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Abstract(s)
Introdução: Na gestação ocorrem várias alterações fisiológicas ao nível dos diferentes
sistemas para que se consiga corresponder às necessidades materno-fetais que esta
acarreta. A diabetes gestacional é uma das principais complicações decorrente destas
alterações fisiológicas na gravidez, afetando cerca de 9,4% das grávidas em Portugal.
Além do mais, foi também associada a outras complicações maternas, do parto e
perinatais. Esta resistência à insulina causada pelo estado gravídico, está associada a
um estado inflamatório subclínico, que poderá ser detetado antes do diagnóstico clínico
de diabetes gestacional.
Objetivos: Este estudo pretende averiguar a associação entre marcadores
inflamatórios no 1º trimestre e o risco de desenvolvimento de diabetes gestacional, bem
como, determinar a sua prevalência, identificar fatores de risco associados ao seu
desenvolvimento e avaliar os outcomes maternos, fetais e do parto que desta advêm.
Materiais e Métodos: Investigação do tipo observacional, transversal e retrospetivo,
com recurso aos processos clínicos das grávidas e respetivos recém-nascidos que
realizaram o parto entre 2015 e 2019 no Centro Hospitalar Universitário Cova da Beira.
Foram incluídas 653 grávidas neste estudo, das quais se estabeleceram dois grupos:
grupo de grávidas que desenvolveram diabetes gestacional e grupo de grávidas que não
desenvolveram diabetes gestacional. A análise estatística foi efetuada através dos
programas informáticos Microsoft Excel 365® e IBM SPSS Statistics 27.0®.
Resultados: A prevalência de diabetes gestacional entre os anos de 2015 e 2019, nesta
amostra, foi cerca de 12,1%, onde 69,6% foi diagnosticada no 1º trimestre de gravidez.
A média da idade materna foi mais elevada no grupo de grávidas com diabetes, assim
como, o peso e o índice de massa corporal. Pelo contrário, o aumento de peso total na
gravidez foi inferior neste grupo. Os ratios neutrófilos/linfócitos, plaquetas/linfócitos e
índice inflamatório sistémico, não demonstraram associação com o desenvolvimento de
diabetes na gravidez. Outcomes negativos maternos e fetais não foram relevantes no
caso em estudo, exceto o facto de no grupo de grávidas com diabetes gestacional se
verificar maior percentagem de recém-nascidos com baixo peso à nascença.
Conclusão: A análise dos ratios inflamatórios não mostrou prever um maior risco de
diabetes gestacional, no entanto, a realização de estudos desta natureza torna-se
fundamental, de modo a identificar precocemente mulheres predispostas a desenvolver
diabetes na gravidez e, assim, agir preventivamente sobre os seus principais fatores de
risco e fazer um melhor seguimento e controle das suas possíveis complicações.
Introduction: During pregnancy, several physiological changes occur at the level of the different systems to make it possible for the maternal-fetal needs to be met. Gestational diabetes is one of the main complications resulting from these physiological changes in pregnancy, affecting about 9.4% of pregnant women in Portugal. In addition, it has also been associated with other maternal, childbirth and perinatal complications. This resistance to insulin caused by pregnancy, is associated with a subclinical inflammatory state, which can be detected before the clinical diagnosis of gestational diabetes. Objectives: This study aims to investigate the association between inflammatory markers in the 1st trimester and the risk of developing gestational diabetes, as well as to determine its prevalence, to identify risk factors associated with gestational diabetes development and to evaluate possible maternal, fetal and childbirth outcomes deriving from this condition. Materials and Methods: Observational, cross-sectional and retrospective investigation, assessing the clinical records of 653 women who gave birth between 2015 and 2019 at the Centro Hospitalar Universitário Cova da Beira, and their newborns. The pregnant women included in this study were divided in two groups: a group of women who developed gestational diabetes and a group of those who did not. Statistical analysis was performed using the Microsoft Excel 365® and IBM SPSS Statistics 27.0® software. Results: The prevalence of gestational diabetes between the years 2015 and 2019, in this sample, was about 12.1%, of which 69.6% were diagnosed in the 1st trimester of pregnancy. The mean maternal age was higher in the group of pregnant women with diabetes, as was their weight and body mass index. On the other hand, the increase in total weight in pregnancy was lower in this group. Neutrophil/lymphocyte ratio, platelets/lymphocytes ratio and systemic inflammatory index, showed no association with the development of diabetes in pregnancy. Negative maternal and fetal outcomes were not relevant in the case under study, except for the fact that in the group of pregnant women with gestational diabetes there is a higher percentage of newborns with low birth weight. Conclusion: The analysis of the inflammatory ratios does not predict a greater risk of gestational diabetes. However, further studies in this subject are crucial to enhance early identification of pregnant women with a predisposition to diabetes, enabling a rapid intervention in preventing the main risk factors and a better follow-up and control of its possible complications.
Introduction: During pregnancy, several physiological changes occur at the level of the different systems to make it possible for the maternal-fetal needs to be met. Gestational diabetes is one of the main complications resulting from these physiological changes in pregnancy, affecting about 9.4% of pregnant women in Portugal. In addition, it has also been associated with other maternal, childbirth and perinatal complications. This resistance to insulin caused by pregnancy, is associated with a subclinical inflammatory state, which can be detected before the clinical diagnosis of gestational diabetes. Objectives: This study aims to investigate the association between inflammatory markers in the 1st trimester and the risk of developing gestational diabetes, as well as to determine its prevalence, to identify risk factors associated with gestational diabetes development and to evaluate possible maternal, fetal and childbirth outcomes deriving from this condition. Materials and Methods: Observational, cross-sectional and retrospective investigation, assessing the clinical records of 653 women who gave birth between 2015 and 2019 at the Centro Hospitalar Universitário Cova da Beira, and their newborns. The pregnant women included in this study were divided in two groups: a group of women who developed gestational diabetes and a group of those who did not. Statistical analysis was performed using the Microsoft Excel 365® and IBM SPSS Statistics 27.0® software. Results: The prevalence of gestational diabetes between the years 2015 and 2019, in this sample, was about 12.1%, of which 69.6% were diagnosed in the 1st trimester of pregnancy. The mean maternal age was higher in the group of pregnant women with diabetes, as was their weight and body mass index. On the other hand, the increase in total weight in pregnancy was lower in this group. Neutrophil/lymphocyte ratio, platelets/lymphocytes ratio and systemic inflammatory index, showed no association with the development of diabetes in pregnancy. Negative maternal and fetal outcomes were not relevant in the case under study, except for the fact that in the group of pregnant women with gestational diabetes there is a higher percentage of newborns with low birth weight. Conclusion: The analysis of the inflammatory ratios does not predict a greater risk of gestational diabetes. However, further studies in this subject are crucial to enhance early identification of pregnant women with a predisposition to diabetes, enabling a rapid intervention in preventing the main risk factors and a better follow-up and control of its possible complications.
Description
Keywords
1º Trimestre Diabetes Gestacional Diagnóstico Gravidez Marcadores Inflamatórios