Role of Nutritional Habits during Pregnancy in the Developing of Gestational Diabetes: A Single-Center Observational Clinical Study.

(1) Background and Objective: Excessive gestational weight gain is associated with serious complications such as pre-eclampsia, fetal macrosomia and a more frequent need for cesarean section. The aim of this study is to develop a simple screening model that includes maternal age, BMI and nutritive habits in the second trimester in order to predict the risk of GDM in the population of pregnant women in the territory of the Republic of Serbia. (2) Materials and Methods: This single-center, prospective and case-control study was performed in the University Clinical Center "Dr. Dragisa Misovic Dedinje", Belgrade, Serbia and included 54 women with singleton pregnancies during the second trimester from July 2023 to November 2023. We used basic demographic and socio-epidemiological data, as well as data of the present comorbidities and previous pregnancies/births. The Serbian version of the Nutritive Status Questionnaire (NSQ) was used to estimate the nutritive habits in GDM (n = 22) and non-GDM groups (n = 32). (3) Results: We observed less frequent vegetable and fruit consumption in the GDM group in comparison with the non-GDM group; meat and chicken intake was 2-3 times per week in both groups; meat products were consumed 2-3 times per week in the GDM group and 2-3 times per month in the non-GDM group; milk products were consumed once a day in 31.8% of GDM patients and twice per day in 24.1% of non-GDM patients. Sweets (cakes, ice creams, biscuits) were consumed very often (2-3 times per week) in the GDM group (36.4%), while in the non-GDM group this habit was less frequent (26.7%). Cronbach alpha and internal consistency for this instrument were very good (Cronbach alpha = 0.87). (4) Conclusions: We have found that a non-adequate intake of fruits/vegetables, dairy and whole grain, as well as an excessive intake of sugar/artificially sweetened beverages and dairy, was associated with a higher risk of gestational diabetes mellitus (OR = 0.04; 95% CI).

Risk Factors of Adverse Maternal Outcome among SARS-CoV-2 Infected Critically Ill Pregnant Women in Serbia.

BACKGROUND AND OBJECTIVES: During the COVID-19 pandemic, Serbia has faced devastating losses related to increased mortality rates among men and women of all ages. With 14 registered cases of maternal death in 2021, it became obvious that pregnant women are faced with a serious threat that jeopardises their life as well as the life of their unborn child. Studying the consequences of the COVID-19 pandemic on maternal outcomes is vivifying and stimulating for many professionals and decision-makers, and knowing the contextual characteristics can facilitate the application of literature findings in practice. Therefore, the aim of this study was to present findings of maternal mortality in Serbia associated with SARS-CoV-2 infected and critically ill pregnant women. METHODS: Clinical status and pregnancy-related features were analysed for a series of 192 critically ill pregnant women with confirmed SARS-CoV-2 infection. According to the treatment outcome, pregnant women were divided in two study groups: a group of survivors and a group of deceased patients. RESULTS: A lethal outcome was recorded in seven cases. Pregnant women in the deceased group were presenting at admission more commonly with X-ray-confirmed pneumonia, a body temperature of >38 °C, cough, dyspnea, and fatigue. They were more likely to have a progression of the disease, to be admitted to intensive care unit, and be dependent from mechanical ventilation, as well as to have nosocomial infection, pulmonary embolism, and postpartum haemorrhage. On average, they were in their early third trimester of pregnancy, presenting more commonly with gestational hypertension and preeclampsia. CONCLUSIONS: Initial clinical manifestations of SARS-CoV-2 infection, such as dyspnea, cough, fatigue, and fever, could be a potent factors in risk stratification and outcome prediction. Prolonged hospitalization, ICU admission, and associated risk of hospital-acquired infections require strict microbiological surveillance and should be a constant reminder of rational antibiotics use. Understanding and identification of risk factors associated with poor maternal outcomes among pregnant women infected with SARS-CoV-2 should warn medical professionals of potentially unwanted outcomes and can be used for organising an individualised treatment for a pregnant patient's specific needs, including a guide to necessary consultations with medical specialists in various fields.