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CC BY 4.0 · Rev Bras Ginecol Obstet 2020; 42(01): 012-018
DOI: 10.1055/s-0039-1700797
Original Article
Obstetrics/High Risk Pregnancy
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

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

Diabetes gestacional na população atendida pelo sistema público de saúde no Brasil. Prevalência e fatores de risco
Pâmela Antoniazzi dos Santos 
1   Health Sciences Postgraduate Program, Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil
,
José Mauro Madi 
1   Health Sciences Postgraduate Program, Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil
,
Emerson Rodrigues da Silva 
1   Health Sciences Postgraduate Program, Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil
,
Daiane de Oliveira Pereira Vergani 
1   Health Sciences Postgraduate Program, Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil
,
Breno Fauth de Araújo 
1   Health Sciences Postgraduate Program, Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil
,
Rosa Maria Rahmi Garcia 
1   Health Sciences Postgraduate Program, Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil
› Author Affiliations
Further Information

Publication History

03 June 2019

17 September 2019

Publication Date:
27 February 2020 (online)

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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.

Resumo

Objetivo Avaliar a prevalência de diabetes mellitus gestacional, e dos principais fatores de risco associados, em população usuária do Sistema Único de Saúde em Caxias do Sul-RS.

Métodos Um estudo descritivo, transversal e retrospectivo foi feito. As variáveis maternas foram coletadas de registros de prontuários de todas gestantes atendidas nas Unidades Básicas de Saúde do município em 2016. A identificação de hiperglicemia na gestação (diabetes pré-gestacional, diabetes identificado durante a gestação e diabetes mellitus gestacional) foi feita pela avaliação dos resultados do teste oral de tolerância com 75 g glicose, conforme preconizado pelo Ministério da Saúde. Com base nesses dados, as gestantes foram separadas em dois grupos: o grupo com diabetes gestacional e o grupo sem diabetes gestacional.

Resultados A prevalência estimada de diabetes gestacional em 2.313 gestantes foi de 5,4% (intervalo de confiança de 95% [IC95%]: 4,56–6,45). Gestantes com 3 ou mais gestações apresentaram chance 2 vezes maior para a ocorrência de diabetes gestacional, quando comparadas às primigestas (razão de possibilidades [RP] = 2,19; IC95%: 1,42- 3,37; p < 0,001). Gestantes com idade de 35 anos ou mais apresentaram chance três vezes maior do que as mais jovens (RP = 3,01; IC95%: 1,97–4,61; p < 0,001). A chance de desenvolver diabetes gestacional em gestantes com sobrepeso foi 84% maior do que a das com índice de massa corporal inferior a 25 kg/m2 (RP = 1,84; IC95%: 1,25–2,71; p = 0,002). A análise de regressão multivariada mostrou sobrepeso e idade materna como variáveis com associação independente.

Conclusão Nesta população, a prevalência de diabetes mellitus gestacional foi de 5,4%. Idade materna e sobrepeso pré-gestacional foram fatores preditivos para diabetes gestacional.

Keywords

gestational diabetes - public health - prevalence - maternal health

Palavras-chave

diabetes gestacional - saúde pública - prevalência - saúde materna

Contributors

All authors contributed with the project and the interpretation of data, the writing of the article, the critical review of the intellectual content, and with the final approval of the version to be published.


 

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