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  • Original Article

    Gestational Diabetes in the Population Served by Brazilian Public Health Care. Prevalence and Risk Factors

    Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(1):12-18

    Summary

    Original Article

    Gestational Diabetes in the Population Served by Brazilian Public Health Care. Prevalence and Risk Factors

    Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(1):12-18

    DOI 10.1055/s-0039-1700797

    Views75

    Abstract

    Objective

    To assess the prevalence of gestational diabetes mellitus and the main associated risk factors in the population served by the Brazilian Unified Health System in the city of Caxias do Sul, state of Rio Grande do Sul.

    Materials and Methods

    A descriptive, cross-sectional and retrospective study was conducted. Maternal variables were collected from the medical records of all pregnant women treated at the basic health units in 2016. Hyperglycemia during pregnancy (pregestational diabetes, overt diabetes and gestational diabetes mellitus) was identified by analyzing the results of a 75-g oral glucose tolerance test, as recommended by the Brazilian Ministry of Health. Based on the data, the women were allocated into two groups: the gestational diabetes group and the no gestational diabetes group.

    Results

    The estimated prevalence of gestational diabetes among 2,313 pregnant women was of 5.4% (95% confidence interval [95%CI]: 4.56-6.45). Pregnant women with 3 or more pregnancies had twice the odds of having gestational diabetes compared with primiparous women (odds ratio [OR]=2.19; 95%CI: 1.42-3.37; p<0.001). Pregnant women aged 35 years or older had three times the odds of having gestational diabetes when compared with younger women (OR=3.01; 95%CI: 1.97-4.61; p<0.001). Overweight pregnant women were 84% more likely to develop gestational diabetes than those with a body mass index lower than 25 kg/m2 (OR =1.84; 95%CI: 1.25-2.71; p=0.002). A multivariable regression analysis showed that being overweight and being 35 years old or older were independent variables.

    Conclusion

    In this population, the prevalence of gestational diabetes mellitus was of 5.4%. Age and being overweight were predictive factors for gestational diabetes.

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    Gestational Diabetes in the Population Served by Brazilian Public Health Care. Prevalence and Risk Factors
  • Case Report

    Ectopia Cordis Associated with Pentalogy of Cantrell-A Case Report

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(5):352-356

    Summary

    Case Report

    Ectopia Cordis Associated with Pentalogy of Cantrell-A Case Report

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(5):352-356

    DOI 10.1055/s-0039-1679878

    Views8

    Abstract

    Pentalogy of Cantrell (PC) is a rare congenital anomaly characterized by changes in the mesodermal median structures and congenital heart disease, often with a poor prognosis. In 1958, Cantrell et al2 defined the full spectrum of the syndrome with the following anomalies: defects of the anterior diaphragm, of the lower part of the sternum, of the supraumbilical region and the abdominal wall, of the diaphragmatic pericardium, and various intracardiac congenital abnormalities. The present report describes a case of ectopia cordis associated with PC and the importance of the participation of a multidisciplinary team in the treatment of this condition.

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    Ectopia Cordis Associated with Pentalogy of Cantrell-A Case Report
  • Original Article

    Effect of Obesity on Gestational and Perinatal Outcomes

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(7):330-336

    Summary

    Original Article

    Effect of Obesity on Gestational and Perinatal Outcomes

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(7):330-336

    DOI 10.1055/s-0037-1603826

    Views9

    Abstract

    Purpose

    To assess the impact of pre-pregnancy obesity (body mass index [BMI] ≥30 kg/m2) on the gestational and perinatal outcomes.

    Methods

    Retrospective cohort study of 731 pregnant women with a BMI ≥30 kg/m2 at the first prenatal care visit, comparing them with 3,161 women with a BMI between 18.5 kg/m2 and 24.9 kg/m2. Maternal and neonatal variables were assessed. Statistical analyses reporting the demographic features of the pregnant women (obese and normal) were performed with descriptive statistics followed by two-sided independent Student’s t tests for the continuous variables, and the chi-squared (χ2) test, or Fisher’s exact test, for the categorical variables. We performed a multiple linear regression analysis of newborn body weight based on the mother’s BMI, adjusted by maternal age, hyperglycemic disorders, hypertensive disorders, and cesarean deliveries to analyze the relationships among these variables. All analyses were performed with the R (R Foundation for Statistical Computing, Vienna, Austria) for Windows software, version 3.1.0. A value of p < 0.05 was considered statistically significant.

    Results

    Obesity was associated with older age [OR 9.8 (7.8-12.2); p < 0.01], hyperglycemic disorders [OR 6.5 (4.8-8.9); p < 0.01], hypertensive disorders [OR 7.6 (6.1-9.5); p < 0.01], caesarean deliveries [OR 2.5 (2.1-3.0); p < 0.01], fetal macrosomia [OR 2.9 (2.3-3.6); p < 0.01] and umbilical cord pH [OR 2.1 (1.4-2.9); p < 0.01). Conversely, no association was observed with the duration of labor, bleeding during labor, Apgar scores at 1 and 5 minutes after birth, gestational age, stillbirth and early neonatal mortality, congenital malformations, and maternal and fetal injury.

    Conclusion

    We observed that pre-pregnancy obesity was associated with maternal age, hyperglycemic disorders, hypertension syndrome, cesarean deliveries, fetal macrosomia, and fetal acidosis.

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    Effect of Obesity on Gestational and Perinatal Outcomes

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