Caroline Baldini Prudencio1, Sthefanie Kenickel Nunes1, Fabiane Affonso Pinheiro1, Carlos Isaias Sartorão Filho1, Flávia Ignácio Antônio2, Guilherme Thomaz de Aquino Nava3, Marilza Vieira Cunha Rudge1, Angélica Mércia Pascon Barbosa4,5. 1. Postgraduate Program on Tocogynecology, São Paulo State University (UNESP), São Paulo, Botucatu, Brazil. 2. School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada. 3. Department of Physical Education, Institute of Biosciences of Rio Claro, São Paulo State University (UNESP), São Paulo, Rio Claro, Brazil. 4. Postgraduate Program on Tocogynecology, São Paulo State University (UNESP), São Paulo, Botucatu, Brazil. angelicapascon@gmail.com. 5. School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada. angelicapascon@gmail.com.
Abstract
INTRODUCTION AND HYPOTHESIS: To investigate relaxin-2 concentration comparing gestational diabetes mellitus (GDM) and non-GDM patients during pregnancy according to urinary incontinence (UI) and pelvic function status. METHODS: This is a cross-sectional study evaluating 282 pregnant women from 24 weeks of gestation. The participants were divided into two groups, non-GDM and GDM, according to American Diabetes Association's diabetes mellitus gestational threshold. In addition, according to subanalysis, both groups were subdivided according to the presence of pregnancy-specific urinary incontinence: non-GDM continent, non-GDM incontinent, GDM continent, and GDM incontinent. All participants filled in questionnaires on clinical, obstetric, and urinary continence status (International Consultation on Incontinence Questionnaire-Short Form, ICIQ-SF, and Incontinence Severity Index, ISI), followed by pelvic floor muscle evaluation by the PERFECT scheme in which strength, endurance, and speed of contractions were evaluated. RESULTS: Serum relaxin-2 concentrations were significantly lower in pregnant women with pregnancy-specific urinary incontinence in both non-GDM and GDM patients, but GDM showed the lowest concentration. In addition, the stratification of the groups according to pelvic floor muscle strength showed that pregnant patients with GDM and modified Oxford scale 0-2 had significantly lower levels than those who were non-GDM and GDM with Modified Oxford Scale 3-5. Relaxin-2 level was much lower in GDM incontinent pregnant women with MOS 0-2 compared to the other three groups. CONCLUSIONS: Lower relaxin-2 concentration was associated with the presence of pregnancy-specific urinary incontinence, but the combination of GDM, pregnancy-specific urinary incontinence, and lower levels of pelvic floor strength led to lower levels of relaxin-2 compared to the other three groups.
INTRODUCTION AND HYPOTHESIS: To investigate relaxin-2 concentration comparing gestational diabetes mellitus (GDM) and non-GDM patients during pregnancy according to urinary incontinence (UI) and pelvic function status. METHODS: This is a cross-sectional study evaluating 282 pregnant women from 24 weeks of gestation. The participants were divided into two groups, non-GDM and GDM, according to American Diabetes Association's diabetes mellitus gestational threshold. In addition, according to subanalysis, both groups were subdivided according to the presence of pregnancy-specific urinary incontinence: non-GDM continent, non-GDM incontinent, GDM continent, and GDM incontinent. All participants filled in questionnaires on clinical, obstetric, and urinary continence status (International Consultation on Incontinence Questionnaire-Short Form, ICIQ-SF, and Incontinence Severity Index, ISI), followed by pelvic floor muscle evaluation by the PERFECT scheme in which strength, endurance, and speed of contractions were evaluated. RESULTS: Serum relaxin-2 concentrations were significantly lower in pregnant women with pregnancy-specific urinary incontinence in both non-GDM and GDM patients, but GDM showed the lowest concentration. In addition, the stratification of the groups according to pelvic floor muscle strength showed that pregnant patients with GDM and modified Oxford scale 0-2 had significantly lower levels than those who were non-GDM and GDM with Modified Oxford Scale 3-5. Relaxin-2 level was much lower in GDM incontinent pregnant women with MOS 0-2 compared to the other three groups. CONCLUSIONS: Lower relaxin-2 concentration was associated with the presence of pregnancy-specific urinary incontinence, but the combination of GDM, pregnancy-specific urinary incontinence, and lower levels of pelvic floor strength led to lower levels of relaxin-2 compared to the other three groups.
Authors: José Tadeu Nunes Tamanini; Miriam Dambros; Carlos Arturo Levi D'Ancona; Paulo César Rodrigues Palma; Nelson Rodrigues Netto Journal: Rev Saude Publica Date: 2004-07-08 Impact factor: 2.106
Authors: Caroline B Prudencio; Marilza V C Rudge; Fabiane A Pinheiro; Carlos I Sartorão Filho; Sthefanie K Nunes; Cristiane R Pedroni; Baerbel Junginger; Angélica M P Barbosa Journal: PLoS One Date: 2019-11-07 Impact factor: 3.240
Authors: Giovana Vesentini; Angélica M P Barbosa; Débora C Damasceno; Gabriela Marini; Fernanda Piculo; Selma M M Matheus; Raghavendra L S Hallur; Sthefanie K Nunes; Bruna B Catinelli; Claudia G Magalhães; Roberto Costa; Joelcio F Abbade; José E Corrente; Iracema M P Calderon; Marilza V C Rudge Journal: PLoS One Date: 2020-04-03 Impact factor: 3.240