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Papers by Juan-Maria Adelantado

Research paper thumbnail of Are birth weight predictors in diabetic pregnancy the same in boys and girls?

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2010

To study the predictors of abnormal fetal growth in diabetic pregnancy, analyzing the role of fet... more To study the predictors of abnormal fetal growth in diabetic pregnancy, analyzing the role of fetal sex. Study design: Observational retrospective study was carried out in a University hospital. We studied 2833 newborns of diabetic mothers who attended the Diabetes and Pregnancy Clinic and delivered in the center between 1/1/1982 and 31/12/2006 (2370 born to women with gestational diabetes mellitus, 391 to women with type 1 diabetes mellitus (DM), and 72 to women with type 2 DM). Logistic regression analyses were performed with a backward method to predict large for gestational age (LGA), small for gestational age (SGA) and macrosomic newborns using relevant variables and their interaction with fetal sex. We have used as potential predictors of abnormal birth weight: maternal prepregnancy age, weight, height and body mass index, prior pregnancy, prior macrosomia, smoking habit, weight increase during pregnancy, hypertension, gestational age at delivery, twin pregnancy, fetal sex, diabetes type, third trimester HbA1c and interaction of fetal sex with all these variables. Results: Variables predictive of LGA, SGA and macrosomia were as formerly described. Moreover, some predictors of abnormal growth displayed an interaction with fetal sex. In LGA prediction, male sex displayed a positive interaction with delivery week, prior gestation, diabetes type and twin pregnancy and a negative one with weight increase. In SGA prediction, male sex displayed a positive interaction with delivery week and diabetes type. In macrosomia prediction, male sex displayed a negative interaction with weight increase. Conclusions: In this cohort of diabetic pregnancies, some predictors of abnormal birth weight display interaction with fetal sex. In general, associations were more favorable to female fetuses.

Research paper thumbnail of Schmerzerfassung und Mehrstufenplan in der gynäkologischen Onkologie

Research paper thumbnail of Increased uterine prostaglandin E receptors in menorrhagic women

BJOG: An International Journal of Obstetrics and Gynaecology, 1988

PGE receptor concentrations were measured in myometrial samples collected from 10 women at hyster... more PGE receptor concentrations were measured in myometrial samples collected from 10 women at hysterectomy. Five women had normal measured menstrual blood loss (35-44 ml) and the remainder had unexplained menorrhagia occurring in the absence of any uterine, pelvic or general pathology, with losses ranging from 85 to 925 ml. Median PGE receptor concentrations were significantly higher in the women with menorrhagia (1077 fmol/mg protein) than in the women with normal mcnstrual blood loss (625 fmol/mg protein) and correlated with menstrual blood loss (P<0.02). These findings suggest that unexplained menorrhagia may simply be a constitutional variant in some women and that specific and potent PGE uterine receptor antagonists would furnish effective non-surgical treatment for unexplained menorrhagia. Unexplained menorrhagia, occurring in the absence of uterine. pelvic or general pathology, is a common clinical problem, associated with excessive uterine prostaglandin (PG) levels. PG synthetase inhibitors can reduce menstrual blood loss in this condition and have been used successfully in its treatment (Willman rf ul. 1976; Anderson et ml. 1976; Frascr et al. 1983). However, when PG levels in endometrium, myometrium and menstrual fluid have been related to total mcnstrual blood loss, results have been conflicting (Smith etal. 1981; Rees etal. 19840. b). We have therefore investigated the potential role of PG receptors in the uterus in unexplained menorrhagia. PGa are thought to act through receptors in thc cell membrane. PG receptors have been detected in human niyonietrium but

Research paper thumbnail of Erhöhte Konzentration von Prostaglandin-E-Rezeptoren bei Frauen mit Menorrhagie

Gynäkologisch-geburtshilfliche Rundschau, 1989

Research paper thumbnail of Hypopituitarism and Pregnancy : Clinical Characteristics, Management and Pregnancy Outcome

Dipòsit Digital de Documents de la UAB

Research paper thumbnail of Erh�hte Konzentration von Prostaglandin-E-Rezeptoren bei Frauen mit Menorrhagie

Gynakol Geburtshilfl Rundsch, 1989

Research paper thumbnail of Topographical distribution of prostaglandin E receptors in human myometrium

BJOG: An International Journal of Obstetrics and Gynaecology, 1988

T h e binding of radiolabelled prostaglandin (PG) F2<, and PGE, by human myometrium was measured ... more T h e binding of radiolabelled prostaglandin (PG) F2<, and PGE, by human myometrium was measured in vitro and the distribution and characteristics of the binding sites in non-pregnant and pregnant uteri were studied. PGF,, binding sites were of low affinity (Kd 30 nM) and could b e occupied by PG of the E series with higher affinity than PGFZcl itself. PGE binding sites were of high affinity (Kd 1.5 nM) and highly specific for PG of the E series, suggesting that they represent truc PGE receptors. T h e concentration of PGE receptors was higher in nonpregnant than in pregnant uteri a t term. In non-pregnant uteri the concentration of PGE receptors was highest in the fundus and decreased towards the cervix; in term pregnant uteri the concentration was constant in all areas. In both non-pregnant and pregnant uteri there was a significantly lower PGE binding affinity in cervix than in myometrium from the fundus-corpus area. The concentrations and affinity

Research paper thumbnail of Period of gestational diabetes mellitus diagnosis and maternal and fetal morbidity

Acta Obstetricia et Gynecologica Scandinavica, 2005

The aim of the study was to analyze the association between the period of diagnosis of gestationa... more The aim of the study was to analyze the association between the period of diagnosis of gestational diabetes mellitus (GDM) and maternal and neonatal outcome. In this retrospective study, 1708 offspring (1571 singleton, 119 twins, and 18 triplets) born to women with GDM who attended the Diabetic and Pregnancy Clinic were included. Pregnancies were divided into three groups according to the gestational age at GDM diagnosis. The association of the period of diagnosis with maternal and fetal outcome was assessed adjusting for potentially confounding variables (logistic regression analysis). The period of diagnosis was a predictor in two out of three maternal outcomes (pregnancy-induced hypertension and insulin treatment) and in four out of 12 fetal outcomes (preterm birth, 5-min Apgar &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;7, perinatal mortality, and hyperbilirubinemia). Whereas pregnancy-induced hypertension was higher in women diagnosed with GDM in the second period, the other outcomes displayed higher occurrences with earlier diagnosis. Diagnosis of GDM earlier in pregnancy is a predictor of adverse maternal and neonatal outcome.

Research paper thumbnail of Are birth weight predictors in diabetic pregnancy the same in boys and girls?

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2010

To study the predictors of abnormal fetal growth in diabetic pregnancy, analyzing the role of fet... more To study the predictors of abnormal fetal growth in diabetic pregnancy, analyzing the role of fetal sex. Study design: Observational retrospective study was carried out in a University hospital. We studied 2833 newborns of diabetic mothers who attended the Diabetes and Pregnancy Clinic and delivered in the center between 1/1/1982 and 31/12/2006 (2370 born to women with gestational diabetes mellitus, 391 to women with type 1 diabetes mellitus (DM), and 72 to women with type 2 DM). Logistic regression analyses were performed with a backward method to predict large for gestational age (LGA), small for gestational age (SGA) and macrosomic newborns using relevant variables and their interaction with fetal sex. We have used as potential predictors of abnormal birth weight: maternal prepregnancy age, weight, height and body mass index, prior pregnancy, prior macrosomia, smoking habit, weight increase during pregnancy, hypertension, gestational age at delivery, twin pregnancy, fetal sex, diabetes type, third trimester HbA1c and interaction of fetal sex with all these variables. Results: Variables predictive of LGA, SGA and macrosomia were as formerly described. Moreover, some predictors of abnormal growth displayed an interaction with fetal sex. In LGA prediction, male sex displayed a positive interaction with delivery week, prior gestation, diabetes type and twin pregnancy and a negative one with weight increase. In SGA prediction, male sex displayed a positive interaction with delivery week and diabetes type. In macrosomia prediction, male sex displayed a negative interaction with weight increase. Conclusions: In this cohort of diabetic pregnancies, some predictors of abnormal birth weight display interaction with fetal sex. In general, associations were more favorable to female fetuses.

Research paper thumbnail of Schmerzerfassung und Mehrstufenplan in der gynäkologischen Onkologie

Research paper thumbnail of Increased uterine prostaglandin E receptors in menorrhagic women

BJOG: An International Journal of Obstetrics and Gynaecology, 1988

PGE receptor concentrations were measured in myometrial samples collected from 10 women at hyster... more PGE receptor concentrations were measured in myometrial samples collected from 10 women at hysterectomy. Five women had normal measured menstrual blood loss (35-44 ml) and the remainder had unexplained menorrhagia occurring in the absence of any uterine, pelvic or general pathology, with losses ranging from 85 to 925 ml. Median PGE receptor concentrations were significantly higher in the women with menorrhagia (1077 fmol/mg protein) than in the women with normal mcnstrual blood loss (625 fmol/mg protein) and correlated with menstrual blood loss (P<0.02). These findings suggest that unexplained menorrhagia may simply be a constitutional variant in some women and that specific and potent PGE uterine receptor antagonists would furnish effective non-surgical treatment for unexplained menorrhagia. Unexplained menorrhagia, occurring in the absence of uterine. pelvic or general pathology, is a common clinical problem, associated with excessive uterine prostaglandin (PG) levels. PG synthetase inhibitors can reduce menstrual blood loss in this condition and have been used successfully in its treatment (Willman rf ul. 1976; Anderson et ml. 1976; Frascr et al. 1983). However, when PG levels in endometrium, myometrium and menstrual fluid have been related to total mcnstrual blood loss, results have been conflicting (Smith etal. 1981; Rees etal. 19840. b). We have therefore investigated the potential role of PG receptors in the uterus in unexplained menorrhagia. PGa are thought to act through receptors in thc cell membrane. PG receptors have been detected in human niyonietrium but

Research paper thumbnail of Erhöhte Konzentration von Prostaglandin-E-Rezeptoren bei Frauen mit Menorrhagie

Gynäkologisch-geburtshilfliche Rundschau, 1989

Research paper thumbnail of Hypopituitarism and Pregnancy : Clinical Characteristics, Management and Pregnancy Outcome

Dipòsit Digital de Documents de la UAB

Research paper thumbnail of Erh�hte Konzentration von Prostaglandin-E-Rezeptoren bei Frauen mit Menorrhagie

Gynakol Geburtshilfl Rundsch, 1989

Research paper thumbnail of Topographical distribution of prostaglandin E receptors in human myometrium

BJOG: An International Journal of Obstetrics and Gynaecology, 1988

T h e binding of radiolabelled prostaglandin (PG) F2<, and PGE, by human myometrium was measured ... more T h e binding of radiolabelled prostaglandin (PG) F2<, and PGE, by human myometrium was measured in vitro and the distribution and characteristics of the binding sites in non-pregnant and pregnant uteri were studied. PGF,, binding sites were of low affinity (Kd 30 nM) and could b e occupied by PG of the E series with higher affinity than PGFZcl itself. PGE binding sites were of high affinity (Kd 1.5 nM) and highly specific for PG of the E series, suggesting that they represent truc PGE receptors. T h e concentration of PGE receptors was higher in nonpregnant than in pregnant uteri a t term. In non-pregnant uteri the concentration of PGE receptors was highest in the fundus and decreased towards the cervix; in term pregnant uteri the concentration was constant in all areas. In both non-pregnant and pregnant uteri there was a significantly lower PGE binding affinity in cervix than in myometrium from the fundus-corpus area. The concentrations and affinity

Research paper thumbnail of Period of gestational diabetes mellitus diagnosis and maternal and fetal morbidity

Acta Obstetricia et Gynecologica Scandinavica, 2005

The aim of the study was to analyze the association between the period of diagnosis of gestationa... more The aim of the study was to analyze the association between the period of diagnosis of gestational diabetes mellitus (GDM) and maternal and neonatal outcome. In this retrospective study, 1708 offspring (1571 singleton, 119 twins, and 18 triplets) born to women with GDM who attended the Diabetic and Pregnancy Clinic were included. Pregnancies were divided into three groups according to the gestational age at GDM diagnosis. The association of the period of diagnosis with maternal and fetal outcome was assessed adjusting for potentially confounding variables (logistic regression analysis). The period of diagnosis was a predictor in two out of three maternal outcomes (pregnancy-induced hypertension and insulin treatment) and in four out of 12 fetal outcomes (preterm birth, 5-min Apgar &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;7, perinatal mortality, and hyperbilirubinemia). Whereas pregnancy-induced hypertension was higher in women diagnosed with GDM in the second period, the other outcomes displayed higher occurrences with earlier diagnosis. Diagnosis of GDM earlier in pregnancy is a predictor of adverse maternal and neonatal outcome.