Asploro Journal of Biomedical and Clinical Case Reports

Asploro Journal of Biomedical and Clinical Case Reports

Canêdo JA¹, Faleiros GQA¹, dos Santos Toledo PM¹, Catizani RB¹, Panconi CR², Coutinho LM², de Souza HD², Machado PP², Andrade LB³, Antunes MA², de Oliveira MF², Zimmermmann JB^2*
1Faculty of Medicine of Barbacena, Minas Gerais, Brazil
²Faculty of Medicine, Federal University of Juiz de Fora, Minas Gerais, Brazil
³Universitary Hospital, Federal University of Juiz de Fora and High Risk Prenatal Care Group, Cnpq, Brazil

Corresponding Author: Prof. Juliana Barroso Zimmermmann ^{ORCID ID}
Address: Faculty of Medicine, Federal University of Juiz de Fora, Maternal and Child Department of Medicine’s Faculty, Juiz de Fora, MG, Brazil.
Received date: 12 December 2019; Accepted date: 06 March 2020; Published date: 14 March 2020

Citation: Canêdo JA, Faleiros GQA, dos Santos Toledo PM, Catizani RB, Panconi CR, Coutinho LM, de Souza HD, Machado PP, Andrade LB, Antunes MA, de Oliveira MF, Zimmermmann JB. Gestational and Previous Diabetes in Pregnancy: Perinatal Results. Asp Biomed Clin Case Rep. 2020 Mar 14;3(1):75-86.

Copyright © 2020 Canêdo JA, Faleiros GQA, dos Santos Toledo PM, Catizani RB, Panconi CR, Coutinho LM, de Souza HD, Machado PP, Andrade LB, Antunes MA, de Oliveira MF, Zimmermmann JB. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium provided the original work is properly cited.

Keywords: Gestational and Previous Diabetes in Pregnancy; Macrosomia; Glycaemia; Diabetes Mellitus

Abstract

Objective: Evaluating the association between gestational diabetes and fetal/maternal complications such as poor obstetric outcomes.
Methods: Historical cohort comprising patients from the High-Risk Service of Federal University of Juiz de Fora (UFJF,) who were diagnosed with diabetes (exposed), as well as patients from the Low-Risk Service of UFJF (non-exposed). Data generated through anamnesis, physical examination and medical conduct, as well as data of newborns such as fetal weight, ICU admission and fetal/neonatal death), were collected and stored in the Epi Info software (version 6.0); p < 0.05.
Results: 176 patients treated in the aforementioned services, 108 diabetic, and 68 non-diabetics, were investigated in the current study. In total, 92 (52.2%) of them were diagnosed with Gestational Diabetes Mellitus (GDM); 6 had DM type 1 (3.4%) and 10 had DM type 2 (5.6%). Therefore, 68 patients (38.6%) presented normal glucose metabolism. The mean age of the patients was 30.27 ± 6.77 years, the mean number of births was 1.06 ± 1.20. Macrosomia was diagnosed in 6.81% (n = 6) of the cases; it was associated with maternal glycemia (p < 0.05). D- and F-class pregnant women, who had been previously diagnosed with diabetes, presented lower fetal weight than other pregnant women (p = 0.03). Treatment was based on diet, insulin or metformin, whenever necessary. Fasting glycemia levels decreased throughout the gestational trimesters. Eighteen (10.2%) preterm fetuses were identified; 12 were born from diabetic mothers and 6 were born from non-diabetic ones (p = 0.01; X² = 10.51). All infants hospitalized in the neonatal ICU (n = 10) were born from diabetic mothers; their mean gestational age was 36.28 + 2.9 weeks, whereas the mean gestational age of infants who were not hospitalized in the ICU was 38.31 ± 1.5 (p = 0.005; T = 12.58). Cesarean section was the most common way of delivery adopted for diabetic pregnant women (p = 0.04).
Conclusion: Based on the results, gestational diabetes (GDM) is a predisposing factor to fetal macrosomia, prematurity, and hospitalization in neonatal ICUs. Pregnant women subjected to proper glycemic control in the current study presented lower complication rates in comparison to other studies in the literature.