Gestational diabetes is associated with alteration on pelvic floor muscle activation pattern during pregnancy and postpartum: Prospective cohort using electromyography assessment
Background and objectiveGestational diabetes mellitus (GDM) is a comorbidity which may cause acute and lifelong disorders to mother and child. Alterations in muscular and connective tissues have been associated with GDM in translation studies, characterizing gestational diabetic myopathy. Pregnancy-...
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2022.958909/full |
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| author | Caroline Baldini Prudencio Sthefanie Kenickel Nunes Fabiane Affonso Pinheiro Carlos Izaias Sartorão Filho Guilherme Thomaz de Aquino Nava Sauro Emerick Salomoni Cristiane Rodrigues Pedroni Marilza Vieira Cunha Rudge Angélica Mércia Pascon Barbosa Angélica Mércia Pascon Barbosa Diamater Study Group M. V. C. Rudge A. M. P. Barbosa I. M. P. Calderon F. P. Souza B. Berghmans L. Thabane B. Junginger C. F. O. Graeff C. G. Magalhães R. A. Costa S. A. M. Lima M. R. Kron-Rodrigues S. Felisbino W. Barbosa F. J. Campos G. Bossolan J. E. Corrente J. Nunes HRC Abbade P. S. Rossignoli C. R. Pedroni A. N. Atallah Z. I. K. J. Di Bella S. M. M. Uchoa M. A. Hungaro E. A. Mareco M. E. Sakalem N. Martinho L. S. R. Hallur D. R. A. Reyes F. C. B. Alves J. P. C. Marcondes C. B. Prudencio F. A. Pinheiro C. I. Sartorão Filho S. B. C. V. Quiroz T. Pascon S. K. Nunes B. B. Catinelli F. V. D. S. Reis R. G. Oliveira S. Barneze E. M. A. Enriquez L. Takano A. M. Carr A. B. M. Magyori L. F. Iamundo C. N. F. Carvalho M. Jacomin R. E. Avramidis A. J. B. Silva M. I. G. Orlandi T. D. Dangió H. C. M. Bassin J. V. F. Melo M. L. S. Takemoto M. D. Menezes T. D. Caldeirão N. J. Santos I. O. Lourenço J. Marostica de Sá I. P. Caruso L. T. Rasmussen G. A. Garcia G. T. A. Nava C. Pascon D. G. Bussaneli V. K. C. Nogueira C. V. C. Rudge F. Piculo G. M. Prata V. P. Barbosa |
| author_facet | Caroline Baldini Prudencio Sthefanie Kenickel Nunes Fabiane Affonso Pinheiro Carlos Izaias Sartorão Filho Guilherme Thomaz de Aquino Nava Sauro Emerick Salomoni Cristiane Rodrigues Pedroni Marilza Vieira Cunha Rudge Angélica Mércia Pascon Barbosa Angélica Mércia Pascon Barbosa Diamater Study Group M. V. C. Rudge A. M. P. Barbosa I. M. P. Calderon F. P. Souza B. Berghmans L. Thabane B. Junginger C. F. O. Graeff C. G. Magalhães R. A. Costa S. A. M. Lima M. R. Kron-Rodrigues S. Felisbino W. Barbosa F. J. Campos G. Bossolan J. E. Corrente J. Nunes HRC Abbade P. S. Rossignoli C. R. Pedroni A. N. Atallah Z. I. K. J. Di Bella S. M. M. Uchoa M. A. Hungaro E. A. Mareco M. E. Sakalem N. Martinho L. S. R. Hallur D. R. A. Reyes F. C. B. Alves J. P. C. Marcondes C. B. Prudencio F. A. Pinheiro C. I. Sartorão Filho S. B. C. V. Quiroz T. Pascon S. K. Nunes B. B. Catinelli F. V. D. S. Reis R. G. Oliveira S. Barneze E. M. A. Enriquez L. Takano A. M. Carr A. B. M. Magyori L. F. Iamundo C. N. F. Carvalho M. Jacomin R. E. Avramidis A. J. B. Silva M. I. G. Orlandi T. D. Dangió H. C. M. Bassin J. V. F. Melo M. L. S. Takemoto M. D. Menezes T. D. Caldeirão N. J. Santos I. O. Lourenço J. Marostica de Sá I. P. Caruso L. T. Rasmussen G. A. Garcia G. T. A. Nava C. Pascon D. G. Bussaneli V. K. C. Nogueira C. V. C. Rudge F. Piculo G. M. Prata V. P. Barbosa |
| author_sort | Caroline Baldini Prudencio |
| collection | DOAJ |
| description | Background and objectiveGestational diabetes mellitus (GDM) is a comorbidity which may cause acute and lifelong disorders to mother and child. Alterations in muscular and connective tissues have been associated with GDM in translation studies, characterizing gestational diabetic myopathy. Pregnancy-specific urinary incontinence and sexual disabilities, disorders that depend on the pelvic floor muscle (PFM) integrity, are also associated with GDM both during and after pregnancy. The aim was to compare PFM activation patterns between GDM and non-GDM women from 24–30 gestational weeks to 18–24 months postpartum during a standard clinical test during gestation and postpartum.MethodsWe conducted a prospective three-time-point cohort study from gestation (24–30 weeks—T1, and 36–38 weeks—T2) to 18–24 months postpartum (T3). PFM electromyography was recorded in primigravida or primiparous women with one previous elective c-section with or without the diagnosis of GDM according to the American Diabetes Association criteria. A careful explanation of the muscle anatomy and functionality of the PFM was given to participants before EMG assessment. The outcome measures were PFM activation patterns assessed during pregnancy and postpartum, comparing intra and between groups. PFM activation patterns were assessed by normalized electromyography signal at rest and during 1-second (sec) phasic, 10-sec hold, and 60-sec sustained contractions.ResultsDemographic and obstetric data showed homogeneity between groups. The GDM group achieved peak PFM EMG amplitudes similarly to the non-GDM group, but they took longer to return to baseline levels during the ~1-sec contraction (flicks). During 10-sec hold contractions, the GDM group sustained lower levels of PFM activation than the non-GDM group at both 36–38 weeks of gestation and 18–24 months postpartum when compared to the non-GDM group.ConclusionThe results suggest that GDM impaired PFM control mainly on 1-sec flicks and 10-sec hold contraction, which appears to develop during late pregnancy and extends long-term postpartum. This motor behavior may play a role on pelvic floor dysfunctions. |
| first_indexed | 2024-04-13T20:01:16Z |
| format | Article |
| id | doaj.art-764061f598d6459b9ec0dfa734b08723 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-04-13T20:01:16Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-764061f598d6459b9ec0dfa734b087232022-12-22T02:32:11ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922022-10-011310.3389/fendo.2022.958909958909Gestational diabetes is associated with alteration on pelvic floor muscle activation pattern during pregnancy and postpartum: Prospective cohort using electromyography assessmentCaroline Baldini Prudencio0Sthefanie Kenickel Nunes1Fabiane Affonso Pinheiro2Carlos Izaias Sartorão Filho3Guilherme Thomaz de Aquino Nava4Sauro Emerick Salomoni5Cristiane Rodrigues Pedroni6Marilza Vieira Cunha Rudge7Angélica Mércia Pascon Barbosa8Angélica Mércia Pascon Barbosa9Diamater Study GroupM. V. C. RudgeA. M. P. BarbosaI. M. P. CalderonF. P. SouzaB. BerghmansL. ThabaneB. JungingerC. F. O. GraeffC. G. MagalhãesR. A. CostaS. A. M. LimaM. R. Kron-RodriguesS. FelisbinoW. BarbosaF. J. CamposG. BossolanJ. E. CorrenteJ. Nunes HRC AbbadeP. S. RossignoliC. R. PedroniA. N. AtallahZ. I. K. J. Di BellaS. M. M. UchoaM. A. HungaroE. A. MarecoM. E. SakalemN. MartinhoL. S. R. HallurD. R. A. ReyesF. C. B. AlvesJ. P. C. MarcondesC. B. PrudencioF. A. PinheiroC. I. Sartorão FilhoS. B. C. V. QuirozT. PasconS. K. NunesB. B. CatinelliF. V. D. S. ReisR. G. OliveiraS. BarnezeE. M. A. EnriquezL. TakanoA. M. CarrA. B. M. MagyoriL. F. IamundoC. N. F. CarvalhoM. JacominR. E. AvramidisA. J. B. SilvaM. I. G. OrlandiT. D. DangióH. C. M. BassinJ. V. F. MeloM. L. S. TakemotoM. D. MenezesT. D. CaldeirãoN. J. SantosI. O. LourençoJ. Marostica de SáI. P. CarusoL. T. RasmussenG. A. GarciaG. T. A. NavaC. PasconD. G. BussaneliV. K. C. NogueiraC. V. C. RudgeF. PiculoG. M. PrataV. P. BarbosaSão Paulo State University (Unesp), Postgraduate Program on Tocogynecology, Botucatu Medical School, Botucatu, BrazilSão Paulo State University (Unesp), Postgraduate Program on Tocogynecology, Botucatu Medical School, Botucatu, BrazilSão Paulo State University (Unesp), Postgraduate Program on Tocogynecology, Botucatu Medical School, Botucatu, BrazilSão Paulo State University (Unesp), Postgraduate Program on Tocogynecology, Botucatu Medical School, Botucatu, BrazilHuman Development and Technologies, Institute of Biosciences, São Paulo State University (UNESP), Rio Claro, BrazilIndependent Researcher, Hobart, TAS, AustraliaSão Paulo State University (Unesp), School of Philosophy and Sciences, Marilia, BrazilSão Paulo State University (Unesp), Postgraduate Program on Tocogynecology, Botucatu Medical School, Botucatu, BrazilSão Paulo State University (Unesp), Postgraduate Program on Tocogynecology, Botucatu Medical School, Botucatu, BrazilSão Paulo State University (Unesp), School of Philosophy and Sciences, Marilia, BrazilBackground and objectiveGestational diabetes mellitus (GDM) is a comorbidity which may cause acute and lifelong disorders to mother and child. Alterations in muscular and connective tissues have been associated with GDM in translation studies, characterizing gestational diabetic myopathy. Pregnancy-specific urinary incontinence and sexual disabilities, disorders that depend on the pelvic floor muscle (PFM) integrity, are also associated with GDM both during and after pregnancy. The aim was to compare PFM activation patterns between GDM and non-GDM women from 24–30 gestational weeks to 18–24 months postpartum during a standard clinical test during gestation and postpartum.MethodsWe conducted a prospective three-time-point cohort study from gestation (24–30 weeks—T1, and 36–38 weeks—T2) to 18–24 months postpartum (T3). PFM electromyography was recorded in primigravida or primiparous women with one previous elective c-section with or without the diagnosis of GDM according to the American Diabetes Association criteria. A careful explanation of the muscle anatomy and functionality of the PFM was given to participants before EMG assessment. The outcome measures were PFM activation patterns assessed during pregnancy and postpartum, comparing intra and between groups. PFM activation patterns were assessed by normalized electromyography signal at rest and during 1-second (sec) phasic, 10-sec hold, and 60-sec sustained contractions.ResultsDemographic and obstetric data showed homogeneity between groups. The GDM group achieved peak PFM EMG amplitudes similarly to the non-GDM group, but they took longer to return to baseline levels during the ~1-sec contraction (flicks). During 10-sec hold contractions, the GDM group sustained lower levels of PFM activation than the non-GDM group at both 36–38 weeks of gestation and 18–24 months postpartum when compared to the non-GDM group.ConclusionThe results suggest that GDM impaired PFM control mainly on 1-sec flicks and 10-sec hold contraction, which appears to develop during late pregnancy and extends long-term postpartum. This motor behavior may play a role on pelvic floor dysfunctions.https://www.frontiersin.org/articles/10.3389/fendo.2022.958909/fullgestational diabetespelvic floorpregnantelectromyographypostpartum |
| spellingShingle | Caroline Baldini Prudencio Sthefanie Kenickel Nunes Fabiane Affonso Pinheiro Carlos Izaias Sartorão Filho Guilherme Thomaz de Aquino Nava Sauro Emerick Salomoni Cristiane Rodrigues Pedroni Marilza Vieira Cunha Rudge Angélica Mércia Pascon Barbosa Angélica Mércia Pascon Barbosa Diamater Study Group M. V. C. Rudge A. M. P. Barbosa I. M. P. Calderon F. P. Souza B. Berghmans L. Thabane B. Junginger C. F. O. Graeff C. G. Magalhães R. A. Costa S. A. M. Lima M. R. Kron-Rodrigues S. Felisbino W. Barbosa F. J. Campos G. Bossolan J. E. Corrente J. Nunes HRC Abbade P. S. Rossignoli C. R. Pedroni A. N. Atallah Z. I. K. J. Di Bella S. M. M. Uchoa M. A. Hungaro E. A. Mareco M. E. Sakalem N. Martinho L. S. R. Hallur D. R. A. Reyes F. C. B. Alves J. P. C. Marcondes C. B. Prudencio F. A. Pinheiro C. I. Sartorão Filho S. B. C. V. Quiroz T. Pascon S. K. Nunes B. B. Catinelli F. V. D. S. Reis R. G. Oliveira S. Barneze E. M. A. Enriquez L. Takano A. M. Carr A. B. M. Magyori L. F. Iamundo C. N. F. Carvalho M. Jacomin R. E. Avramidis A. J. B. Silva M. I. G. Orlandi T. D. Dangió H. C. M. Bassin J. V. F. Melo M. L. S. Takemoto M. D. Menezes T. D. Caldeirão N. J. Santos I. O. Lourenço J. Marostica de Sá I. P. Caruso L. T. Rasmussen G. A. Garcia G. T. A. Nava C. Pascon D. G. Bussaneli V. K. C. Nogueira C. V. C. Rudge F. Piculo G. M. Prata V. P. Barbosa Gestational diabetes is associated with alteration on pelvic floor muscle activation pattern during pregnancy and postpartum: Prospective cohort using electromyography assessment Frontiers in Endocrinology gestational diabetes pelvic floor pregnant electromyography postpartum |
| title | Gestational diabetes is associated with alteration on pelvic floor muscle activation pattern during pregnancy and postpartum: Prospective cohort using electromyography assessment |
| title_full | Gestational diabetes is associated with alteration on pelvic floor muscle activation pattern during pregnancy and postpartum: Prospective cohort using electromyography assessment |
| title_fullStr | Gestational diabetes is associated with alteration on pelvic floor muscle activation pattern during pregnancy and postpartum: Prospective cohort using electromyography assessment |
| title_full_unstemmed | Gestational diabetes is associated with alteration on pelvic floor muscle activation pattern during pregnancy and postpartum: Prospective cohort using electromyography assessment |
| title_short | Gestational diabetes is associated with alteration on pelvic floor muscle activation pattern during pregnancy and postpartum: Prospective cohort using electromyography assessment |
| title_sort | gestational diabetes is associated with alteration on pelvic floor muscle activation pattern during pregnancy and postpartum prospective cohort using electromyography assessment |
| topic | gestational diabetes pelvic floor pregnant electromyography postpartum |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2022.958909/full |
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