medigraphic.com
ISSN 1560-4381 (Print)

2016, Number 4

<< Back Next >>

Correo Científico Médico 2016; 20 (4)

Preconception care and perinatal outcomes in diabetic women

Pérez PA, Cruz FJD, Rodríguez UA, Osorio FL, Santana HM

Language: Spanish
References: 24
Page: 615-629
PDF size: 285.00 Kb.


ABSTRACT

Introduction: pregestacional care to diabetic women is considered a requirement to obtain good results during the gestational stage. The beginning of pregnancy without an adequate metabolic control, predispose to the loss of the pregnancy or to a risk of increasing congenital bad formations, although there are other alterations which have been described in the fetus and the newly born.
Objective: to determine if the preconceptional care in pregestacional diabetic women have positive repercussions in pregnancy and its perinatal results.
Method: a cohort study about the behavior of the perinatal variables in diabetic women was carried out, this study was related to the preconceptional care in the Diabetes and Pregnancy Service of the Universitary Hospital "Vladimir I. Lenin" of Holguín, in the period of time between 2004-2013. The universe was formed by 218 pregestacional diabetic women. The sample was integrated by 203 pregnant women who presented their childbirth with 28 weeks or more of gestation. The patients were divided in two groups, one involving 57 pregnant women (study group), who were assisted before the pregnancy and a pregnant second group of 146 (control group), to whom, this assistance was not provided.
Results: the big newly born to the gestational age of (23,03%) and the prematurity (21,07%) were predominant in the pregnants who were not assisted before pregnancy and just in them the fetal death (2.94%), the neonatal death (0.98%), the bad formations (1.12%) as well as other neonatal complications were seen.
Conclusions: the study demonstrated that the preconcepcional care in the woman with pregestational diabetes impacts positively in pregnancy and perinatal results.


REFERENCES

  1. Cuba. Ministerio de Salud Pública. Programa Nacional de atención integral a la gestante diabética. La Habana: MINSAP; 2002.

  2. Valdés Amador L. Riesgo preconcepcional en la mujer diabética. Rev Cubana Obstet Ginecol.2010 [citado 20 abr 2014]; 36(1):1-3. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138-600X2010000100001

  3. Hayfaa AW, Alzeidan RA, Esmaeil SA. Pre-pregnancy care for women with pre-gestational diabetes mellitus: a systematic review and meta-analysis. BMC Public Health. 2012[citado 20 abr 2014]; 12: 792. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3575330/

  4. Mattar R, Gomes MB. Adverse pregnancy outcomes in women with diabetes. Diabetol Metab Syndr. 2012[citado 20 abr 2014]; 4:41. Disponible en: http://www.dmsjournal.com/content/4/1/41

  5. Sukanya S, Bay BH, Wah SS, Dheen ST. Frontiers in research on maternal diabetes-induced neural tube defects: Past, present and future. World J Diabetes. 2012 [citado 20 abr 2014]; 3(12): 196–200. Disponible en: http://www.wjgnet.com/1948-9358/full/v3/i12/196.htm

  6. Mills JL, Knopp RH, Simpson JL, Jovanovic-Peterson L, Metzger BE, Holmes LB, et al. Lack of relation of increased Malformation rates in infant of diabetic mother to glycemic control during organogénesis. N Engl J Med. 1988 [citado 20 abr 2014];318(11):671-676. Disponible en: http://www.nejm.org/doi/full/10.1056/NEJM198803173181104

  7. Glinianaia SV, Tennant PW, Bilous RW, Rankin J, Bell R. HbA(1c) and birthweight in women with pre-conception type 1 and type 2 diabetes: a population-based cohort study Diabetologia. 2012; 55(12):3193-203.

  8. Álvarez Zapata D, Valdés Amador L, Santana BacallaoO, Lugo Alonso J. El exceso y el bajo peso corporal al nacimiento en hijos de madres con diabetes. Rev Cubana Obst Ginecol. 2012[citado 20 abr 2014]; 38(3)294-304. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138-600X2012000300002&lng=es&nrm=iso&tlng=es

  9. Black MH, Sacks DA, Xiang AH, Lawrence JM. The relative contribution of prepregnancy overweight and obesity, gestational weight gain, and IADPSG-defined gestational diabetes mellitus to fetal overgrowth. Diabetes Care. 2013 [citado 20 abr 2014]; 36(1):56-62. Disponible en: http://care.diabetesjournals.org/content/36/1/56

  10. El Masry SA, El Ganzoury MM, El Farrash RA, Anwar M, AbdEllatife RZ. Size at birth and insulin-like growth factor-I and its binding protein-1 among infants of diabetic mothers. J Matern Fetal Neonatal Med. 2013 [citado 20 abr 2014]; 26(1):5-9. Disponible en: http://www.tandfonline.com/doi/full/10.3109/14767058.2012.718000#abstract

  11. Kitzmiller J L, Block J M, Brown F M, Catalano P M, Conway D L, Coustan D R, et al. Managing Preexisting Diabetes for Pregnancy: Summary of evidence and consensus recommendations for care. Diabetes Care. 2008[citado 20 abr 2014]; 31(5): 1060-1079. Disponible en: http://care.diabetesjournals.org/content/31/5/1060.extract

  12. Pérez Proenza A. Fetopatía diabética y terapia insulínica. Jornada Provincial de Obstetricia y Ginecología; 2014 dic 12-14. Holguín: Hospital Vladimir Ilich Lenin; 2014

  13. Melamed N, Chen R , Soiberman U, Ben-Haroush A, Hod M, Yogev Y. Spontaneous and indicated preterm delivery in pregestational diabetes mellitus: etiology and risk factors. Arch Gynecol Obstet. 2008 [citado 20 abr 2014]; 278(2):129–134. Disponible en: http://link.springer.com/article/10.1007/s00404-007-0541-z

  14. American Medical Association. The Effect of Intensive Diabetes Treatment on the Progression of Diabetic Retinopathy in Insulin-Dependent Diabetes Mellitus the Diabetes Control and Complications Trial. Arch Ophthalmol. 1995[citado 20 abr 2014]; 113(1):36–51. Disponible en: http://archopht.jamanetwork.com/article.aspx?articleid=640967

  15. Hayfaa A W. Pre-existing diabetes mellitus and adverse pregnancy outcomes. BMC Res Notes.2012 [citado 20 abr 2014]; 5: 496. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3506442/

  16. Teramo K, Klemetti M, Tikkanen M, Nuutila M. Maternal diabetes and fetal hypoxia. Duodecim. 2013 [citado 20 abr 2014]; 129(3):228-234. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/23457773

  17. Rackham O, Paize F, Weindling AM. Cause of death in infants of women with pregestational diabetes mellitus and the relationship with glycemic control. Postgrad Med. 2009[citado 20 abr 2014]; 121(4):26–32. Disponible en: http://www.tandfonline.com/doi/abs/10.3810/pgm.2009.07.2026

  18. Yeniel AÖ, Ergenoğlu AM, Sağol S. Prenatal diagnosis of caudal regression syndrome without maternal diabetes mellitus. J Turk Ger Gynecol Assoc. 2011[citado 20 abr 2014]; 12(3): 186–188. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3939279/

  19. Restrepo Ochoa O. Diabetes y Embarazo. Rev Colombiana Obstet Ginecol. 2009[citado 20 abr 2014]; 51(1):1-11. Disponible en: http://www.redalyc.org/pdf/1952/195218311004.pdf

  20. Jensen DM, Korsholm L, Ovesen P, Beck-Nielsen H, Moelsted-Pedersen L, Westergaard JG. Peri-Conceptional A1C and Risk of Serious Adverse Pregnancy Outcome. Diabetes Care. 2009 [citado 20 abr 2014]; 32(6).Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2681038/?tool=pmcentrez

  21. Macintosh MCM, Fleming KM, Bailey JA, Doyle P, Modder J, Acolet D, et al. Perinatal mortality and congenital abnormalities in babies of women with type 1 or type 2 diabetes in England, Wales, and Northern Ireland: population based study. BMJ. 2008 [citado 20 abr 2014]; 333(7560):177–182. Disponible en:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1513435/

  22. Fernández Ramos T, Clapés Hernández S, Suárez Román G, Casanueva Calero K, Armas Castillo DI, Carmen Tormo M. Marcadores de estrés oxidativo en embarazadas diabéticas. Rev Cubana Invest Bioméd. 2010 [citado 20 abr 2014]; 29(4).Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-03002010000400002&lng=es&nrm=iso&tlng=es

  23. Contreras Zúñiga E, Guillermo Arango L, Zuluaga Martínez SX, Ocampo Diabetes y embarazo. Rev Colombiana Obstet Ginecol. 2008[citado 20 abr 2014]; 59 (1). Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0034-74342008000100006&lng=es&nrm=iso&tlng=es

  24. Russell NE, Foley M, Kinsley BT, Firth RG, Coffey M, McAuliffe FM. Effect of pregestational diabetes mellitus on fetal cardiac function and structure. Am J Obstet Gynecol. 2008 [citado 20 abr 2014]; 199(3):312. Disponible en: http://www.sciencedirect.com/science/article/pii/S0002937808007990




2020     |     www.medigraphic.com