Associação entre excesso de peso pré-gestacional e diagnóstico de diabetes mellitus gestacional em gestantes adultas atendidas em uma maternidade pública do Rio de Janeiro

Abstract

Overweight is considered a global epidemic by the World Health Organization, with ample growth in recent decades, among the world's population, including women of childbearing age. Several studies have described the adverse pregnancy and neonatal outcomes associated with this pre-pregnancy nutritional status, highlighting the diabetes gestational diabetes. This, in addition to often be associated with excess weight carries risks of complications that may exceed the pregnancy and postpartum period. Objective: To evaluate the association between excess pre-pregnancy weight and diagnosis of gestational diabetes mellitus in adult pregnant women in a public maternity hospital in the city of Rio de Janeiro. Methods: This is a cross-sectional analytical study of 1417 pregnant / postpartum women and their newborns, divided into 4 groups, referring to 4 different periods between the years 1999-2014: GI (n = 219), GII (n = 208), GIII (n = 377) and GIV (n = 613). Maternal data were analyzed (sociodemographic, anthropometric, prenatal assessment and postpartum) and newborns (birth weight). Results: The prevalence of overweight and obesity in the final sample was 25.8% and 11.6%, respectively. Temporal evolution was shown to be on the rise, in particular, obesity more than tripled over 14 years. The main complication was the maternal gestational diabetes (20.3%), with a considerable increase of the GI (1.8%) and GIV (42.4%) having association with prepregnancy nutritional status (p <0.001), the most likely obese to develop it (48%). Age, marital status and place of residence were associated with both the nutritional status in the development or not of maternal complications. By pre-pregnancy nutritional status it is still associated with the total weight gain during pregnancy. The average birth weight was 3274g (± 519,6g) with rates of 5% underweight and 5.4% of macrosomia. Final considerations: The high prevalence of overweight among the study participants figure as a serious public health problem, considering its possible complications, particularly gestational diabetes, which requires greater monitoring of these women, in order to avoid complications in the short and long term