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CC BY 4.0 · Rev Bras Ginecol Obstet 2021; 43(02): 107-112
DOI: 10.1055/s-0040-1721356
Original Article
High Risk Pregnancy

Gestational Diabetes Mellitus and Obesity are Related to Persistent Hyperglycemia in the Postpartum Period

Diabetes mellitus gestacional e obesidade estão relacionados à hiperglicemia persistente no período pós-parto
Patricia Moretti Rehder 
1   Obstetrics Departament, Universidade Estadual de Campinas, Campinas, SP, Brazil
,
Anderson Borovac-Pinheiro 
1   Obstetrics Departament, Universidade Estadual de Campinas, Campinas, SP, Brazil
,
Raquel Oliveira Mena Barreto de Araujo 
1   Obstetrics Departament, Universidade Estadual de Campinas, Campinas, SP, Brazil
,
Juliana Alves Pereira Matiuck Diniz 
1   Obstetrics Departament, Universidade Estadual de Campinas, Campinas, SP, Brazil
,
Nathalia Lonardoni Crozatti Ferreira 
1   Obstetrics Departament, Universidade Estadual de Campinas, Campinas, SP, Brazil
,
Ana Claudia Rolim Branco 
1   Obstetrics Departament, Universidade Estadual de Campinas, Campinas, SP, Brazil
,
Aline de Fatima Dias 
1   Obstetrics Departament, Universidade Estadual de Campinas, Campinas, SP, Brazil
,
Belmiro Gonçalves Pereira 
1   Obstetrics Departament, Universidade Estadual de Campinas, Campinas, SP, Brazil
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Abstract

Objective To evaluate the obstetric and sociodemographic characteristics of gestational diabetic women who maintained hyperglycemia in the postpartum period (6–12 weeks postpartum).

Methods This is a longitudinal cohort study with women who have had gestational diabetes and/or macrosomic children between March 1st, 2016 and March 1st, 2017. Between 6 and 12 weeks after birth, women who had gestational diabetes collected fasting glycemia, glucose tolerance test, and glycated hemoglobin results. The data were collected from medical records and during an interview in the first postpartum consultation. A statistical analysis was performed using frequency, percentage, Chi-Squared test, Fisher exact test, Mann-Whitney test, and multivariate Poisson regression. The significance level adopted for the statistical tests was 5%.

Results One hundred and twenty-two women were included. Most of the women were younger than 35 years old (70.5%), white, multiparous, and with no history of gestational diabetes. Thirteen percent of the participants developed persistent hyperglycemia. A univariate analysis showed that maternal age above 35 years, being overweight, having grade 1 obesity and weight gain under 5 kg was related to the persistence of hyperglycemia in the postpartum period.

Conclusion Maternal age above 35 years, obesity and overweight, and the diagnosis of gestational diabetes in the first trimester of pregnancy are associated with hyperglycemia during the postpartum period.

Resumo

Objetivo Avaliar características sociodemográficas e obstétricas de mulheres com diabetes gestacional que mantêm hiperglicemia no período pós-parto (6–12 semanas pós-parto).

Métodos Este é um estudo longitudinal de coorte com mulheres com diagnóstico de diabetes gestacional e/ou macrossomia fetal entre 1° de março de 2016 a 1° de março de 2017. As mulheres coletaram glicemia de jejum, teste de tolerância a glicose e hemoglobina glicada entre 6 a 12 semanas pós-parto. Os dados foram coletados de prontuários médicos e durante entrevista na primeira consulta de revisão pós-parto. Uma análise estatística foi realizada através do cálculo de frequências, porcentagens, teste do qui-quadrado, teste exato de Fisher, teste de Mann-Whitney e regressão multivariada de Poisson. A significância estatística adotada foi de 5%.

Resultados Cento e vinte e duas mulheres foram incluídas. A maioria delas tinha menos de 35 anos de idade (70,5%), eram brancas, multíparas, e não tinham história de diabetes gestacional. Treze por cento das participantes desenvolveu hiperglicemia persistente. A análise univariada mostrou que os fatores relacionados com a persistência de hiperglicemia no período pós-natal foram: idade materna acima de 35 anos, sobrepeso, obesidade grau 1 e ganho de peso abaixo de 5 quilos. A análise multivariada incluiu o diagnóstico no primeiro trimestre como fator de risco para hiperglicemia persistente.

Conclusão Mulheres acima de 35 anos, obesidade, sobrepeso e diagnóstico de diabetes gestacional no primeiro trimestre estão relacionados com hiperglicemia persistente no período pós-parto.

Keywords

gestational diabetes - obesity - hyperglycemia - postpartum period - overweight

Palavras-chave

diabetes gestacional - obesidade - hiperglicemia - período pós-parto - sobrepeso

Contributions

P. M. R. had the idea and P. M. R., A. B. P. and B. G. P. conceived the study. A. B. P., R. O. M. B. A., J. A. P. M. D., N. L. C. F., A. C. R. B., and A. F. D. collected the data. A. B. P. and P. M. R. analyzed the data. A. B. P. wrote the first version of the manuscript. All the authors contributed with amendments and suggestions.




Publication History

Received: 09 January 2020

Accepted: 05 October 2020

Article published online:
19 January 2021

© 2021. Federação Brasileira de Ginecologia e Obstetrícia. 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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