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CC BY 4.0 · Rev Bras Ginecol Obstet 2020; 42(10): 607-613
DOI: 10.1055/s-0040-1710300
Original Article
High Risk Pregnancy

The Influence of Preeclampsia, Advanced Maternal Age and Maternal Obesity in Neonatal Outcomes Among Women with Gestational Diabetes

A influência da pré-eclâmpsia, idade materna avançada e obesidade materna em desfechos neonatais entre mulheres com diabetes gestacional
Joana Sousa Nunes 
1   Obstetrics & Gynecology Department, Senhora da Oliveira Hospital, Guimarães, Portugal
2   Obstetrics & Gynecology Department, Faculty of Medicine, Minho University, Braga, Portugal
,
Rita Ladeiras
1   Obstetrics & Gynecology Department, Senhora da Oliveira Hospital, Guimarães, Portugal
,
Luísa Machado 
1   Obstetrics & Gynecology Department, Senhora da Oliveira Hospital, Guimarães, Portugal
2   Obstetrics & Gynecology Department, Faculty of Medicine, Minho University, Braga, Portugal
,
Diana Coelho 
1   Obstetrics & Gynecology Department, Senhora da Oliveira Hospital, Guimarães, Portugal
2   Obstetrics & Gynecology Department, Faculty of Medicine, Minho University, Braga, Portugal
,
Carla Duarte 
1   Obstetrics & Gynecology Department, Senhora da Oliveira Hospital, Guimarães, Portugal
2   Obstetrics & Gynecology Department, Faculty of Medicine, Minho University, Braga, Portugal
,
José Manuel Furtado 
1   Obstetrics & Gynecology Department, Senhora da Oliveira Hospital, Guimarães, Portugal
2   Obstetrics & Gynecology Department, Faculty of Medicine, Minho University, Braga, Portugal
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Abstract

Objective The present study aims to analyze adverse fetal or neonatal outcomes in women with gestational diabetes, including fetal death, preterm deliveries, birthweight, neonatal morbidity and mortality, as well as the synergic effect of concomitant pregnancy risk factors and poor obstetric outcomes, as advanced maternal age, maternal obesity and pre-eclampsia in their worsening.

Methods The present cohort retrospective study included all pregnant women with gestational diabetes, with surveillance and childbirth at the Hospital da Senhora da Oliveira during the years of 2017 and 2018. The data were collected from the medical electronic records registered in health informatic programs Sclinico and Obscare, and statistical simple and multivariate analysis was done using IBM SPSS Statistics.

Results The study participants included 301 pregnant women that contributed to 7.36% of the total institution childbirths of the same years, in a total of 300 live births. It was analyzed the influence of pre-eclampsia coexistence in neonatal morbidity (p = 0.004), in the occurrence of newborns of low and very low birthweight (p < 0.01) and in preterm deliveries (p < 0.01). The influence of maternal obesity (p = 0.270; p = 0.992; p = 0.684) and of advanced maternal age in these 3 outcomes was also analyzed (p = 0,806; p = 0.879; p = 0.985).Using a multivariate analysis, the only models with statistic significance to predict the three neonatal outcomes included only pre-eclampsia (p = 0.04; p < 0.01; p < 0.01).

Conclusion Only coexistence of pre-eclampsia showed an association with adverse neonatal outcomes (neonatal morbidity, newborns of low and very low birthweight and preterm deliveries) and can be used as a predictor of them in women with gestational diabetes.

Resumo

Objetivo O presente estudo tem como objetivo analisar desfechos fetais ou neonatais adversos em mulheres com diabetes gestacional, incluindo morte fetal, partos prematuros, peso ao nascimento, morbilidade neonatal e mortalidade, bem como o efeito sinérgico de fatores de risco e maus desfechos concomitantes da gravidez, como idade materna avançada, obesidade materna e pré-eclâmpsia no seu agravamento.

Métodos O presente estudo retrospetivo de coorte incluiu todas as gestantes com diabetes gestacional, com vigilância e parto no Hospital da Senhora da Oliveira durante 2017 e 2018. Os dados foram obtidos dos registos clínicos eletrónicos dos programas informáticos de saúde Sclinico e Obscare, e a análise estatística simples e multivariada foi feita utilizando o IBM SPSS Statistics.

Resultados Os participantes do estudo incluíram 301 gestantes que contribuíram para 7,36% do total de partos da instituição, num total de 300 nados vivos. Foi analisada a influência da coexistência de pré-eclâmpsia na morbilidade neonatal (p = 0,004), na ocorrência de recém-nascidos de baixo e muito baixo peso ao nascimento (p < 0,01) e em partos prematuros (p < 0,01). Também foi analisada a influência da obesidade materna (p = 0,270; p = 0,992; p = 0,684) e da idade materna avançada nesses 3 desfechos (p = 0,806; p = 0,879; p = 0.985).Usando uma análise multivariada, os únicos modelos com significância estatística para predizer os três desfechos neonatais incluíram apenas a pré-eclâmpsia (p = 0,04; p < 0,01; p < 0,01).

Conclusão Apenas a coexistência de pré-eclâmpsia mostrou associação com desfechos neonatais adversos (morbilidade neonatal, recém-nascidos de baixo e muito baixo peso e partos prematuros) e pode ser utilizada como preditor destes em mulheres com diabetes gestacional.

Keywords

gestational diabetes - advanced maternal age - maternal obesity - preeclampsia - neonatal outcomes

Palavras-chave

diabetes gestacional - idade materna avançada - obesidade materna - pré-eclâmpsia - desfechos neonatais

Contributors

All of the authors contributed with the project and data interpretation, the writing of the article, the critical review of the intellectual content, and with the final approval of the version to be published.




Publication History

Received: 07 January 2020

Accepted: 10 March 2020

Article published online:
19 June 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

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