Notice bibliographique
Résumé
As of 2018 data, 30–60% of reproductive‑aged women in Canada were affected by overweight (body mass index [BMI] 25.9–29.9) and obesity (BMI >30.0), and these rates are increasing. Obesity during pregnancy is associated with higher rates of preeclampsia, gestational diabetes, macrosomia, stillbirth, post‑term pregnancy, and increased caesarean delivery rates. Obesity is also associated with higher rates of diabetes, which has well‑known consequences for pregnancy, and ovulatory dysfunction, which impacts fertility, such as in polycystic ovarian syndrome (PCOS). Addressing obesity and its associated metabolic impacts could have a profound effect on reproductive and fetal health. Since the 2000s, incretin-based therapies for diabetes and obesity have become the focus of research and clinical practice. Glucagon‑like‑peptide 1 (GLP-1), an endogenous incretin hormone secreted by intestinal L-cells in response to food intake, and its agonists, have been available for clinical use in Canada since the introduction of liraglutide in 2011. Recently, pharmacologic agonists of glucose-dependent insulinotropic polypeptide (GIP), an incretin synthesized in the K-cells of the duodenum and jejunum, have also become available. Dual agonism of these hormones is associated with more significant reductions in blood glucose and weight. The currently available incretin-based therapies are listed in Table 1, and their physiologic effects are summarized in Figure 1. Active research is underway on new molecules, for example agonists of amylin and glucagon, in various combinations with GLP‑1 and GIP, to maximize clinical benefits. These combinations have shown weight loss effects rivalling those of metabolic surgery. Considering their potential, this medication class has taken the world by storm. Canada's Drug Agency (CDA) found that expenditure on injectable semaglutide, under the brand-name Ozempic™, increased from $13.5 million in 2019 to $227 million in 2021, with 20% of the claims being for non-type 2 diabetes use. The metabolic improvements and weight loss achieved with incretin-based therapies are associated with improved fertility. While product monographs warn against use in pregnancy and lactation, conception while on these treatments is becoming more common. Considering this increasing reality, this review aims to summarize what is currently known about GLP-1 and GIP agonists and their effects during pregnancy.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».