixed limits.
    Materials and methods: The trajectory of platelets was mapped in 32,778 pregnant women, using 116,798 results. Then we evaluated the accuracy with which a low measurement in early pregnancy (<3rd centile) predicted thrombocytopaenia at term, compared to the existing limit (<150 × 10
    Results: Platelets fell by 14.8% between 8 and 40 weeks. Platelets below the 3rd centile before 20 weeks predicted thrombocytopaenia at term (<100 × 10
    Conclusion: Pregnancy-specific RIs can be defined using routinely collected hospital data, and the abundance of such freely available data enables a detailed investigation of temporal changes throughout gestation. Individualised RIs offer improved accuracy profiles, over and above those already derived specifically from pregnant populations. Clinicians should consider how this may be used to improve diagnostic accuracy for biomarkers used in current clinical practice, and those yet to be defined.
    MeSH term(s) Biomarkers ; Female ; Gestational Age ; Humans ; Pregnancy ; Reference Values
    Chemical Substances Biomarkers
    Language English
    Publishing date 2022-01-14
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 80228-1
    ISSN 1873-3492 ; 0009-8981
    ISSN (online) 1873-3492
    ISSN 0009-8981
    DOI 10.1016/j.cca.2022.01.007
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  6. Article ; Online: Self-monitoring blood pressure in Pregnancy: Evaluation of health professional experiences of the BUMP trials.

    Chisholm, Alison / Tucker, Katherine L / Crawford, Carole / Green, Marcus / Greenfield, Sheila / Hodgkinson, James / Lavallee, Layla / Leeson, Paul / Mackillop, Lucy / McCourt, Christine / Sandall, Jane / Wilson, Hannah / Chappell, Lucy C / McManus, Richard J / Hinton, Lisa

    Pregnancy hypertension

    2024  Volume 35, Page(s) 88–95

    Abstract: Background: The BUMP trials evaluated a self-monitoring of blood pressure intervention in addition to usual care, testing whether they improved detection or control of hypertension for women at risk of hypertension or with hypertension during pregnancy. ...

    Abstract Background: The BUMP trials evaluated a self-monitoring of blood pressure intervention in addition to usual care, testing whether they improved detection or control of hypertension for women at risk of hypertension or with hypertension during pregnancy. This process evaluation aimed to understand healthcare professionals' perspectives and experiences of the BUMP trials of self-monitoring of blood pressure during pregnancy.
    Methods: Twenty-two in-depth qualitative interviews and an online survey with 328 healthcare professionals providing care for pregnant people in the BUMP trials were carried out across five maternity units in England.
    Results: Analysis used Normalisation Process Theory to identify factors required for successful implementation and integration into routine practice. Healthcare professionals felt self-monitoring of blood pressure did not over-medicalise pregnancy for women with, or at risk of, hypertension. Most said self-monitored readings positively affected their clinical encounters and professional roles, provided additive information on which to base decisions and enriched their relationships with pregnant people. Self-monitoring of blood pressure shifts responsibilities. Some healthcare professionals felt women having responsibility to decide on timing of monitoring and whether to act on self-monitored readings was unduly burdensome, and resulted in healthcare professionals taking additional responsibility for supporting them.
    Conclusions: Despite healthcare professionals' early concerns that self-monitoring of blood pressure might over-medicalise pregnancy, our analysis shows the opposite was the case when used in the care of pregnant people with, or at higher risk of, hypertension. While professionals retained ultimate clinical responsibility, they viewed self-monitoring of blood pressure as a means of sharing responsibility and empowering women to understand their bodies, to make judgements and decisions, and to contribute to their care.
    MeSH term(s) Humans ; Female ; Pregnancy ; Blood Pressure ; Pre-Eclampsia/diagnosis ; Hypertension/diagnosis ; England ; Blood Pressure Monitoring, Ambulatory
    Language English
    Publishing date 2024-02-01
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2584464-7
    ISSN 2210-7797 ; 2210-7789
    ISSN (online) 2210-7797
    ISSN 2210-7789
    DOI 10.1016/j.preghy.2024.01.134
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  7. Article ; Online: Short-Term Postpartum Blood Pressure Self-Management and Long-Term Blood Pressure Control: A Randomized Controlled Trial.

    Kitt, Jamie A / Fox, Rachael L / Cairns, Alexandra E / Mollison, Jill / Burchert, Holger H / Kenworthy, Yvonne / McCourt, Annabelle / Suriano, Katie / Lewandowski, Adam J / Mackillop, Lucy / Tucker, Katherine L / McManus, Richard J / Leeson, Paul

    Hypertension (Dallas, Tex. : 1979)

    2021  Volume 78, Issue 2, Page(s) 469–479

    Abstract: Figure: see text]. ...

    Abstract [Figure: see text].
    MeSH term(s) Adult ; Blood Pressure/physiology ; Blood Pressure Monitoring, Ambulatory ; Female ; Humans ; Hypertension, Pregnancy-Induced/physiopathology ; Postpartum Period ; Pregnancy ; Self-Management
    Language English
    Publishing date 2021-06-28
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 423736-5
    ISSN 1524-4563 ; 0194-911X ; 0362-4323
    ISSN (online) 1524-4563
    ISSN 0194-911X ; 0362-4323
    DOI 10.1161/HYPERTENSIONAHA.120.17101
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  8. Article ; Online: Placental Growth Factor (PlGF) in Women with Suspected Pre-Eclampsia Prior to 35 Weeks' Gestation: A Budget Impact Analysis.

    Duckworth, Suzy / Chappell, Lucy C / Seed, Paul T / Mackillop, Lucy / Shennan, Andrew H / Hunter, Rachael

    PloS one

    2016  Volume 11, Issue 10, Page(s) e0164276

    Abstract: Objective: To model the resource implications of placental growth factor (PlGF) testing in women with suspected pre-eclampsia prior to 35 weeks' gestation as part of a management algorithm, compared with current practice.: Methods: Data on resource ... ...

    Abstract Objective: To model the resource implications of placental growth factor (PlGF) testing in women with suspected pre-eclampsia prior to 35 weeks' gestation as part of a management algorithm, compared with current practice.
    Methods: Data on resource use from 132 women with suspected pre-eclampsia prior to 35 weeks' gestation, enrolled in a prospective observational cohort study evaluating PlGF measurement within antenatal assessment units within two UK consultant-led maternity units was extracted by case note review. A decision analytic model was developed using these data to establish the budget impact of managing women with suspected pre-eclampsia for two weeks from the date of PlGF testing, using a clinical management algorithm and reference cost tariffs. The main outcome measures of resource use (numbers of outpatient appointments, ultrasound investigations and hospital admissions) were correlated to final diagnosis and used to calculate comparative management regimes.
    Results: The mean cost saving associated with the PlGF test (in the PlGF plus management arm) was £35,087 (95% CI -£33,181 to -£36,992) per 1,000 women. This equated to a saving of £582 (95% CI -552 to -£613) per woman tested. In 94% of iterations, PlGF testing was associated with cost saving compared to current practice.
    Conclusions: This analysis suggests PlGF used as part of a clinical management algorithm in women presenting with suspected pre-eclampsia prior to 35 weeks' gestation could provide cost savings by reducing unnecessary resource use. Introduction of PlGF testing could be used to direct appropriate resource allocation and overall would be cost saving.
    MeSH term(s) Adult ; Algorithms ; Biomarkers/analysis ; Blood Pressure ; Cohort Studies ; Cost-Benefit Analysis ; Female ; Gestational Age ; Humans ; Models, Theoretical ; Placenta Growth Factor/analysis ; Pre-Eclampsia/diagnosis ; Pre-Eclampsia/economics ; Pregnancy ; Prospective Studies ; Sensitivity and Specificity
    Chemical Substances Biomarkers ; Placenta Growth Factor (144589-93-5)
    Language English
    Publishing date 2016-10-14
    Publishing country United States
    Document type Journal Article
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0164276
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  9. Article ; Online: Machine Learning-Based Risk Stratification for Gestational Diabetes Management.

    Yang, Jenny / Clifton, David / Hirst, Jane E / Kavvoura, Foteini K / Farah, George / Mackillop, Lucy / Lu, Huiqi

    Sensors (Basel, Switzerland)

    2022  Volume 22, Issue 13

    Abstract: Gestational diabetes mellitus (GDM) is often diagnosed during the last trimester of pregnancy, leaving only a short timeframe for intervention. However, appropriate assessment, management, and treatment have been shown to reduce the complications of GDM. ...

    Abstract Gestational diabetes mellitus (GDM) is often diagnosed during the last trimester of pregnancy, leaving only a short timeframe for intervention. However, appropriate assessment, management, and treatment have been shown to reduce the complications of GDM. This study introduces a machine learning-based stratification system for identifying patients at risk of exhibiting high blood glucose levels, based on daily blood glucose measurements and electronic health record (EHR) data from GDM patients. We internally trained and validated our model on a cohort of 1148 pregnancies at Oxford University Hospitals NHS Foundation Trust (OUH), and performed external validation on 709 patients from Royal Berkshire Hospital NHS Foundation Trust (RBH). We trained linear and non-linear tree-based regression models to predict the proportion of high-readings (readings above the UK's National Institute for Health and Care Excellence [NICE] guideline) a patient may exhibit in upcoming days, and found that XGBoost achieved the highest performance during internal validation (0.021 [CI 0.019-0.023], 0.482 [0.442-0.516], and 0.112 [0.109-0.116], for MSE, R2, MAE, respectively). The model also performed similarly during external validation, suggesting that our method is generalizable across different cohorts of GDM patients.
    MeSH term(s) Blood Glucose ; Diabetes, Gestational/diagnosis ; Diabetes, Gestational/therapy ; Female ; Humans ; Machine Learning ; Pregnancy ; Pregnancy Trimester, Third ; Risk Assessment
    Chemical Substances Blood Glucose
    Language English
    Publishing date 2022-06-25
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2052857-7
    ISSN 1424-8220 ; 1424-8220
    ISSN (online) 1424-8220
    ISSN 1424-8220
    DOI 10.3390/s22134805
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  10. Article ; Online: Gestation-Specific Vital Sign Reference Ranges in Pregnancy.

    Green, Lauren J / Mackillop, Lucy H / Salvi, Dario / Pullon, Rebecca / Loerup, Lise / Tarassenko, Lionel / Mossop, Jude / Edwards, Clare / Gerry, Stephen / Birks, Jacqueline / Gauntlett, Rupert / Harding, Kate / Chappell, Lucy C / Watkinson, Peter J

    Obstetrics and gynecology

    2020  Volume 135, Issue 3, Page(s) 653–664

    Abstract: Objective: To estimate normal ranges for maternal vital signs throughout pregnancy, which have not been well defined in a large contemporary population.: Methods: We conducted a three-center, prospective, longitudinal cohort study in the United ... ...

    Abstract Objective: To estimate normal ranges for maternal vital signs throughout pregnancy, which have not been well defined in a large contemporary population.
    Methods: We conducted a three-center, prospective, longitudinal cohort study in the United Kingdom from August 2012 to September 2017. We recruited women at less than 20 weeks of gestation without significant comorbidities with accurately dated singleton pregnancies. We measured participants' blood pressure (BP), heart rate, respiratory rate, oxygen saturation and temperature following standardized operating procedures at 4-6 weekly intervals throughout pregnancy.
    Results: We screened 4,279 pregnant women, 1,041 met eligibility criteria and chose to take part. Systolic and diastolic BP decreased slightly from 12 weeks of gestation: median or 50th centile (3rd-97th centile) 114 (95-138); 70 (56-87) mm Hg to reach minimums of 113 (95-136); 69 (55-86) mm Hg at 18.6 and 19.2 weeks of gestation, respectively, a change (95% CI) of -1.0 (-2 to 0); -1 (-2 to -1) mm Hg. Systolic and diastolic BP then rose to a maximum median (3rd-97th centile) of 121 (102-144); 78 (62-95) mm Hg at 40 weeks of gestation, a difference (95% CI) of 7 (6-9) and9 (8-10) mm Hg, respectively. The median (3rd-97th centile) heart rate was lowest at 12 weeks of gestation: 82 (63-105) beats per minute (bpm), rising progressively to a maximum of 91 (68-115) bpm at 34.1 weeks. SpO2 decreased from 12 weeks of gestation: median (3-97 centile) 98% (94-99%) to 97% (93-99%) at 40 weeks. The median (3-97 centile) respiratory rate at 12 weeks of gestation was 15 (9-22), which did not change with gestation. The median (3-97 centile) temperature at 12 weeks of gestation was 36.7 (35.6-37.5)°C, decreasing to a minimum of 36.5 (35.3-37.3)°C at 33.4 weeks.
    Conclusion: We present widely relevant, gestation-specific reference ranges for detecting abnormal BP, heart rate, respiratory rate, oxygen saturation and temperature during pregnancy. Our findings refute the existence of a clinically significant BP drop from 12 weeks of gestation.
    Clinical trial registration: ISRCTN, ISRCTN10838017.
    MeSH term(s) Female ; Humans ; Longitudinal Studies ; Pregnancy ; Prospective Studies ; Reference Values ; Vital Signs
    Language English
    Publishing date 2020-02-05
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 207330-4
    ISSN 1873-233X ; 0029-7844
    ISSN (online) 1873-233X
    ISSN 0029-7844
    DOI 10.1097/AOG.0000000000003721
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

To top