Estado nutricional de gestantes com diabetes mellitus e sua relação com as características do neonato no nascimento

Abstract

The main objective of this study was to correlate the nutritional status of pregnant women with diabetes mellitus and the characteristics of the neonate at birth. It is a cross-sectional quantitative study conducted at the Woman and Child Unit of the University Hospital of the Federal University of Grande Dourados, comprised of a non-probabilistic sample of postpartum women and neonates with a diagnosis of diabetes mellitus. After ethical approval, data were collected through the pregnant woman's booklet, the neonate's medical record, and the application of a structured questionnaire on sociodemographic data and lifestyle, obstetric history, prenatal and nutritionist consultations, as well as anthropometric data, medical diagnosis of diabetes, presence of comorbidities, type of labor, gestational age, and clinical and nutritional characteristics of neonates. A prevalence of Gestational Diabetes Mellitus of 86.07% was obtained, followed by Type II Diabetes Mellitus 8.20% and Type I Diabetes Mellitus 5.74%. It was observed that 75.05% of pregnant women did not engage in any type of physical activity. There was a predominance of insufficient weight gain during pregnancy in 48.36% of women. The resolution of childbirth was mainly through cesarean section (71.31%), and labor induction was performed in 32.78% of pregnant women. Regarding neonates, the majority were female (51.38%), had adequate weight (64.75%), were considered to have a nutritional status appropriate for gestational age (68.85%), and were born at term (81.97%). Clinical complications occurred in 40.16% of neonates, with respiratory distress syndrome being the most prevalent (89.79%), followed by jaundice (8.16%), and fetal malformation (2.04%). Of all neonates, the need for admission to neonatal units occurred in 10.66%, for hypoglycemia (38.46%), respiratory distress syndrome (30.77%), treatment of jaundice (15.38%), and prematurity (15.38%). In this study, no statistically significant relationship was identified between the nutritional status of diabetic pregnant women and neonatal characteristics at birth. Among pregnant women, there was a predominance of overweight, obesity, sedentary lifestyle, excessive weight gain during pregnancy, a higher number of cesarean sections, and labor induction. In neonates, an adequate nutritional state for gestational age was observed, with the majority born at term, with adequate weight, and with the presence of complications, mainly SDR. Hypoglycemia and SDR were the main reasons for admission to neonatal units. These findings highlight the complexity and challenges associated with pregnancy in women with diabetes, underscoring the need for preventive interventions and specific care protocols to improve maternal and infant outcomes in this high-risk population.