Complicações obstétricas e neonatais associadas ao diabetes e sobrepeso/obesidade em gestantes atendidas em um centro estadual de especialidades

Abstract

The significant incidence of high-risk pregnancies and their adverse maternal and fetal outcomes underscores the importance of specialized and interdisciplinary care aimed at providing comprehensive, preventive, and quality care for pregnant women, with the goal of reducing maternal-fetal morbidity and mortality. Among the most common metabolic complications in high-risk pregnancies are dysglycemia, often associated with pre-existing conditions or gestational diabetes mellitus (GDM). In this context, the objective of the present study is to evaluate the profile of pregnant women with diabetes and/or overweight/obesity and their respective maternal and neonatal outcomes, as well as to assess the interdisciplinary interventions provided to these women served at a State Center for Specialized Care (CEAE) in a health micro-region in the south of Minas Gerais, which covers 10 municipalities with a total population of approximately 185,000. This descriptive study collected variables related to

the clinical-epidemiological profile of pregnant women with overweight/obesity, pre- gestational diabetes (PGD), or GDM, between 2015 and 2021. In addition to maternal clinical- epidemiological data, interdisciplinary care, prenatal adherence, delivery mode, and respective

perinatal outcomes were analyzed. Independent variables were extracted from CEAE patient records, and perinatal and neonatal outcomes were collected through telephone contact, as listed in the clinical records, totaling 120 pregnancies evaluated, with 11 cases of type I/II DM, 26 with overweight/obesity, and 83 with GDM. Logistic regression models were built to evaluate the association between the clinical-epidemiological profile of these pregnant women and adverse perinatal outcomes. The potential impacts of multidisciplinary care were also analyzed. The study revealed a high cesarean rate, with a prevalence of 87.5% (n=105). Pre-eclampsia affected 35.3% (n=42) of the pregnant women, with similar prevalence among those with diabetes and overweight/obesity. Prematurity was observed in 18.5% (n=22) of the babies, especially among mothers with type I or II diabetes mellitus (45.5%, n=5). Among neonatal complications, respiratory distress syndrome affected 45.5% (n=5) of babies born to mothers with type I or II diabetes, 17.3% (n=14) of those with GDM, and 15.4% (n=4) of those with overweight/obesity. Neonatal ICU admission was required in 18.5% (n=22) of the babies, with a high frequency among those of mothers with type I or II diabetes mellitus (36.4%, n=4). Among the studied outcomes, pregnancy hemorrhage, prematurity, respiratory distress syndrome, congenital malformation, and fetal death were more prevalent in babies born to mothers with pre-gestational diabetes. Due to the low prevalence in each category, statistical differences could not be observed in the logistic regression model. The findings of this study may support strategies aimed at this target population to improve care quality and reduce both maternal and infant mortality. Future studies with more extensive postpartum data may further clarify and strengthen knowledge in this context.