Diabetes mellitus gestacional e fatores preditores entre mulheres de uma coorte de nascimento do Nordeste do Brasil

Abstract

Gestational diabetes mellitus (GDM) is an important global public health problem. Its increase in contemporary society has required the formulation of public policies that encompass the diversity of factors related to its occurrence. GDM is the most frequent metabolic complication in pregnancy and in recent years its prevalence has increased in several regions of the world and different countries have shown great variations in results. The absence of a universal diagnostic criterion, ethnic / racial characteristics, socioeconomic and cultural factors and different methodologies hinder the direct comparison of the available studies, as well as the evaluation of the global estimate of the rates of the referred disease. In this context, and considering the high risks of adverse pregnancy results for the maternal-fetal binomial of this condition, it is important to investigate the factors that predict its development in brazilian women, since the recognition of the magnitude of the problem is essential for the development of actions aimed at the prevention and control of the disease. In order to contribute to the discussion of the problem, a literature review chapter and an original article were prepared in this dissertation. The review chapter addresses the diagnostic criteria, the prevalence of GDM in several countries and in Brazil, the main predictive factors and the strategies adopted by the Brazilian government and the public authorities to face the disease in question. The original article aimed to describe gestational diabetes mellitus (GDM) in the immediate postpartum period and the predictive factors among women in a birth cohort in a municipality in northeastern Brazil. This is a cross-sectional study nested in a 2017 birth cohort entitled Health, Food, Nutrition and Child Development - HFND. The analysis of the prevalence and predictive factors for GDM included sociodemographic, demographic, maternal, gestational and behavioral aspects of women. Linear regression was performed to identify the predictors of GDM. Higher rates of prevalence of GDM were observed in women aged 35 years or older, who lived with a spouse, who had obesity in the immediate postpartum period and who consumed fatty meats. In the final model of linear regression, predictive factors for GDM were age greater than or equal to 35 years and obesity in the immediate postpartum period. These findings reinforce the need for measures based on strategies for the prevention and control of the disease, which contribute to reducing the burden of the disease and its complications, which is still present in a significant way in the country.