Maryam de BrunTitle: Doctoral Student School/office: School of Medical Sciences
Phone: +46 19 303000
Diabetes, Endocrinology and Metabolism Research Centre
About Maryam de Brun
About Maryam Saeedi
Maryam Saeedi is a Resident Physician at the Department of Obstetrics and Gynecology, Örebro University Hospital. She is also a doctoral student at the Department of Obstetrics, Faculty of Medicine and Health, Örebro University since 2018. The aim of her research is to contribute to evidence on the challenges of deciding diagnostic criteria and screening methods for gestational diabetes mellitus (GDM) in Sweden.
Pregnancy is seen as a stress test for the woman where physiological induction of insulin resistance occurs. GDM is either present from conception or occurs de novo when the woman cannot meet insulin resistance with increased insulin production. GDM is associated with several long-term and short-term consequences for both the mother and child, such as large for gestational age (LGA) infants with higher risk of shoulder dystocia, neonatal hypoglycemia and caesarean section. Women also have a greater degree of hypertension and preeclampsia. Long-term, the frequency of metabolic diseases like type 2 diabetes and obesity is higher among mothers and their offspring. How to screen, diagnose and treat these women has long been debated and varies nationally and internationally due to historical, socio-political and health economic factors. The Swedish national board of health and welfare (SNBHW) agreed in 2015 to adopt the World Health Organization (WHO) recommendations for the criteria for GDM. The new GDM criteria are expected to result in 3-5-fold increase in prevalence of GDM compared to previously used diagnostic criteria.
In paper I we assess the test characteristics of today’s screening methods (risk factor screening) and fasting blood glucose when using the new GDM diagnostic criteria. In paper II, a systematic review and meta-analysis is made to study the proportional increase in prevalence of GDM depending on the diagnostic criteria. In paper III-IV, a stepped-wedge randomized control trial is conducted to evaluate the adverse neonatal and maternal outcomes when implementing the new GDM criteria in Sweden and if the change is cost-effective (www.cdc4g.com).
Maryam is a base group supervisor in the medical education at Örebro University.