57 Preeclampsia influence on the newborn’s weight percentile of pregnant women with type 1 diabetes mellitus: Perinatal outcomes

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• 作者：Tiago José ; de Oliveira Gomes ; Rodrigo Rocha Codarin ; Rafaela Alkmin da Costa ; Marcelo Zugaib ; Rossana Pulcineli Vieira Francisco
• 刊名：Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：6
• 期：3
• 页码：204
• 全文大小：38 K

文摘

Preeclampsia (PE) has a higher incidence in women with type 1 diabetes mellitus (DM). While the loss of glycemic control cause hyperinsulinemia and exaggerated fetal growth, diabetic vasculopathy can be associated with placental insufficiency and fetal growth restriction, similarly to preeclampsia.

Objective

To evaluate the influence of pre-eclampsia in newborn’s weight percentile of pregnant women with type 1 diabetes mellitus.

Methods

A prospective cohort study that evaluated pregnant women diagnosed with type 1 diabetes mellitus whose prenatal follow-up was performed at the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP) between the years 2013 and 2016. For analysis of the results at the end of the study, the patients were divided into two groups: without PE (I) and with PE (II). Statistical tests chi-square and analysis of variance (ANOVA) were performed with the help of IBM SPSS 16 software, considering the significance level of p < 0.05. The research is approved by the Ethics Committee for Research Project Analysis at HC-FMUSP.

Results

Of the 65 patients followed in the period, 20 (30.8%) developed preeclampsia. The mean weight percentile at birth was 73.23 (±26.46) in group I and 52.98 (±27.49) in group II, p = 0.0044. The frequency of newborns large for gestational age was 37.7% (n = 17) in group I and 5% (n = 1) in group II (RR  =  0.1294, CI = 0.01–0.90, p = 0.0395). There was no statistical difference in the frequency of infants small for gestational age. The average weight at birth was 3283.13 g (±644.89) in group I and 2785.25 g (±660.03) in group II, p = 0.006. There was no difference of factors such as age, disease duration, body mass index and presence of target organ lesions between the groups.

Conclusions

Preeclampsia decreases the mean of newborn’s weight percentile of pregnant women with type 1 diabetes mellitus, reducing the incidence of those classified as large for gestational age. In this cohort, there was no significant influence on the frequency of infants small for gestational age.