Neonatal Morbidity and Gestational Diabetes: Coincidence or Consequence of the 2011 Protocol

Detalhes bibliográficos
Autor(a) principal: Mimoso, Gabriela
Data de Publicação: 2017
Outros Autores: Oliveira, Guiomar
Tipo de documento: Artigo
Idioma: por
eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8033
Resumo: Introduction: Gestational diabetes is one of the diseases associated with pregnancy with higher rate of complications. Despite being a transitory condition, short and long term complications related to gestational diabetes have been described. There is scientific evidence to say that good metabolic control decreases perinatal complications. In 2011, new criteria was proposed for its diagnosis, which made possible its diagnosis during the 1st trimester of pregnancy. The aim of this study is to compare neonatal morbidity in two groups of women with gestational diabetes diagnosis before and after the latest Portuguese guidelines for diabetes and pregnancy were published (February 2011).Material and Methods: We included all newborns born in Maternidade Bissaya Barreto whose mother, followed at our maternity between 2008 and 2013, had unifetal pregnancy complicated by diabetes. We used a perinatal database and analysed the impact of the new guidelines in perinatal morbidity over two periods of three years.Results: There were 774 women who met the inclusion criteria. We found that gestational diabetes was diagnosed earlier, insulin therapy was more frequent. Neonatal morbidity was increased, and there were more cases of neonatal hypoglycemia and congenital anomalies, and newborns became smaller for gestational age.Discussion: The increase in neonatal morbidity was associated with early diagnosis and rigorous metabolic control.Conclusion: To analyse national data will be fundamental to understand this unexpected increase in morbidity.
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spelling Neonatal Morbidity and Gestational Diabetes: Coincidence or Consequence of the 2011 ProtocolMorbilidade Neonatal na Diabetes Gestacional: Coincidência ou Consequência do Consenso de 2011DiabetesGestationalInfantNewbornDiseasesPregnancy ComplicationsComplicações na GravidezDiabetes GestacionalDoenças do Recém-NascidoIntroduction: Gestational diabetes is one of the diseases associated with pregnancy with higher rate of complications. Despite being a transitory condition, short and long term complications related to gestational diabetes have been described. There is scientific evidence to say that good metabolic control decreases perinatal complications. In 2011, new criteria was proposed for its diagnosis, which made possible its diagnosis during the 1st trimester of pregnancy. The aim of this study is to compare neonatal morbidity in two groups of women with gestational diabetes diagnosis before and after the latest Portuguese guidelines for diabetes and pregnancy were published (February 2011).Material and Methods: We included all newborns born in Maternidade Bissaya Barreto whose mother, followed at our maternity between 2008 and 2013, had unifetal pregnancy complicated by diabetes. We used a perinatal database and analysed the impact of the new guidelines in perinatal morbidity over two periods of three years.Results: There were 774 women who met the inclusion criteria. We found that gestational diabetes was diagnosed earlier, insulin therapy was more frequent. Neonatal morbidity was increased, and there were more cases of neonatal hypoglycemia and congenital anomalies, and newborns became smaller for gestational age.Discussion: The increase in neonatal morbidity was associated with early diagnosis and rigorous metabolic control.Conclusion: To analyse national data will be fundamental to understand this unexpected increase in morbidity.Introdução: A diabetes gestacional constitui uma das doenças associada à gravidez com maior taxa de complicações. Apesar de ser uma condição habitualmente transitória, estão reconhecidas as suas complicações a curto e longo prazo. Há evidência científica para afirmar que um bom controlo metabólico reduz as complicações perinatais. Em 2011, foram propostos novos critérios para o seu diagnóstico, o que o tornou possível logo no primeiro trimestre de gravidez. Neste trabalho, propomo-nos comparar a morbilidade neonatal entre dois grupos de recém nascidos filhos de mulheres com diabetes gestacional submetidos a dois protocolos diferentes.Material e Métodos: Estudo observacional analítico, retrospetivo descritivo de recém nascidos de mães com diabetes gestacional com gravidez unifetal seguida na Maternidade Bissaya Barreto no período de 2008 a 2013. Utilizou-se a informação clinica de recém nascidos e mães com diabetes gestacional armazenada em base de dados. Analisaram-se as repercussões clínicas da utilização do novo consenso comparando dois períodos de três anos.Resultados: Analisaram-se 774 díades mãe-filho. No segundo período a diabetes gestacional foi diagnosticada mais precocemente e a terapêutica com insulina foi instituída com mais frequência. Registou-se um aumento significativo da morbilidade neonatal, com mais casos de hipoglicémia neonatal e de anomalias congénitas e maior taxa de recém nascidos leves para a idade gestacional.Discussão: O aumento da morbilidade neonatal, nos últimos anos, associou-se de um modo positivo à precocidade do diagnostico de diabetes gestacional e ao rigor do controlo metabólico.Conclusão: Analisar os dados nacionais será fundamental para compreender este inesperado e preocupante aumento da morbilidade.Ordem dos Médicos2017-09-29info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/pdfapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/pdfapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8033oai:ojs.www.actamedicaportuguesa.com:article/8033Acta Médica Portuguesa; Vol. 30 No. 9 (2017): September; 589-598Acta Médica Portuguesa; Vol. 30 N.º 9 (2017): Setembro; 589-5981646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8033https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8033/5146https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8033/5371https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8033/8616https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8033/9116https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8033/9318https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8033/9327Direitos de Autor (c) 2017 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessMimoso, GabrielaOliveira, Guiomar2022-12-20T11:05:23Zoai:ojs.www.actamedicaportuguesa.com:article/8033Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:19:32.179924Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Neonatal Morbidity and Gestational Diabetes: Coincidence or Consequence of the 2011 Protocol
Morbilidade Neonatal na Diabetes Gestacional: Coincidência ou Consequência do Consenso de 2011
title Neonatal Morbidity and Gestational Diabetes: Coincidence or Consequence of the 2011 Protocol
spellingShingle Neonatal Morbidity and Gestational Diabetes: Coincidence or Consequence of the 2011 Protocol
Mimoso, Gabriela
Diabetes
Gestational
Infant
Newborn
Diseases
Pregnancy Complications
Complicações na Gravidez
Diabetes Gestacional
Doenças do Recém-Nascido
title_short Neonatal Morbidity and Gestational Diabetes: Coincidence or Consequence of the 2011 Protocol
title_full Neonatal Morbidity and Gestational Diabetes: Coincidence or Consequence of the 2011 Protocol
title_fullStr Neonatal Morbidity and Gestational Diabetes: Coincidence or Consequence of the 2011 Protocol
title_full_unstemmed Neonatal Morbidity and Gestational Diabetes: Coincidence or Consequence of the 2011 Protocol
title_sort Neonatal Morbidity and Gestational Diabetes: Coincidence or Consequence of the 2011 Protocol
author Mimoso, Gabriela
author_facet Mimoso, Gabriela
Oliveira, Guiomar
author_role author
author2 Oliveira, Guiomar
author2_role author
dc.contributor.author.fl_str_mv Mimoso, Gabriela
Oliveira, Guiomar
dc.subject.por.fl_str_mv Diabetes
Gestational
Infant
Newborn
Diseases
Pregnancy Complications
Complicações na Gravidez
Diabetes Gestacional
Doenças do Recém-Nascido
topic Diabetes
Gestational
Infant
Newborn
Diseases
Pregnancy Complications
Complicações na Gravidez
Diabetes Gestacional
Doenças do Recém-Nascido
description Introduction: Gestational diabetes is one of the diseases associated with pregnancy with higher rate of complications. Despite being a transitory condition, short and long term complications related to gestational diabetes have been described. There is scientific evidence to say that good metabolic control decreases perinatal complications. In 2011, new criteria was proposed for its diagnosis, which made possible its diagnosis during the 1st trimester of pregnancy. The aim of this study is to compare neonatal morbidity in two groups of women with gestational diabetes diagnosis before and after the latest Portuguese guidelines for diabetes and pregnancy were published (February 2011).Material and Methods: We included all newborns born in Maternidade Bissaya Barreto whose mother, followed at our maternity between 2008 and 2013, had unifetal pregnancy complicated by diabetes. We used a perinatal database and analysed the impact of the new guidelines in perinatal morbidity over two periods of three years.Results: There were 774 women who met the inclusion criteria. We found that gestational diabetes was diagnosed earlier, insulin therapy was more frequent. Neonatal morbidity was increased, and there were more cases of neonatal hypoglycemia and congenital anomalies, and newborns became smaller for gestational age.Discussion: The increase in neonatal morbidity was associated with early diagnosis and rigorous metabolic control.Conclusion: To analyse national data will be fundamental to understand this unexpected increase in morbidity.
publishDate 2017
dc.date.none.fl_str_mv 2017-09-29
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8033/5371
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8033/8616
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dc.rights.driver.fl_str_mv Direitos de Autor (c) 2017 Acta Médica Portuguesa
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dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 30 No. 9 (2017): September; 589-598
Acta Médica Portuguesa; Vol. 30 N.º 9 (2017): Setembro; 589-598
1646-0758
0870-399X
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