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  • Original Article

    Impact of Carbohydrate Counting Method during Pregnancy in Women with Pregestational Diabetes Mellitus: A Controlled Clinical Trial

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):220-230

    Summary

    Original Article

    Impact of Carbohydrate Counting Method during Pregnancy in Women with Pregestational Diabetes Mellitus: A Controlled Clinical Trial

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):220-230

    DOI 10.1055/s-0042-1742291

    Views26

    Abstract

    Objective

    To evaluate the effect of the carbohydrate counting method (CCM) on glycemic control,maternal, and perinatal outcomes of pregnant women with pregestational diabetes mellitus (DM).

    Methods

    Nonrandomized controlled clinical trial performed with 89 pregnant women who had pregestational DMand received prenatal care in a public hospital in Rio de Janeiro, state of Rio de Janeiro, Brazil, between 2009 and 2014, subdivided into historic control group and intervention group, not simultaneous. The intervention group (n=51) received nutritional guidance from the carbohydrate counting method (CCM), and the historical control group (n=38), was guided by the traditionalmethod (TM). The Mann-Whitney test or the Wilcoxon test were used to compare intra- and intergroup outcomes andanalysis of variance (ANOVA) for repeated measures, corrected by the Bonferroni post-hoc test,was used to assess postprandial blood glucose.

    Results

    Only the CCM group showed a reduction in fasting blood glucose. Postprandial blood glucose decreased in the 2nd (p=0.00) and 3rd (p=0.00) gestational trimester in the CCM group, while in the TM group the reduction occurred only in the 2nd trimester (p=0.015). For perinatal outcomes and hypertensive disorders of pregnancy, there were no differences between groups. Cesarean delivery was performed in 82% of the pregnant women and was associated with hypertensive disorders (gestational hypertension or pre-eclampsia; p=0.047).

    Conclusion

    Both methods of nutritional guidance contributed to the reduction of postprandial glycemia of women and no differences were observed for maternal and perinatal outcomes. However, CCM had a better effect on postprandial glycemia and only this method contributed to reducing fasting blood glucose throughout the intervention. ReBEC Clinical Trials Database The present study was registered in the ReBEC Clinical Trials Database (Registro Brasileiro de Ensaios Clínicos, number RBR-524z9n).

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    Impact of Carbohydrate Counting Method during Pregnancy in Women with Pregestational Diabetes Mellitus: A Controlled Clinical Trial
  • Artigos Originais

    Temporal evolution of anemia prevalence in pregnant adolescents of a public maternity of Rio de Janeiro

    Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(5):208-215

    Summary

    Artigos Originais

    Temporal evolution of anemia prevalence in pregnant adolescents of a public maternity of Rio de Janeiro

    Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(5):208-215

    DOI 10.1590/SO100-720320150005321

    Views0

    PURPOSE:

    To describe the evolution of the prevalence of anemia in pregnant adolescents
    attended at a public maternity in the city of Rio de Janeiro from 2004 to 2013.

    METHODS:

    A retrospective cross-sectional study with 628 pregnant/postpartum women divided
    into 3 groups: Group A (2004-2006), Group B (2007-2010) and Group C (2013).
    Information about anthropometric, clinical, sociodemographic data and obstetric
    and prenatal care of adolescents was obtained from medical records of the pregnant
    women. A hemoglobin concentration n<11 g/dL was considered to be anemia. Data were analyzed statistically by the chi-square test, Student's t-test and ANOVA, and the post hoc Tukey test.

    RESULTS:

    The prevalence of gestational anemia over the years was 43% (GA=138), 36% (GB=80)
    and 47.1% (GC=40) and the overall prevalence for the 2004-2013 period was 41.1%
    (n=258). The occurrence of anemic pregnant women increased with the progression of
    pregnancy; however, in the 3rd quarter there was a decrease in the prevalence of
    anemia in GB (29.3%) compared to GA (38.7%; p=0.04). Factors associated with
    anemia were number of prenatal visits and prenatal nutritional assistance, place
    of residence, pre-pregnancy BMI, and gestational weight gain.

    CONCLUSION:

    The results showed that the prevalence of anemia among pregnant adolescents seen
    at a public maternity is high. There was no reduction of anemia during the study
    period and other factors in addition to iron deficiency were involved in the
    genesis of anemia in this population.

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