Gravidanza e diabete: una rassegna della letteratura

2009 ◽  
pp. 73-86
Author(s):  
Renata Tambelli ◽  
Manuela Errante

- In this review are discussed the main researches about high-risk pregnancy and, particularly, gestational diabetes mellitus (GDM). The results of these researches highlight that pregnant women with GDM are extremely vulnerable, anxious and worried. However there are not many clinical studies about the effect of GDM on the quality of mother-child relationship.

2021 ◽  
Vol 15 (58) ◽  
pp. 278-291
Author(s):  
Ana Luiza Almeida da Silva ◽  
Ana Paula Silveira Santos ◽  
Simei Gleide Silva Matos ◽  
Matheus Santos Marques

Resumo: Considerando o Diabetes Mellitus um problema de saúde pública e sendo um dos principais fatores de morbimortalidade no Brasil, torna-se relevante destacar o aumento de casos ocorridos do DMG em gestantes de alto risco. Esta pesquisa teve por objetivo: investigar o perfil clínico do diabetes mellitus gestacional (DMG) e como o mesmo pode levar a uma gravidez de alto risco, sua associação aos fatores de riscos e suas principais complicações. Quanto à metodologia é exclusivamente de caráter bibliográfico. Foi feita uma pesquisa de revisão bibliográfica, a qual utilizou fontes de internet, onde foram aplicados critérios de inclusão e exclusão, chegando a um total de 12 artigos selecionados. A partir desses artigos, a pesquisa verificou que os fatores de riscos associados ao DMG e suas complicações, fazem correlação com a gravidez de alto risco. Assim, se faz necessário o rastreamento e monitoramento, a prevenção, o diagnóstico e tratamento do DMG tanto para a mãe quanto para o feto. Logo é fundamental a atuação do farmacêutico na equipe multidisciplinar, pois contribui desde a gestão, aquisição até a dispensação eficiente dos medicamentos auxiliando de forma a reduzir os riscos, promovendo atenção, cuidado e uma saúde de qualidade às gestantes. Palavras Chave: Diabetes Mellitus. Diabetes Mellitus Gestacional. Gravidez de Alto Risco. Abstract: Considering Diabetes Mellitus a public health problem and one of the main morbidity and mortality factors in Brazil, it is relevant to highlight the increase in cases of GDM in high-risk pregnant women. This research aimed to: investigate the clinical profile of gestacional diabetes mellitus (GDM) and how it can lead to a high-risk pregnancy, its association with risk factors and its main complications. As for the methodology, it is exclusively bibliographic in nature. A bibliographic review research was carried out, using internet  sources,  where inclusion   and exclusion  criteria   were applied, reaching a total of  12 selected articles. From these articles, the research found that the risk factors associated with GDM and its complications are correlated with high-risk pregnancy. Thus, it is necessary the tracking and monitoring, prevention, diagnosis and treatment of GDM for both mother and fetus. Therefore, the role of the pharmacist in the multidisciplinary team is essential, as he contributes from the management, acquisition to the efficient dispensing of medicines, helping to reduce risks, promoting attention, care and quality health for pregnant women. Keywords: Diabetes Mellitus. Gestational Diabetes Mellitus. High-risk Pregnancy.


2019 ◽  
Author(s):  
samira mokhlesi ◽  
masoumeh simbar ◽  
fahimeh ramezani tehrani ◽  
Nourossadat kariman ◽  
hamid alavi majd

Abstract Background Gestational diabetes mellitus carries serious risks to mother and fetus and causes social, mental, and psychological consequences which can affect mothers’ quality of life. Accordingly, this study aims to develop and assess the psychometric properties of quality of life questionnaire for women with gestational diabetes mellitus. Methods A methodological study of sequential exploratory mixed method was developed and implemented. It included qualitative (development of a quality of life questionnaire for mothers with GDM) and quantitative (assessment of psychometric prosperities of quality of life questionnaire for mothers with GDM) phases. Results Based on the findings of the qualitative phase and literature review, the primary questionnaire was prepared with 142 items. The outcome of face validity and content validity assessment was a 67-item questionnaire. S-CVI and S-CVR turned out to be 0.92 and 0.68, respectively. The results of exploratory factor analysis yielded an instrument with 36 items in five domains including concerns about high-risk pregnancy, perceived constraints, disease complications, medication and treatment, and support. Five factors explained 46.68% of the total variance of the questionnaire. The results indicated a moderate and significant correlation between the questionnaire of “Diabetes Clients Quality Of Life” and the researcher-made questionnaire (r=0.63). Cronbach’s alpha coefficient for the entire scale was 0.93 and the intra-class correlation coefficient was 0.95. Conclusion Quality of life questionnaire for mothers with GDM is a valid and reliable tool capable of measuring the quality of life of women with GDM.


Author(s):  
Deepti Khenwar ◽  
Juhi Agarwal ◽  
Sushruta Shriastava

Background: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of variable severity with onset or first recognition during the present pregnancy. It affects 7% of all pregnancies worldwide and in India it ranges from 6 to 9% in rural and 12 to 21% in urban area. The aim of this study was to compare the DIPSI criteria with the two-step method (Carpenter and Couston criteria.) and to study merits and demerits of one step and two step tests for GDM.Methods: A total 400 pregnant women of gestational age between 24-28 weeks attending antenatal clinic at this study tertiary care center were enrolled in this study. 200 pregnant women were enrolled in each of the study group (Group I OGTT and Group II DIPSI).Results: In Group I (OGTT) screening 47 (23.5%) were tested positive. In Group II cases, screening test results were found positive among 44 (22%). Out of 95 high-risk pregnant women 38 (40%) were positive for GDM by OGTT and 34 (35.78%) were positive by DIPSI. Out of 305 non high-risk pregnant women, 9 (2.95%) were positive for GDM by OGTT and 10 (3.27%) were positive by DIPSI.Conclusions: Present study concludes that DIPSI is the test which can predict GDM in population comparable to another test like OGTT. Also, India’s major population reside in rural areas, ANC are mostly conducted by ANM, therefore screening test should be easy to perform and interpret.


2019 ◽  
Author(s):  
samira mokhlesi ◽  
masoumeh simbar ◽  
fahimeh ramezani tehrani ◽  
Nourossadat kariman ◽  
hamid alavi majd

Abstract Background Gestational diabetes mellitus carries serious risks to mother and fetus and causes social, mental, and psychological consequences which can affect mothers’ quality of life. Accordingly, this study aims to develop and assess the psychometric properties of quality of life questionnaire for women with gestational diabetes mellitus. Methods A methodological study of sequential exploratory mixed method was developed and implemented. It included qualitative (development of a quality of life questionnaire for mothers with GDM) and quantitative (assessment of psychometric prosperities of quality of life questionnaire for mothers with GDM) phases. Results Based on the findings of the qualitative phase and literature review, the primary questionnaire was prepared with 142 items. The outcome of face validity and content validity assessment was a 67-item questionnaire. S-CVI and S-CVR turned out to be 0.92 and 0.68, respectively. The results of exploratory factor analysis yielded an instrument with 36 items in five domains including concerns about high-risk pregnancy, perceived constraints, disease complications, medication and treatment, and support. Five factors explained 46.68% of the total variance of the questionnaire. The results indicated a moderate and significant correlation between the questionnaire of “Diabetes Clients Quality Of Life” and the researcher-made questionnaire (r=0.63). Cronbach’s alpha coefficient for the entire scale was 0.93 and the intra-class correlation coefficient was 0.95. Conclusion Quality of life questionnaire for mothers with GDM is a valid and reliable tool capable of measuring the quality of life of women with GDM.


Author(s):  
Amrutha R. Thota ◽  
Ambarisha Bhandiwad ◽  
Vineet Sakhireddy

Background: Obesity is such a common health care problem of female population that have major impact on pregnancy. The worldwide prevalence of obesity is more than doubled in between 1980 and 2015. The objectives of present study are to observe whether obese women have an increased risk of pregnancy related complications and adverse fetal outcome and also to compare pregnancy outcomes in different classes of BMI in obese group.Methods: A prospective observational study conducted in OBG department JSS Hospital, Mysore from November 2014 to July 2016. All pregnant women attending OPD and inpatients of antenatal wards were screened for pre-pregnancy BMI. Total number of singleton births were 5727 in our institution. Out of which 314 obese pregnant women were included in the study group, remaining 5413 non-obese pregnant mothers were taken as control group respectively. They are closely monitored in every antenatal visit for development of complications such as pre-eclampsia, gestational diabetes mellitus, increased rate of caesarean section and presence of macrosomia (B.wt >3.5kg).Results: In comparison to normal BMI pregnant women, obese mothers had an increased risk of gestational hypertension (16.9% versus 2.0%, OR-2.3) gestational diabetes mellitus (35.7% versus 3.1%, OR-2.84), preeclampsia (23.9% versus 5%,0R-1.64) cesarean sections (75.2% versus 65.4%), macrosomia (45.9% versus 22%, OR-1.64), it was also found that as BMI increases the incidence of these complications increase as seen in different classes of obese population.Conclusions: Pregnancy associated with obesity is considered as a high-risk pregnancy and obesity being a modifiable risk factor, educating women in early pregnancy and preconceptional counseling regarding harmful effects of obesity and information regarding appropriate gestational weight gain is essential. 


2011 ◽  
Vol 108 (5) ◽  
pp. 910-917 ◽  
Author(s):  
Eeva Korpi-Hyövälti ◽  
Ursula Schwab ◽  
David E. Laaksonen ◽  
Hilpi Linjama ◽  
Seppo Heinonen ◽  
...  

As part of a feasibility study to prevent gestational diabetes mellitus (GDM), we evaluated the effect of an intensive dietary therapy on quality of diet, weight gain and birth weight in women at high risk of GDM. Women with risk factors for GDM (n 54) were randomly assigned from April 2005 to May 2006 to a lifestyle intervention group (n 27) including dietary advice six times during pregnancy or to a close follow-up group (n 27) in a community-based setting in Finland. Dietary intake was recorded three times during pregnancy using 4 d food records. The main outcome was the incidence of GDM. The secondary outcomes were the changes in nutrient intake, weight gain and birth weight. Overall, seventeen (65 %) women in the intervention group and eighteen (69 %) women in the close follow-up group returned all three food records. PUFA intake increased (P = 0·008) during pregnancy in the intervention as compared to the close follow-up group. There were no clear differences in the changes of saturated fat or fibre intake between the groups. Intensive dietary education resulted in a somewhat lower weight gain during pregnancy (P = 0·062) and higher birth weights of the infants (P = 0·047) without an effect on macrosomia as compared to the close follow-up group. Individualised counselling by a clinical nutritionist as part of a lifestyle intervention improved the quality of dietary fat intake in pregnant women at high risk of GDM.


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