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Study protocol to investigate biomolecular muscle profile as predictors of long-term urinary incontinence in women with gestational diabetes mellitus.


ABSTRACT: BACKGROUND:Pelvic floor muscles (PFM) and rectus abdominis muscles (RAM) of pregnant diabetic rats exhibit atrophy, co-localization of fast and slow fibers and an increased collagen type I/III ratio. However, the role of similar PFM or RAM hyperglycemic-related myopathy in women with gestational diabetes mellitus (GDM) remains poorly investigated. This study aims to assess the frequency of pelvic floor muscle disorders and pregnancy-specific urinary incontinence (PS-UI) 12?months after the Cesarean (C) section in women with GDM. Specifically, differences in PFM/RAM hyperglycemic myopathy will be evaluated. METHODS:The Diamater is an ongoing cohort study of four groups of 59 pregnant women each from the Perinatal Diabetes Research Centre (PDRC), Botucatu Medical School (FMB)-UNESP (São Paulo State University), Brazil. Diagnosis of GDM and PS-UI will be made at 24-26?weeks, with a follow-up at 34-38?weeks of gestation. Inclusion in the study will occur at the time of C-section, and patients will be followed at 24-48?h, 6 weeks and 6 and 12?months postpartum. Study groups will be classified as (1) GDM plus PS-UI; (2) GDM without PS-UI; (3) Non-GDM plus PS-UI; and (4) Non-GDM without PS-UI. We will analyze relationships between GDM, PS-UI and hyperglycemic myopathy at 12?months after C-section. The mediator variables to be evaluated include digital palpation, vaginal squeeze pressure, 3D pelvic floor ultrasound, and 3D RAM ultrasound. RAM samples obtained during C-section will be analyzed for ex-vivo contractility, morphological, molecular and OMICS profiles to further characterize the hyperglycemic myopathy. Additional variables to be evaluated include maternal age, socioeconomic status, educational level, ethnicity, body mass index, weight gain during pregnancy, quality of glycemic control and insulin therapy. DISCUSSION:To our knowledge, this will be the first study to provide data on the prevalence of PS-UI and RAM and PFM physical and biomolecular muscle profiles after C-section in mothers with GDM. The longitudinal design allows for the assessment of cause-effect relationships between GDM, PS-UI, and PFMs and RAMs myopathy. The findings may reveal previously undetermined consequences of GDM.

SUBMITTER: Rudge MVC 

PROVIDER: S-EPMC7031907 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Study protocol to investigate biomolecular muscle profile as predictors of long-term urinary incontinence in women with gestational diabetes mellitus.

Rudge Marilza V C MVC   Souza Fátima P FP   Abbade Joelcio F JF   Hallur Raghavendra L S RLS   Marcondes João Paulo C JPC   Piculo Fernanda F   Marini Gabriela G   Vesentini Giovana G   Thabane Lehana L   Witkin Steven S SS   Calderon Iracema M P IMP   Barbosa Angélica M P AMP   Rudge M V MV   Barbosa A M P AMP   Calderon I M P IMP   Souza F P FP   Abbade J F JF   Hallur L S R LSR   Piculo F F   Marini G G   Vesentini G G   Thabane L L   Palma M S MS   Graeff C F O CFO   Arni R K RK   Herculano R D RD   Salvadori D F DF   Mateus S S   Dal Pai Silva M M   Magalhães C G CG   Costa R A RA   Lima S A M SAM   Felisbino S L SL   Barbosa W W   Atallah A A   Girão M J B MJB   Di Bella Z Z   Uchoa S M SM   Payão S S   Hijas A A   Berghman B B   De Bie R R   Sobrevia L L   Junginger B B   Alves F C B FCB   Rossignoli P S PS   Prudencio C B CB   Orlandi M I G MIG   Gonçalves M I MI   Nunes S K SK   Catinelli B B BB   Quiroz S S   Sarmento B V BV   Pinheiro F A FA   Sartorão C I CI   Lucas R R RR   Reyes D R A DRA   Quiroz S B C V SBCV   Enriquez E M A EMA   Oliveira R G RG   Floriano J F JF   Marcondes J P C JPC   Barneze S S   Dangió T D TD   Pascon T T   Rossignoli P P   Freitas J V JV   Takano L L   Reis F F   Caldeirão T D TD   Fernandes J N JN   Carr A M AM   Gaitero M V C MVC   Corrente J E JE   Nunes H R C HRC   Candido A F AF   Costa S M B SMB   Dangió T D TD   Pascon T T   Melo J V F JVF   Takano L L   Reis F V D S FVDS   Caldeirão T D TD   Carr A M AM   Garcia G A GA   Rabadan G B GB   Bassin H C M HCM   Suyama K S KS   Damasceno L N LN   Takemoto M L S MLS   Menezes M D MD   Bussaneli D G DG   Nogueira V K C VKC   Lima P R PR   Lourenço I O IO   Marostica de Sá J J   Megid R A RA   Caruso I P IP   Rasmussen L T LT   Prata G M GM   Piculo F F   Vesentini G G   Arantes M A MA   Ferraz G A R GAR   Camargo L P LP   Kron M R MR   Corrente J E JE   Nunes H R C HRC  

BMC pregnancy and childbirth 20200219 1


<h4>Background</h4>Pelvic floor muscles (PFM) and rectus abdominis muscles (RAM) of pregnant diabetic rats exhibit atrophy, co-localization of fast and slow fibers and an increased collagen type I/III ratio. However, the role of similar PFM or RAM hyperglycemic-related myopathy in women with gestational diabetes mellitus (GDM) remains poorly investigated. This study aims to assess the frequency of pelvic floor muscle disorders and pregnancy-specific urinary incontinence (PS-UI) 12 months after t  ...[more]

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