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            "title": "An Early Pregnancy HbA1c ≥5.9% (41 mmol/mol) Is Optimal for Detecting Diabetes and Identifies Women at Increased Risk of Adverse Pregnancy Outcomes",
            "creators": [
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                    "creatorType": "author",
                    "firstName": "Ruth C. E.",
                    "lastName": "Hughes"
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                {
                    "creatorType": "author",
                    "firstName": "M. Peter",
                    "lastName": "Moore"
                },
                {
                    "creatorType": "author",
                    "firstName": "Joanna E.",
                    "lastName": "Gullam"
                },
                {
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                    "firstName": "Khadeeja",
                    "lastName": "Mohamed"
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                    "firstName": "Janet",
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            "abstractNote": "OBJECTIVE: Pregnant women with undiagnosed diabetes are a high-risk group that may benefit from early intervention. Extrapolating from nonpregnancy data, HbA1c ≥6.5% (48 mmol/mol) is recommended to define diabetes in pregnancy. Our aims were to determine the optimal HbA1c threshold for detecting diabetes in early pregnancy as defined by an early oral glucose tolerance test (OGTT) at <20 weeks' gestation and to examine pregnancy outcomes relating to this threshold.\nRESEARCH DESIGN AND METHODS: During 2008-2010 in Christchurch, New Zealand, women were offered an HbA1c measurement with their first antenatal bloods. Pregnancy outcome data were collected. A subset completed an early OGTT, and HbA1c performance was assessed using World Health Organization criteria.\nRESULTS: HbA1c was measured at a median 47 days' gestation in 16,122 women. Of those invited, 974/4,201 (23%) undertook an early OGTT. In this subset, HbA1c ≥5.9% (41 mmol/mol) captured all 15 cases of diabetes, 7 with HbA1c <6.5% (<48 mmol/mol). This HbA1c threshold was also 98.4% (95% CI 97-99.9%) specific for gestational diabetes mellitus (GDM) before 20 weeks (positive predictive value = 52.9%). In the total cohort, excluding women referred for GDM management, women with HbA1c of 5.9-6.4% (41-46 mmol/mol; n = 200) had poorer pregnancy outcomes than those with HbA1c <5.9% (<41 mmol/mol; n = 8,174): relative risk (95% CI) of major congenital anomaly was 2.67 (1.28-5.53), preeclampsia was 2.42 (1.34-4.38), shoulder dystocia was 2.47 (1.05-5.85), and perinatal death was 3.96 (1.54-10.16).\nCONCLUSIONS: HbA1c measurements were readily performed in contrast to the low uptake of early OGTTs. HbA1c ≥5.9% (≥41 mmol/mol) identified all women with diabetes and a group at significantly increased risk of adverse pregnancy outcomes.",
            "publicationTitle": "Diabetes Care",
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            "date": "Sep 4, 2014",
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            "DOI": "10.2337/dc14-1312",
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            "language": "ENG",
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            "title": "[Bariatric surgery and pregnancy: literature review]",
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                    "creatorType": "author",
                    "firstName": "Pedro",
                    "lastName": "Ferrand"
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                {
                    "creatorType": "author",
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                    "firstName": "Stephanie",
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            "abstractNote": "Obesity has currently reached epidemic proportions, both in Chile and in the world. This condition is associated to a variety of maternal complications in all stages of the vital cycle and during pregnancy. Medical treatment has not proved successful thus resulting in an increase in bariatric surgery in recent years, even when it is not first line treatment. This literature review aims to report updated results of surgical treatment for obesity before and during pregnancy with respect to fertility, gestational diabetes, pre-eclampsia and pregnancy-induced hypertension. It also looks into the possible effects of surgery on fetal development, and its relation to premature delivery, fetal macrosomy, low birth weight and neural tube defects, as well as effects on maternal and fetal outcomes, mainly in nutrition. Lastly, we suggest some recommendations that arise from this review on the role of contraception, nutrition and time between surgery and pregnancy.",
            "publicationTitle": "Medwave",
            "publisher": "",
            "place": "",
            "date": "2014",
            "volume": "14",
            "issue": "1",
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            "title": "Placental Protein 13 (PP13) - A Placental Immunoregulatory Galectin Protecting Pregnancy",
            "creators": [
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                    "creatorType": "author",
                    "firstName": "Nándor Gábor",
                    "lastName": "Than"
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                    "creatorType": "author",
                    "firstName": "Andrea",
                    "lastName": "Balogh"
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                {
                    "creatorType": "author",
                    "firstName": "Roberto",
                    "lastName": "Romero"
                },
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                    "creatorType": "author",
                    "firstName": "Eva",
                    "lastName": "Kárpáti"
                },
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                    "creatorType": "author",
                    "firstName": "Offer",
                    "lastName": "Erez"
                },
                {
                    "creatorType": "author",
                    "firstName": "András",
                    "lastName": "Szilágyi"
                },
                {
                    "creatorType": "author",
                    "firstName": "Ilona",
                    "lastName": "Kovalszky"
                },
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                    "firstName": "Marei",
                    "lastName": "Sammar"
                },
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                    "firstName": "Sveinbjorn",
                    "lastName": "Gizurarson"
                },
                {
                    "creatorType": "author",
                    "firstName": "János",
                    "lastName": "Matkó"
                },
                {
                    "creatorType": "author",
                    "firstName": "Péter",
                    "lastName": "Závodszky"
                },
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                    "creatorType": "author",
                    "firstName": "Zoltán",
                    "lastName": "Papp"
                },
                {
                    "creatorType": "author",
                    "firstName": "Hamutal",
                    "lastName": "Meiri"
                }
            ],
            "abstractNote": "Galectins are glycan-binding proteins that regulate innate and adaptive immune responses, and some confer maternal-fetal immune tolerance in eutherian mammals. A chromosome 19 cluster of galectins has emerged in anthropoid primates, species with deep placentation and long gestation. Three of the five human cluster galectins are solely expressed in the placenta, where they may confer additional immunoregulatory functions to enable deep placentation. One of these is galectin-13, also known as Placental Protein 13 (PP13). It has a \"jelly-roll\" fold, carbohydrate-recognition domain and sugar-binding preference resembling other mammalian galectins. PP13 is predominantly expressed by the syncytiotrophoblast and released from the placenta into the maternal circulation. Its ability to induce apoptosis of activated T cells in vitro, and to divert and kill T cells as well as macrophages in the maternal decidua in situ, suggests important immune functions. Indeed, mutations in the promoter and an exon of LGALS13 presumably leading to altered or non-functional protein expression are associated with a higher frequency of preeclampsia and other obstetrical syndromes, which involve immune dysregulation. Moreover, decreased placental expression of PP13 and its low concentrations in first trimester maternal sera are associated with elevated risk of preeclampsia. Indeed, PP13 turned to be a good early biomarker to assess maternal risk for the subsequent development of pregnancy complications caused by impaired placentation. Due to the ischemic placental stress in preterm preeclampsia, there is increased trophoblastic shedding of PP13 immunopositive microvesicles starting in the second trimester, which leads to high maternal blood PP13 concentrations. Our meta-analysis suggests that this phenomenon may enable the potential use of PP13 in directing patient management near to or at the time of delivery. Recent findings on the beneficial effects of PP13 on decreasing blood pressure due to vasodilatation in pregnant animals suggest its therapeutic potential in preeclampsia.",
            "publicationTitle": "Frontiers in Immunology",
            "publisher": "",
            "place": "",
            "date": "2014",
            "volume": "5",
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            "pages": "348",
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