METHOD: Data from 1,538 women were analyzed. At the first visit for prenatal care, the 50-gram glucose challenge test was followed by the 75-gram glucose tolerance test in those who screened positive. GDM was diagnosed based on the WHO (1999) criteria. Maternal complete blood count was obtained at the first visit, hospitalization for birth, and after birth. Receiver operator characteristic curves were generated to establish thresholds. Multivariable logistic regression analyses were performed to establish independent predictors of GDM.
RESULTS: GDM was diagnosed in 182/1,538 (11.8%). GDM was associated with hemoglobin level, hematocrit and erythrocyte count at the first visit for prenatal care only. Hemoglobin threshold at the first visit was established at 11.5 g/dl. After adjustment, high hemoglobin [AOR 1.5 (95% CI 1.0-2.1); p = 0.027] remained predictive of GDM.
CONCLUSIONS: High maternal hemoglobin level at the first prenatal visit is independently predictive of GDM.
MATERIALS AND METHODS: A total of 119 healthy infants and children fulfilling our inclusion and exclusion criteria were recruited. They were divided into three groups according to age - 0-2 years old in group 1; 2-6 years old in group 2; 6- 12 years old in group 3. Sonography B-mode was used to assess bilateral diaphragmatic thickness and M-mode to assess diaphragmatic excursion during quiet spontaneous respiration.
RESULTS: In our paediatric population, the normal right and left diaphragmatic thickness were 2.0 mm ± 0.5 and 2.0 mm ± 0.5 for group 1; 2.5 mm ± 0.8 and 2.4 mm ± 0.6 for group 2; 2.7 mm ± 0.7 and 2.5 mm ± 0.5 for group 3, respectively. The normal right and left diaphragmatic excursion were 7.7 mm ± 2.5 and 7.3 mm ± 2.6 for group 1; 11.5 mm ± 3.8 and 10.6 mm ± 3.8 for group 2; 13.8 mm ± 3.9 and 12.9 mm ± 3.3 for group 3, respectively (data presented in mean ± standard deviation). There were no significant differences between two genders for each group. Significant positive correlation between age, weight, height, and body surface area with bilateral diaphragmatic thickness and excursion were detected in all studied population. The percentage difference between excursions of both hemidiaphragm was below 40%.
CONCLUSIONS: M-mode sonography is the modality of choice for diaphragmatic kinetics especially in paediatric population. This study provides normal sonographic reference value of diaphragmatic excursion and thickness in the Malaysian paediatric population as well as percentile curves for right diaphragmatic excursion plotted against body weight. The availability of this data will aid in the diagnosis of diaphragmatic dysfunction and hence immediate intervention for better recovery.