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Objective: Evaluate the prevalence of macrosomic newborns (birth weight above 4000 grams) in a high-risk maternity from 2014 to 2019, as well as the maternal characteristics involved, risk factors, mode of delivery and associated outcomes, comparing newborns weighing 4000-4500 grams and those weighing above 4500 grams. Methods: This is an observational study, case-control type, carried out by searching for data in hospital's own system and clinical records. The criteria for inclusion in the study were all patients monitored at the service who had newborns with birth weight equal than or greater than 4000 grams in the period from January 2014 to December 2019, being subsequently divided into two subgroups (newborns with 4000 to 4500 grams and newborns above 4500 grams). After being collected, the variables were transcribed into a database, arranged in frequency tables. For treatment and statistical analysis of the data, Excel and R software were used. This tool was used to create graphs and tables that helped in the interpretation of the results. The statistical analysis of the variables collected included both simple descriptive analyzes as well as inferential statistics, with univariate, bivariate and multivariate analysis. Results: From 2014 to 2019, 3.3% of deliveries were macrosomic newborns. The average gestational age in the birth was 39.4 weeks. The most common mode of delivery (65%) was cesarean section. Diabetes mellitus was present in 30% of the deliveries studied and glycemic control was absent in most patients. Among the vaginal deliveries, only 6% were instrumented and there was shoulder dystocia in 21% of the cases. The majority (62%) of newborns had some complication, with jaundice (35%) being the most common. Conclusion: Birth weight above 4000 grams had a statistically significant impact on the occurrence of neonatal complications, such as hypoglycemia, respiratory distress and 5th minute APGAR less than 7, especially if birth weight was above 4500 grams. Gestational age was also shown to be statistically significant associated with neonatal complications, the lower, the greater the risk. Thus, macrosomia is strongly linked to complications, especially neonatal complications.

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RESUMEN Objetivo: Identificar la influencia del consumo de hidratos de carbono (HCO) sobre el estado oxidante en mujeres con y sin diabetes mellitus gestacional (DMG). Materiales y métodos: Se realizó un estudio transversal, observacional y comparativo a dos grupos de 21 mujeres con y sin DMG, respectivamente, en la ciudad de Toluca, México, de enero a diciembre del 2022. Para evaluar parámetros sociodemográficos, se les aplicó un cuestionario de historia clínica; en cuanto a los parámetros antropométricos, se les midió peso corporal y estatura; y respecto a los parámetros bioquímicos, colesterol total (CT) y triglicéridos (TG). Para evaluar el estado oxidante/antioxidante se cuantificaron, como marcador oxidante, el malondihaldeído (MDA), y como antioxidantes, catalasa (cat), superóxido dismutasa (SOD) y capacidad antioxidante total (CAT). Los hábitos dietéticos se evaluaron a través de un recordatorio de 24 horas, en ambos grupos de mujeres, para obtener los macronutrientes: proteínas, lípidos e HCO. A partir de los hidratos de carbono totales (HCOT), se calcularon los hidratos de carbono complejos (HCOC) e hidratos de carbono simples (HCOS) como la sacarosa. Para el cálculo de HCOS por día, se usó la lista de alimentos con contenido de sacarosa por cada 100 gramos de consumo que emplea el Sistema Mexicano de Equivalentes; para el análisis de dieta, se utilizó el programa Nutrikcal VO. Se usaron las pruebas estadísticas t de Student para muestras independientes, U de Mann-Whitney para las variables no homogéneas y se realizó la correlación de Spearman (p < 0,05) en el programa SPSS, versión 19. Resultados: Los resultados mostraron que la diferencia entre los valores de CT (p < 0,029), TG (p < 0,029), las enzimas: cat (p < 0,011), SOD (p < 0,013), así como el MDA (p < 0,039), fueron significativamente mayores en las pacientes del grupo con DMG en comparación con el grupo sin DMG. Además, el grupo con DMG consumió mayor proporción de sacarosa. Conclusiones: Las mujeres con DMG tienen un desequilibrio en el estado oxidante/antioxidante influenciado por el tipo de HCO que consumen, en particular los HCOS como la sacarosa.

ABSTRACT Objective: To identify the influence of carbohydrate (CHO) intake on oxidative status among women with and without gestational diabetes mellitus (GDM). Materials and methods: A cross-sectional, observational and comparative study was carried out with two groups of 21 women each with and without GDM in the city of Toluca, Mexico, from January to December 2022. The sociodemographic parameters were determined by administering the patients a medical history questionnaire; anthropometric parameters such as body weight and height were measured; and biochemical parameters including total cholesterol (TC) and triglycerides (TG) were calculated. The oxidant/antioxidant status was assessed as follows: malondialdehyde (MDA) as oxidative stress marker; and catalase (CAT), superoxide dismutase (SOD) and total antioxidant capacity (TAC) as antioxidants. Dietary habits were evaluated through a 24-hour reminder in both groups of women to obtain the macronutrient classes, i.e., proteins, fats and CHOs. Based on the total carbohydrates (TCHOs), complex (CCHOs) and simple carbohydrates (SCHOs) such as sucrose were calculated. SCHOs per day were measured using the list of foods with sucrose content per 100 grams according to the Mexican Food Equivalence System (SMAE). The NutriKcal VO program was used for the dietary analysis. Statistical tests such as Student's t test and Mann-Whitney U test were performed for the independent samples and nonhomogeneous variables, respectively, and Spearman's rank correlation coefficient (p < 0.05) was determined using the IBM SPSS Statistics V19. Results: The results showed that the difference between the levels of TC (p < 0.029), TG (p < 0.029), enzymes CAT (p < 0.011) and SOD (p < 0.013), as well as MDA (p < 0.039) was significantly higher among patients in the group with GDM compared to that in the group without GDM. In addition, the group with GDM consumed a higher proportion of sucrose. Conclusions: Women with GDM have an imbalance in the oxidant/antioxidant status, influenced by the type of CHO they consume, particularly SCHOs such as sucrose.

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Resumo Objetivo Avaliar o efeito da intervenção de enfermagem com objetivos diversificados e orientados no periodo perinatal de pacientes com diabetes melittus gestacional (DMG). Métodos Estudo prospectivo de 96 pacientes com DMG tratadas entre fevereiro 2020 e fevereiro 2023, selecionadas e divididas aleatoriamente em grupo Observação (n=48) e grupo Controle (n=48). As pacientes do grupo Controle receberam cuidados de enfermagem de rotina, enquanto as do grupo Observação receberam intervenção de enfermagem com objetivos diversificados e orientados. As taxas de incidência de complicações perioperatórias e resultados neonatais adversos e indicadores de glicose no sangue, bem como a pontuação da versão chinesa da Diabetes Management Self-efficacy Scale (C-DMSES) e da escala Diabetes Specific Quality of Life Scale (DSQL) antes e após a intervenção foram comparados entre os dois grupos. Resultados Os níveis de glicemia plasmática em jejum, glicemia pós-prandial de 2 horas e hemoglobina glicosilada no grupo Observação durante o parto foram inferiores aos do grupo Controle e antes da intervenção (P<0,05). A pontuação em cada dimensão da C-DMSES no grupo Observação após a intervenção foi maior do que no grupo Controle e antes da intervenção (P<0,05). Após a intervenção, as pontuações de tratamento, fisiologia, psicologia e relacionamento social na DSQL no grupo Observação foram significativamente inferiores às pontuações do grupo Controle e antes da intervenção (P<0,05). A taxa de incidência de complicações perioperatórias foi significativamente inferior no grupo Observação (10,42%) em comparação ao grupo Controle (31,25%) (P<0,05). Conclusão A intervenção de enfermagem com objetivos diversificados e orientados para gestantes com Diabetes Melitus pode controlar eficazmente os indicadores de glicemia, melhorar a capacidade de autogestão, reduzir a incidência de complicações perioperatórias e resultados neonatais adversos.

Resumen Objetivo Analizar los efectos de una intervención de enfermería con objetivos diversificados y dirigidos al período perinatal de pacientes con diabetes mellitus gestacional (DMG). Métodos Estudio prospectivo de 96 pacientes con DMG tratadas entre febrero de 2020 y febrero de 2023, seleccionadas y divididas de forma aleatoria en un grupo de observación (n=48) y un grupo de control (n=48). Las pacientes del grupo de control recibieron cuidados de enfermería de rutina, mientras que las del grupo de observación recibieron una intervención de enfermería con objetivos diversificados y dirigidos. Las tasas de incidencia de complicaciones perioperatorias y los resultados neonatales adversos e indicadores de glucosa en sangre se compararon entre los grupos, antes y después de la intervención, así como también el puntaje de la versión china de las escalas Diabetes Management Self-efficacy Scale (C-DMSES) y Diabetes Specific Quality of Life Scale (DSQL). Resultados Los niveles de glucemia en plasma en ayunas, la glucemia posprandial de 2 horas y la hemoglobina glucosilada en el grupo de observación durante el parto fueron inferiores que los del grupo de control y antes de la intervención (P<0,05). El puntaje de cada dimensión de la C-DMSES en el grupo de observación después de la intervención fue mayor que en el grupo de control y antes de la intervención (P<0,05). Después de la intervención, los puntajes de tratamiento, fisiología, psicología y relaciones sociales de la DSQL fueron significativamente inferiores en el grupo de observación que los puntajes del grupo de control y antes de la intervención (P<0,05). La tasa de incidencia de complicaciones perioperatorias fue significativamente inferior en el grupo de observación (10,42 %) en comparación con el grupo de control (31,25 %) (P<0,05). Conclusión La intervención de enfermería con objetivos diversificados y dirigidos a mujeres embarazadas con diabetes mellitus pudo controlar eficazmente los indicadores de glucemia, mejorar la capacidad de autogestión, reducir la incidencia de complicaciones perioperatorias y de resultados neonatales adversos.

Abstract Objective To assess the effect of goal diversified nursing intervention on the perinatal period of patients with gestational diabetes mellitus (GDM). Methods In this prospective study, 96 patients with GDM treated from February 2020 to February 2023 were selected and randomly divided into observation group (n=48) and control group (n=48). The patients in control group were given routine nursing, based on which those in observation group received goal-oriented diversified nursing intervention. The incidence rates of perioperative complications and adverse neonatal outcomes, and blood glucose indicators, the Chinese Version of the Diabetes Management Self-efficacy Scale (C-DMSES) score and the Diabetes Specific Quality of Life Scale (DSQL) score before and after intervention were compared between the two groups. Results The levels of fasting plasma glucose, 2-hour postprandial blood glucose and glycosylated hemoglobin in the observation group during delivery were lower than those in the control group and before intervention (P<0.05). The C-DMSES score in each dimension in the observation group after intervention was higher than that in the control group and before intervention (P<0.05). After intervention, the scores of treatment, physiology, psychology and social relationship in DSQL in the observation group were significantly lower than those in the control group and before intervention (P<0.05). The incidence rate of perioperative complications in the observation group (10.42%) was significantly lower than that in the control group (31.25%) (P<0.05). Conclusion Goal-oriented diversified nursing intervention can effectively control the blood glucose indicators, improve self-management ability, reduce the incidence of perioperative complications and adverse neonatal outcomes.

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Abstract Objective Evaluate the prevalence of macrosomic newborns (birth weight above 4000 grams) in a high-risk maternity from 2014 to 2019, as well as the maternal characteristics involved, risk factors, mode of delivery and associated outcomes, comparing newborns weighing 4000-4500 grams and those weighing above 4500 grams. Methods This is an observational study, case-control type, carried out by searching for data in hospital's own system and clinical records. The criteria for inclusion in the study were all patients monitored at the service who had newborns with birth weight equal than or greater than 4000 grams in the period from January 2014 to December 2019, being subsequently divided into two subgroups (newborns with 4000 to 4500 grams and newborns above 4500 grams). After being collected, the variables were transcribed into a database, arranged in frequency tables. For treatment and statistical analysis of the data, Excel and R software were used. This tool was used to create graphs and tables that helped in the interpretation of the results. The statistical analysis of the variables collected included both simple descriptive analyzes as well as inferential statistics, with univariate, bivariate and multivariate analysis. Results From 2014 to 2019, 3.3% of deliveries were macrosomic newborns. The average gestational age in the birth was 39.4 weeks. The most common mode of delivery (65%) was cesarean section. Diabetes mellitus was present in 30% of the deliveries studied and glycemic control was absent in most patients. Among the vaginal deliveries, only 6% were instrumented and there was shoulder dystocia in 21% of the cases. The majority (62%) of newborns had some complication, with jaundice (35%) being the most common. Conclusion Birth weight above 4000 grams had a statistically significant impact on the occurrence of neonatal complications, such as hypoglycemia, respiratory distress and 5th minute APGAR less than 7, especially if birth weight was above 4500 grams. Gestational age was also shown to be statistically significant associated with neonatal complications, the lower, the greater the risk. Thus, macrosomia is strongly linked to complications, especially neonatal complications.

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Background: Gestational diabetes mellitus (GDM) refers to diabetes diagnosed in the second or third trimester of pregnancy. Assessing the weight gain in each pregnant women's appointment is a common task of primary care during their visit. However, the implications of this increase in weight for the development of GDM are unknown. Objective: Evaluate if the greater than expected weight gain (HEWG) in pregnancy is a risk factor for the development of GDM. Methods: Analytical, observational, longitudinal, retrolective study, which included pregnant women between 15 and 40 years of age with complete follow-up of the preg-nancy with > 2 prenatal check-ups, somatometry and complete medical history was made. During follow-up, the GPME was determined. Odds ratio (OR) and 95% confi-dence intervals (95% CI) were calculated. Variables with significance were entered into a multiple logistic regression model (MLR), where the dependent variable was DMG. The sample size calculation was for convenience. Results: 1000 pregnant women with a median age of 28 years were included. In the MLR The pre-gestational body mass index (BMI) with overweight had an RM of 1.3 (95% CI 0.86-1.98), BMI with obesity an OR of 2.57 (95% CI 1.6-4.14), the HEWG during pregnancy had an OR 1.14 95% CI (0.71-1.81), Age> 30 years shows an RM of 2.24 (95% CI 1.55-3.25). Conclusions: HEWG during pregnancy is not an independent risk factor for the devel-opment of GDM. The main ones are age> 30 years and pre-gestational obesity.

Introducción: la diabetes mellitus gestacional (DMG) se refiere a la diabetes diagnosti-cada a partir del segundo trimestre del embarazo. Evaluar el incremento de peso de mu-jeres embarazadas es una labor habitual en la consulta del primer nivel de atención. Sin embargo, se desconocen las implicaciones que tiene este incremento ponderal para el desarrollo de DMG. Objetivo: evaluar si la ganancia ponderal mayor a la esperada (GPME) en el embarazo es factor de riesgo para el desarrollo de DMG. Métodos: estudio analítico, observacional, longitudinal, retrolectivo, que incluyó a em-barazadas de 15 a 40 años con seguimiento completo del embarazo con más de dos consultas de control prenatal, somatometría e historia clínica completa. Durante el se-guimiento se determinó la GPME. Se calculó razón de momios (RM) e intervalos de confianza del 95% (IC95%). Las variables con significancia se ingresaron a un modelo de regresión logística múltiple (RLM), en donde la variable de desenlace fue DMG. Resultados: se incluyeron a 1000 embarazadas con mediana de edad de 28 años. En la RLM el índice de masa corporal (IMC) pre-gestacional con sobrepeso tuvo una RM de 1.3 (IC95%: 0.86-1.98), IMC con obesidad una RM de 2.57 (IC95%: 1.6-4.14), la GPME durante el embarazo tuvo una RM de 1.14 (IC95%: 0.71-1.81) y la edad > 30 años una RM de 2.24 (IC95%: 1.55-3.25). Conclusiones: la GPME durante el embarazo no es un factor de riesgo independiente para el desarrollo de DMG. Los principales son la edad >30 años y la obesidad preges-tacional.

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INTRODUCTION: Gestational diabetes mellitus (GDM) is underdiagnosed in Mexico. Early GDM risk stratification through prediction modeling is expected to improve preventative care. We developed a GDM risk assessment model that integrates both genetic and clinical variables. RESEARCH DESIGN AND METHODS: Data from pregnant Mexican women enrolled in the 'Cuido mi Embarazo' (CME) cohort were used for development (107 cases, 469 controls) and data from the 'Mónica Pretelini Sáenz' Maternal Perinatal Hospital (HMPMPS) cohort were used for external validation (32 cases, 199 controls). A 2-hour oral glucose tolerance test (OGTT) with 75 g glucose performed at 24-28 gestational weeks was used to diagnose GDM. A total of 114 single-nucleotide polymorphisms (SNPs) with reported predictive power were selected for evaluation. Blood samples collected during the OGTT were used for SNP analysis. The CME cohort was randomly divided into training (70% of the cohort) and testing datasets (30% of the cohort). The training dataset was divided into 10 groups, 9 to build the predictive model and 1 for validation. The model was further validated using the testing dataset and the HMPMPS cohort. RESULTS: Nineteen attributes (14 SNPs and 5 clinical variables) were significantly associated with the outcome; 11 SNPs and 4 clinical variables were included in the GDM prediction regression model and applied to the training dataset. The algorithm was highly predictive, with an area under the curve (AUC) of 0.7507, 79% sensitivity, and 71% specificity and adequately powered to discriminate between cases and controls. On further validation, the training dataset and HMPMPS cohort had AUCs of 0.8256 and 0.8001, respectively. CONCLUSIONS: We developed a predictive model using both genetic and clinical factors to identify Mexican women at risk of developing GDM. These findings may contribute to a greater understanding of metabolic functions that underlie elevated GDM risk and support personalized patient recommendations.

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SUMMARY OBJECTIVE: The aim of this study was to compare the correlation of maternal visceral adiposity with sonographic variables related to fetal biometry in the second trimester of pregnancy in mothers who were previously obese versus nonobese and gestational diabetic versus nondiabetic. METHODS: This cross-sectional study included 583 pregnant women who received prenatal care between October 2011 and September 2013 at the Instituto de Medicina Integral Prof. Fernando Figueira, northeast of Brazil. Maternal visceral adiposity was measured by ultrasound examination at the same time as fetal biometry. Gestational age was 14.9±3.2 weeks. The correlation between maternal visceral adiposity and fetal biometric variables was evaluated using Pearson's correlation coefficient. Among the groups, the correlation coefficients were compared using Fisher's Z-test. This test was also used to evaluate the null hypothesis of correlation coefficients between pairs of variables. RESULTS: Maternal visceral adiposity positively correlated with fetal abdominal circumference, estimated fetal weight, head circumference, femur length, and biparietal diameter in pregnant women with obesity, nonobesity, gestational diabetes, and nondiabetes, but the correlation coefficients were statistically similar among the groups. CONCLUSION: Maternal visceral adiposity positively correlated with fetal biometry in the second trimester of pregnancy in the same manner in pregnant women previously obese and nonobese, as well as in pregnant women with gestational diabetes and nondiabetes.

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SUMMARY OBJECTIVE: The aim of this study was to compare the efficiency of fetal thymic-thoracic ratio and fetal thymus transverse diameter measurements in gestational diabetes mellitus. METHODS: Fetal thymic-thoracic ratio and fetal thymus transverse diameter were assessed in 360 pregnant women. Patients were examined in two groups: 180 gestational diabetes mellitus (study group) and 180 healthy pregnant women (control group). RESULTS: There were no statistically significant differences between the cases with gestational diabetes mellitus and the control group in terms of fetal thymus transverse diameter; however, the fetal thymic-thoracic ratio was found to be significantly lower in cases with gestational diabetes mellitus compared to that in the control group (p<0.001). CONCLUSION: The fetal thymic-thoracic ratio is superior to the fetal thymus transverse diameter in evaluating the fetal thymus size.

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ABSTRACT Objective: This study aims to evaluate the impact of morning-evening preference in pregnancy outcomes in gestational diabetes mellitus (GDM). Materials and methods: This is a prospective cohort study of 2nd-3rd trimester GDM outpatient care in Fortaleza, Brazil (2018-2020). Eveningness was defined by the Horne-Östberg Morningness-Eveningness-Questionnaire (MEQ ≤ 41). Furthermore, we obtained a 7-day actigraphic register. Subjective sleep quality, daytime somnolence, insomnia, fatigue and depressive symptoms were also evaluated. Associations with pregnancy outcomes were investigated. Results: Among 305 patients with GDM, evening preference was found in 21 (6.9%). Patients with evening preference had worse sleep quality (p < 0.01), greater severity of insomnia (p < 0.005), fatigue (p < 0.005) and depressive symptoms (<0.009). Evening chronotype was associated with preeclampsia [p = 0.01; OR = 0.27; CI 0.09-0.79] and a greater need for admission to a neonatal intensive care unit (NICU) [p = 0.02; OR = 0.23; CI .0.06-0.80]. A lower MEQ score confirmed an association with preeclampsia [p = 0.002; OR = 0.94; CI 0.90-0.97] and this was maintained after controlling for age, arterial hypertension, sleep quality, fatigue and depressive symptoms [p < 005; OR = 0.91; CI 0.87-0.95]. Conclusion: In GDM, patients with evening preference had worse sleep quality, more insomnia, fatigue, and depressive symptoms. Furthermore, eveningness was independently associated with preeclampsia. These results indicate the important role of eveningness in adverse pregnancy outcomes.

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Objective: This study aims to evaluate the impact of morning-evening preference in pregnancy outcomes in gestational diabetes mellitus (GDM). Methods: This is a prospective cohort study of 2nd-3rd trimester GDM outpatient care in Fortaleza, Brazil (2018-2020). Eveningness was defined by the Horne-Östberg Morningness-Eveningness-Questionnaire (MEQ ≤ 41). Furthermore, we obtained a 7-day actigraphic register. Subjective sleep quality, daytime somnolence, insomnia, fatigue and depressive symptoms were also evaluated. Associations with pregnancy outcomes were investigated. Results: Among 305 patients with GDM, evening preference was found in 21 (6.9%). Patients with evening preference had worse sleep quality (p < 0.01), greater severity of insomnia (p < 0.005), fatigue (p < 0.005) and depressive symptoms (<0.009). Evening chronotype was associated with preeclampsia [p = 0.01; OR = 0.27; CI 0.09-0.79] and a greater need for admission to a neonatal intensive care unit (NICU) [p = 0.02; OR = 0.23; CI .0.06-0.80]. A lower MEQ score confirmed an association with preeclampsia [p = 0.002; OR = 0.94; CI 0.90-0.97] and this was maintained after controlling for age, arterial hypertension, sleep quality, fatigue and depressive symptoms [p < 005; OR = 0.91; CI 0.87-0.95]. Conclusion: In GDM, patients with evening preference had worse sleep quality, more insomnia, fatigue, and depressive symptoms. Furthermore, eveningness was independently associated with preeclampsia. These results indicate the important role of eveningness in adverse pregnancy outcomes.

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AIM: To analyze the bibliometric indicators of the world scientific production on periodontal disease and gestational diabetes. MATERIALS AND METHODS: Bibliometric study in which a search strategy was designed with logical operators and MESH terms. After the search and application of selection criteria, 83 articles were included. SciVal, VOSviewer, and the Bibliometrix module of R Studio were used to analyze the metadata. RESULTS: From 2012 to 2021, there is evidence of an increase in scientific dissemination on gestational diabetes and periodontal disease, especially in high-impact journals (79.2%). SUNY Buffalo (6), United State University, and Ege University, Turkey (5) are the most productive; however, the one that received more citations than the global average was the University of Birmingham (FWCI: 5.59). In addition, the United States, Brazil, and India were the most influential countries; while, Graziani F, Akcali A, and Buduneli N, were the most representative authors. The Journal of Periodontology and the Journal of Clinical Periodontology published the most articles, with 13 and 6, respectively. CONCLUSIONS: The scientific production on periodontal disease and gestational diabetes is higher in recent years, with a better proportion of articles in high-impact journals. In addition, the United States concentrates many publications, and the activity of Chilean institutions stands out. CLINICAL SIGNIFICANCE: The clinical significance of this study lies in its capacity to synthesize the currently available published information regarding the correlation between periodontal disease and gestational diabetes. This study enables researchers and clinicians to ascertain the current level of knowledge on this subject.

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RESUMO Objetivo verificar a prontidão para via oral e aleitamento materno em recém-nascidos de mães diagnosticadas com diabetes mellitus gestacional (DMG). Métodos estudo observacional, analítico, quantitativo, do tipo caso-controle. Para avaliação da sucção não nutritiva, foi utilizado o Protocolo de Prontidão do Prematuro para Início da Alimentação por Via Oral - POFRAS e, para avaliação do desempenho em seio materno, o Protocolo de Acompanhamento Fonoaudiológico - Aleitamento Materno. A amostra foi estratificada em dois grupos, sendo o grupo experimental composto por recém-nascidos de mães diagnosticadas com DMG e o grupo-controle, por recém-nascidos de mães hígidas. Para a análise estatística, foram utilizados os testes Mann-Whitney, Shapiro Wilk e t de Student. Resultados a amostra total foi composta por 46 recém-nascidos, sendo 21 do grupo experimental e 25 do grupo-controle. Observou-se p<0,05 na comparação entre os grupos nas seguintes variáveis: oscilação do estado de consciência, hipotonia global, reflexo de procura débil, menos de cinco sucções por pausa na avaliação da sucção não nutritiva, pega em seio, adormecimento após iniciar sucção e posicionamento mãe-bebê. Conclusão recém-nascidos de mães diagnosticadas com DMG apresentaram maior dificuldade na prontidão para via oral e na prática do aleitamento materno nas primeiras 72 horas de vida, comparados aos filhos de mães hígidas.

ABSTRACT Purpose to verify the readiness for oral feeding and breastfeeding in newborns of mothers diagnosed with gestational diabetes mellitus (GDM). Methods observational, analytical, quantitative case-control study. For the evaluation of non-nutritive sucking, the PROFAS protocol was used and for the evaluation of performance at the mother's breast, the protocol of Speech Therapy - Breastfeeding. The sample was stratified into two groups, the experimental group, composed of newborns of mothers diagnosed with GDM, and the control group, with newborns of healthy mothers. For statistical analysis, the Mann-Whitney, Shapiro Wilk and Student's t tests were used. Results the total sample consisted of 46 newborns, 21 from the experimental group and 25 from the control group. P<0.05 was observed in the comparison between the groups in the variables: oscillation in the state of consciousness, global hypotonia, weak search reflex, less than five suctions per pause in the assessment of non-nutritive sucking, holding on to the breast, falling asleep after starting suction and mother-infant positioning. Conclusion newborns of mothers diagnosed with GDM had greater difficulty in readiness for oral feeding and in the practice of breastfeeding in the first 72 hours of life, compared to children of healthy mothers.

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ABSTRACT OBJETIVE To evaluate the association between the use of iron salts during the first two trimesters of gestation in non-anemic women and the development of gestational diabetes mellitus. METHODS The study used maternal data from the 2015 Pelotas Birth Cohort. All non-anemic women at the 24th week of gestation (n = 2,463) were eligible for this study. Gestational diabetes mellitus was self-reported by women. Crude and adjusted logistic regression were performed considering level of significance = 0.05. RESULTS Among the women studied, 69.7% were exposed to prophylactic iron supplementation in the first two trimesters of gestation. The prevalence of gestational diabetes mellitus among those exposed was 8.7% (95%CI: 7.4-10.1) and 9.3% (95%CI: 7.4-11.6) among those who were not exposed. Iron supplementation was not associated with increased risk of gestational diabetes mellitus in crude (OR = 0.9; 95%CI: 0,7-1,3) and adjusted analysis (OR = 1.1; 95%CI :0,8-1,6). CONCLUSIONS The results suggest that routine iron use in non-anemic pregnant women does not increase the risk of developing gestational diabetes. This evidence supports the existing national and international guidelines, in which prophylactic iron supplementation is recommended for all pregnant women as soon as they initiate antenatal care in order to prevent iron deficiency anemia.

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Resumen OBJETIVO: Describir la prevalencia de diabetes gestacional e hipertensión arterial en pacientes embarazadas con obesidad pregestacional. MATERIALES Y MÉTODOS: Estudio retrospectivo, transversal y descriptivo llevado a cabo en mujeres embarazadas con diagnóstico previo de obesidad (índice de masa corporal superior a 29.99) y con control prenatal. Parámetros evaluados: estilo de vida (alimentación, actividad física, consumo de alcohol, tabaco o alguna toxicomanía) y características físicas, clínicas y bioquímicas durante el embarazo actual por trimestre (índice de masa corporal, glucosa, presión arterial sistólica y diastólica). El diagnóstico de diabetes gestacional se estableció mediante una prueba de tolerancia a la glucosa entre las semanas 24 y 28 de embarazo. La hipertensión gestacional se diagnosticó por cifras de presión arterial mayores e iguales a 140-90 mmHg a partir de la semana 20 de embarazo y en ausencia de proteinuria. El análisis estadístico incluyó porcentajes, promedios e intervalos de confianza. RESULTADOS: La prevalencia de diabetes gestacional en embarazadas con obesidad fue 13.7% (IC95%: 9.6 a 17.9) y la de hipertensión gestacional en embarazadas con obesidad 7.4% (IC95%: 4.3 a 10.6). CONCLUSIÓN: La obesidad es un factor conocido de riesgos, en particular de diabetes e hipertensión en el embarazo. Su alta prevalencia hace necesario implementar campañas de prevención que favorezcan su reducción.

Abstract OBJECTIVE: To describe the prevalence of gestational diabetes and arterial hypertension in pregnant patients with pre-pregnancy obesity. MATERIALS AND METHODS: Retrospective, cross-sectional and descriptive study in pregnant women with a diagnosis of obesity prior to pregnancy (body mass index greater than 29.99) and with prenatal care. The sample size was 269 pregnant women. Lifestyle (diet, physical activity, alcohol, tobacco or drug addiction) and physical, clinical and biochemical characteristics during the current pregnancy were evaluated by gestational trimester (body mass index, glucose, systolic and diastolic blood pressure). The diagnosis of gestational diabetes was established by a glucose tolerance test between the 24th and 28th week of gestation and gestational hypertension was diagnosed by blood pressure figures greater than or equal to 140/90 mmHg from the 20th week of gestation and in the absence of proteinuria. Statistical analysis included percentages, means, and confidence intervals. RESULTS: The prevalence of gestational diabetes in obese pregnant women was 13.7% (95%CI: 9.6-17.9) and the prevalence of gestational hypertension in obese pregnant women was 7.4% (95%CI: 4.3-10.6). CONCLUSION: Obesity is a known risk factor, particularly for diabetes and hypertension in pregnancy. Its high prevalence makes it necessary to implement prevention campaigns to reduce it.

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ABSTRACT Objective This study aims to determine the effect of fruit consumption time on blood glucose regulation in pregnant women with gestational diabetes. Methods The study was carried out with 64 volunteer participants diagnosed with gestational diabetes. Participants who were directed to the Department of Nutrition and Dietetics were divided into two groups according to the order of application; Group 1 was included in the nutrition treatment program for a week, consuming fruit for the main meal and Group 2 for the snack. During this process, the participants were applied a personalized nutrition plan that was adjusted equally for macronutrients of all meals containing isocaloric 3 main and 4 snacks. In this process, blood glucose values were measured six times a day by the participants and the blood glucose results of both groups before starting the nutrition therapy and on the seventh day after starting the medical nutrition therapy were compared. Results The mean age of the women participating in the study was 33.50±4.95 years and 32.28±5.18 years for the 1st and 2nd groups, respectively, and the groups were similar in terms of anthropometric measurements. The post-diet average of postprandial blood glucose levels in the morning within each group dropped from 180mg/d to 115mg/dL (p<0,001) for Group 1 and from 185mg/dL to 110mg/dL (p<0,001) for Group 2. There was a decrease in the fasting plasma glucose and postprandial blood glucose levels measured in the morning, noon and evening before and after the medical nutrition therapy of the groups, but no statistically significant difference was found between the groups (p>0.05). All participants on the gestational diabetes diet had normal blood sugar levels without the need for insulin. A statistically significant decrease was observed in the postprandial blood glucose-fasting plasma glucose difference levels of the pregnant women in the group that consumed fruit for snacks (Group 2) on the seventh day of the study (p<0,001). There was no significant difference in the pre-diet and post-diet morning fasting plasma glucose values of both groups (p>0,05). Conclusion This study found that medical nutrition therapy in pregnant women with gestational diabetes led to a decrease in blood glucose levels, but consuming fruits as a snack or at the main meal did not make a significant difference on fasting plasma glucose and postprandial blood glucose. It was concluded that the type and amount of carbohydrates consumed daily in gestational diabetes are determinative on blood glucose level.

RESUMO Objetivo O objetivo deste estudo é determinar o efeito do tempo de consumo de fruta na regulação da glucose no sangue em mulheres grávidas com diabetes gestacional. Métodos Este estudo foi realizado com 64 participantes voluntários diagnosticados com diabetes gestacional. Os participantes que foram encaminhados para o Departamento de Nutrição e Dietética foram divididos em dois grupos, de acordo com a ordem da sua aplicação. O grupo 1 foi incluído no programa de tratamento médico nutricional durante uma semana, consumindo fruta para a refeição principal e o grupo 2 para os lanches. Neste processo, foi aplicado aos participantes um plano de nutrição personalizado, com isocalórico, 3 refeições principais e 4 lanches, os macronutrientes de todas as refeições foram ajustados igualmente. Neste processo, os valores de glicemia foram medidos seis vezes por dia pelos participantes, e foram comparados os resultados da glicemia de ambos os grupos antes de se iniciar a terapia nutricional médica e no sétimo dia após o início da terapia nutricional médica. Resultados A idade média das mulheres que participaram no estudo foi de 33,50±4,95 e 32,28±5,18 anos para o 1º e 2º grupos, respetivamente, e não houve diferença entre os grupos em termos de medidas antropométricas. A glicemia média pós-prandial de manhã após terapia nutricional médica dentro dos grupos variou entre 180mg/d a 115mg/dL (p<0,001) para o Grupo 1, e de 185mg/dL a 110mg/dL para o Grupo 2 (p<0,001). Houve uma diminuição nos níveis de glicemia em jejum e glicemia média pós-prandial medidos de manhã, meio-dia e noite antes e depois da terapia nutricional médica dos grupos, mas não houve diferença estatisticamente significativa entre os grupos (p>0,05). Os níveis de açúcar no sangue de todos os participantes na dieta diabetes gestacional baixaram para níveis normais sem necessidade de terapia com insulina. Uma diminuição estatisticamente significativa foi observada no sétimo dia do estudo nos níveis de diferença do glicemia média pós-prandial-glicemia em jejum das mulheres grávidas do grupo que consumiram fruta como aperitivo (Grupo 2). (p<0.001). Não houve diferença significativa nos valores de glicemia em jejum matinal de ambos os grupos antes e depois da dieta (p>0,05). Conclusão Como resultado deste estudo, verificou-se que a terapia nutricional levou a uma diminuição do açúcar no sangue em mulheres grávidas com diabetes gestacional, mas o consumo de fruta como lanche ou refeição principal não fez uma diferença significativa no jejum e na glucose do sangue pós-prandial. Concluiu-se que o tipo e a quantidade de hidratos de carbono consumidos diariamente na diabetes gestacional são determinantes para o nível de glicose no sangue.

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ABSTRACT Introduction: Gestational Diabetes is a group of metabolic disorders that result in glucose intolerance during pregnancy. Among the range of treatments are diet, continuous use of medication, and psychological monitoring. Since it is a multidisciplinary treatment, a proper protocol is vital for a favorable outcome. In addition, there are questions about the benefits of physical activity as a complementary therapy. Objective: To verify the impact of adding exercise to the hospital protocol for patients with gestational diabetes, both on the risks of type 2 diabetes in pregnant women and on the obesity of their offspring. Methods: Sixty pregnant women diagnosed with Gestational Diabetes were randomly divided into control and intervention groups. Both groups received specific treatment and intervention, and the experimental group practiced controlled moderate-intensity physical activity (125-146bpm). Morning blood samples were collected from both groups to check fasting glucose and insulin levels, indicators of lipid metabolism, low and high-density lipoprotein cholesterol, apolipoprotein B. The Brog scale measured the fatigue level. In addition, the premature rupture of membranes, postpartum hemorrhage, neonatal asphyxia, macrosomia, and others was checked. Results: The peripheral blood total cholesterol levels were 5.93, 5. 38, low-density lipoprotein cholesterol levels were 2.95 before versus 2.64 after, and apolipoprotein B levels were 1.84 versus 1.59 in the control group, high-density lipoprotein cholesterol content increased from 1.74 to 1.88, blood cholesterol, and apolipoprotein B levels after the intervention in the experimental group were lower than those in the control group, with an elevation of high-density lipoprotein cholesterol. Conclusion: Aerobic exercise proved to be more appropriate for patients with gestational diabetes in the later stages of pregnancy and may also be adapted for bedridden patients refractory to traditional drugs. Evidence Level II; Therapeutic Studies - Investigating the result.

RESUMO Introdução: O Diabetes Gestacional é um grupo de desordens metabólicas que resultam na intolerância à glicose durante a gravidez, dentre o leque de tratamentos está a dieta, o uso continuo de medicamentos, e acompanhamento psicológico. Por ser um tratamento multidisciplinar, é importante que haja um protocolo adequado para um desfecho favorável. Há questionamentos quanto aos benefícios de atividades físicas como terapia complementar. Objetivo: Verificar o impacto da adição de exercícios ao protocolo hospitalar para pacientes com diabetes gestacional, tanto nos riscos de diabetes tipo 2 em grávidas quanto na obesidade de seus descendentes. Métodos: Sessenta mulheres grávidas que foram diagnosticadas com Diabetes Gestacional foram aleatoriamente divididas em grupos controle e intervenção. Ambos grupos receberam tratamento e intervenção específicos e o grupo experimental praticou atividade física de intensidade moderada controlada (125-146bpm). Amostras de sangue em jejum matinal foram coletados em ambos os grupos para verificar níveis de glicose e insulina em jejum, indicadores de metabolismo lipídico, colesterol lipoproteico de baixa e alta densidade, apolipoproteína B. Verificou-se também o nível de fadiga pela escala Brog, ruptura prematura de bolsa, hemorragia pós-parto, asfixia neo-natal, macrossomia entre outros. Resultados: Os níveis de colesterol total no sangue periférico foram de 5,93, 5.38, os níveis de colesterol lipoproteico de baixa densidade foram 2,95 antes contra 2,64 depois e os níveis de apolipoproteína B foram 1,84 contra 1,59 no grupo controle, o conteúdo de colesterol lipoproteico de alta densidade aumentou de 1,74 para 1,88, os níveis de colesterol, e apolipoproteína B sanguíneos depois da intervenção no grupo experimental foram menores que os do grupo controle, com elevação do colesterol lipoprotéico de alta densidade. Conclusão: O exercício aeróbico mostrou-se mais adequado para pacientes com diabetes gestacional nos estágios posteriores da gravidez, podendo ser adaptado inclusive para as pacientes acamadas refratárias aos fármacos tradicionais. Nível de evidência II; Estudos Terapêuticos - Investigação de Resultados.

Resumen Introducción: La diabetes gestacional es un grupo de trastornos metabólicos que dan lugar a una intolerancia a la glucosa durante el embarazo. Entre la gama de tratamientos se encuentra la dieta, el uso continuado de medicamentos y el seguimiento psicológico. Al tratarse de un tratamiento multidisciplinar, es importante contar con un protocolo adecuado para obtener un resultado favorable. Existen dudas sobre los beneficios de la actividad física como terapia complementaria. Objetivo: Comprobar el impacto de añadir el ejercicio al protocolo hospitalario para pacientes con diabetes gestacional, tanto en los riesgos de diabetes tipo 2 en las mujeres embarazadas como en la obesidad de su descendencia. Métodos: Sesenta mujeres embarazadas a las que se les diagnosticó diabetes gestacional fueron divididas aleatoriamente en grupos de control y de intervención. Ambos grupos recibieron un tratamiento y una intervención específicos y el grupo experimental practicó una actividad física controlada de intensidad moderada (125-146bpm). Se tomaron muestras de sangre en ayunas por la mañana de ambos grupos para comprobar los niveles de glucosa e insulina en ayunas, los indicadores del metabolismo de los lípidos, el colesterol de lipoproteínas de baja y alta densidad, la apolipoproteína B. También se comprobó el nivel de fatiga según la escala de Brog, la rotura prematura de bolsa, la hemorragia posparto, la asfixia neonatal y la macrosomía, entre otros. Resultados: Los niveles de colesterol total en sangre periférica fueron de 5,93, 5. 38, los niveles de colesterol de lipoproteínas de baja densidad eran de 2,95 antes frente a 2,64 después y los niveles de apolipoproteína B eran de 1,84 frente a 1,59 en el grupo de control, el contenido de colesterol de lipoproteínas de alta densidad aumentó de 1,74 a 1,88, el colesterol en sangre y los niveles de apolipoproteína B después de la intervención en el grupo experimental fueron inferiores a los del grupo de control, con una elevación del colesterol de lipoproteínas de alta densidad. Conclusión: El ejercicio aeróbico resultó ser más apropiado para las pacientes con diabetes gestacional en las últimas fases del embarazo, y puede adaptarse incluso a las pacientes encamadas y refractarias a los fármacos tradicionales. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.

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Introduction: Gestational diabetes mellitus (GDM) is defined as glucose intolerance diagnosed during pregnancy. This pathology can be associated with maternal and feto-neonatal complications, both in the short and long term. The prevalence of GDM in Argentina (based on the diagnostic criteria of the Latin American Diabetes Association (ALAD), is estimated between 7.5-10% of pregnant women. Information in Argentina on the incidence of GDM is scarce. The objective of this work was to estimate the incidence of GDM, evaluate its treatment and the frequency of screening for postpartum reclassification of diabetes in a population of pregnant women treated at a private hospital in the city of Buenos Aires. Materials and methods: Retrospective cohort of pregnant women evaluated at the Hospital Italiano de Buenos Aires, Argentina between 2015 and 2018. Results: The cumulative incidence of GDM was 7.6% (95% CI 7.0-8, two). All patients received nutritional advice (food plan). Of the total number of pregnant women studied 229 (39.3%) required pharmacological treatment; Of these, 97 patients received insulin (16.7%) and 132 metformin (22.7%). Regarding the follow-up of the pathology, between six weeks and one year postpartum, 267 women (45.9%) underwent diabetes screening for reclassification. Screening frequency was higher in the insulin-treated group. Of the patients who underwent screening, 36 women (13.5%) had impaired fasting blood glucose, 16 women (6.0%) had impaired glucose tolerance, and 3 women (1.1%) were diagnosed with type 2 diabetes mellitus. two.Of these, 36 women (13.5%) had impaired fasting blood glucose, 16 women (6.0%) had impaired glucose tolerance, and 3 women (1.1%) were diagnosed with type 2 diabetes mellitus. Conclusion: GDM incidence was 7.6%. Less than half of the women diagnosed with GDM required pharmacological treatment. The frequency of diabetes screening up to one year postpartum for reclassification was similar to that reported.

Introducción: La diabetes mellitus gestacional (DMG) se define como la intolerancia a la glucosa diagnosticada en el embarazo. Esta patología puede asociarse a complicaciones maternas y feto-neonatales, tanto a corto como a largo plazo. La prevalencia de DMG en Argentina (basada en el criterio diagnóstico de la Asociación Latinoamericana de Diabetes (ALAD), se estima entre 7,5-10% de las mujeres embarazadas.  Es escasa la información en Argentina sobre la incidencia de DMG. El objetivo de este trabajo fue estimar la incidencia de DMG, evaluar su tratamiento y la frecuencia de tamizaje para reclasificación postparto de la diabetes en una población de mujeres embarazadas atendidas en un hospital privado de la ciudad de Buenos Aires. Materiales y métodos: cohorte retrospectiva de embarazadas evaluadas en el Hospital Italiano de Buenos Aires, Argentina entre los años 2015 a 2018. Resultados: La incidencia acumulada de DMG fue 7,6 % (IC 95% 7,0-8,2). Todas las pacientes recibieron consejo nutricional (plan alimentario). Del total de embarazadas estudiadas requirieron tratamiento farmacológico 229 (39.3%); recibieron insulina 97 (16,7%) y 132 metformina (22,7%). En cuanto al seguimiento de la patología, entre las seis semanas y el año postparto realizaron tamizaje de diabetes para reclasificación 267 mujeres (45,9%). La frecuencia de tamizaje fue mayor en el grupo tratado con insulina. De las pacientes que realizaron el tamizaje, presentaron glucemia alterada en ayuno 36 mujeres (13,5%), tolerancia a la glucosa alterada 16 mujeres (6,0%) y 3 mujeres (1,1%) fueron diagnosticadas con diabetes mellitus tipo 2. Conclusión: la incidencia de DMG fue 7,6%. Menos de la mitad de las mujeres diagnosticadas con DMG requirió tratamiento farmacológico. La frecuencia de tamizaje de diabetes hasta el año postparto para la reclasificación similar a la reportada.

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Objective: To estimate the point prevalence and likely ranges of pregnancy-induced hypertension, pre-eclampsia, gestational diabetes, low birth weight and preterm delivery in Latin America and the Caribbean, and evaluate the heterogeneity of the estimates. Methods: We conducted a systematic review and meta-analysis of observational studies reporting the prevalence of maternal and perinatal adverse outcomes in populations in Latin American and the Caribbean published between 2000 and 2019 in English, Spanish, or Portuguese. We searched PubMed, Embase, and LILACS. We estimated the point prevalence and evaluated overall heterogeneity and, in sub-group analyses, heterogeneity by study design and level of bias. Results: Of 1087 records retrieved, 50 articles were included in the review: two on hypertensive disorders of pregnancy, 14 on pre-eclampsia, six on gestational diabetes, nine on low birth weight and 19 on preterm birth. No meta-analysis for hypertensive disorders of pregnancy could be done because of the small number of studies. Point prevalence estimates and 95% confidence intervals (CIs) for pre-eclampsia, gestational diabetes, low birth weight, and preterm birth were: 6.6% (95% CI: 4.9%, 8.6%), 8.5% (95% CI: 3.9%, 14.7%), 8.5% (95% CI: 7.2%, 9.8%), and 10.0% (95% CI: 8.0%, 12.0%), respectively. We observed substantial heterogeneity overall and by study design. No major differences in estimates were observed by level of bias. Conclusions: The results of this study provide updated estimates of some of the most prevalent adverse pregnancy and perinatal outcomes in Latin America and the Caribbean. They highlight that important heterogeneity exists in prevalence estimates, which may reflect the diversity of populations in the region.

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ABSTRACT Objective To compare the major outcomes of use of metformin and glyburide in treatment of gestational diabetes mellitus. Methods Studies published in English, in the last 10 years, in the databases MEDLINE®, SciELO, LILACS and Cochrane Library were analyzed, and randomized controlled trials were selected. Health Sciences Descriptors were used to compose the search phrase, and the keywords "Gestational diabetes", "Glyburide", "Metformin" and their variations were searched in the Medical Subject Headings. PRISMA systematization was used to prepare this review, and a meta-analysis was conducted aiming to mathematically show the results of fasting blood glucose, postprandial blood glucose, birth weight and weight gain during pregnancy after using metformin and glyburide. Results The studies evaluated birth weight, neonatal hypoglycemia, mode of delivery, need for intensive care, Apgar score, macrosomia, fasting glucose, postprandial glucose and weight gain during pregnancy. In 60% of studies, there were no statistically significant differences regarding safety and efficacy of administration of metformin and glyburide. Meta-analysis demonstrated the absence of statistical differences between these drugs in fasting blood glucose (p=0.821), postprandial blood glucose (p=0.217) and birth weight (p=0.194). However, significant differences were shown in weight gain during pregnancy (p=0.036). Conclusion The methods are effective, but the adverse effects of glyburide are more common; therefore, the use of metformin should be recommended, if in monotherapy.

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ABSTRACT Objective. To estimate the point prevalence and likely ranges of pregnancy-induced hypertension, pre-eclampsia, gestational diabetes, low birth weight and preterm delivery in Latin America and the Caribbean, and evaluate the heterogeneity of the estimates. Methods. We conducted a systematic review and meta-analysis of observational studies reporting the prevalence of maternal and perinatal adverse outcomes in populations in Latin American and the Caribbean published between 2000 and 2019 in English, Spanish, or Portuguese. We searched PubMed, Embase, and LILACS. We estimated the point prevalence and evaluated overall heterogeneity and, in sub-group analyses, heterogeneity by study design and level of bias. Results. Of 1087 records retrieved, 50 articles were included in the review: two on hypertensive disorders of pregnancy, 14 on pre-eclampsia, six on gestational diabetes, nine on low birth weight and 19 on preterm birth. No meta-analysis for hypertensive disorders of pregnancy could be done because of the small number of studies. Point prevalence estimates and 95% confidence intervals (CIs) for pre-eclampsia, gestational diabetes, low birth weight, and preterm birth were: 6.6% (95% CI: 4.9%, 8.6%), 8.5% (95% CI: 3.9%, 14.7%), 8.5% (95% CI: 7.2%, 9.8%), and 10.0% (95% CI: 8.0%, 12.0%), respectively. We observed substantial heterogeneity overall and by study design. No major differences in estimates were observed by level of bias. Conclusions. The results of this study provide updated estimates of some of the most prevalent adverse pregnancy and perinatal outcomes in Latin America and the Caribbean. They highlight that important heterogeneity exists in prevalence estimates, which may reflect the diversity of populations in the region.

RESUMEN Objetivo. Estimar la prevalencia puntual y los rangos probables de hipertensión provocada por embarazo, preeclampsia, diabetes gestacional, peso bajo al nacer y parto prematuro en América Latina y el Caribe, y evaluar la heterogeneidad de las estimaciones. Métodos. Se llevó a cabo una revisión sistemática y metanálisis de los estudios de observación que notificaron la prevalencia de resultados adversos perinatales y maternos en poblaciones de América Latina y el Caribe, publicados entre los años 2000 y 2019 en inglés, español o portugués. Se realizaron búsquedas en PubMed, Embase y LILACS. Se estimó la prevalencia puntual y se evaluó la heterogeneidad general y, en los análisis de subgrupos, la heterogeneidad según el diseño del estudio y nivel de sesgo. Resultados. De 1 087 registros recuperados, se incluyeron 50 artículos en la revisión: 2 sobre los trastornos hipertensivos en el embarazo, 14 sobre preeclampsia, 6 sobre la diabetes gestacional, 9 sobre peso bajo al nacer y 19 sobre parto prematuro. No se pudo realizar ningún metanálisis de los trastornos hipertensivos del embarazo debido al número reducido de estudios. Las estimaciones de prevalencia puntual y los intervalos de confianza (IC) del 95% para la preeclampsia, la diabetes gestacional, el peso bajo al nacer y el parto prematuro fueron: 6,6% (IC de 95%: 4,9%, 8,6%), 8,5% (IC de 95%: 3,9%, 14,7%), 8,5% (IC de 95%: 7,2%, 9,8%) y 10,0% (IC de 95%: 8,0%, 12,0%), respectivamente. Se observó una heterogeneidad significativa en general, así como según el diseño del estudio. No se advirtieron grandes diferencias en las estimaciones según el nivel del sesgo. Conclusiones. Los resultados de este estudio ofrecen cálculos actualizados de algunos de los resultados adversos perinatales y del embarazo con mayor prevalencia en América Latina y el Caribe. Estos resultados ponen de manifiesto que existe una gran heterogeneidad en las estimaciones de prevalencia, que podría reflejar la diversidad de la población de la región.

RESUMO Objetivo. Estimar a prevalência pontual e os intervalos prováveis de hipertensão induzida pela gravidez, pré-eclâmpsia, diabetes gestacional, baixo peso ao nascer e parto prematuro na América Latina e no Caribe e avaliar a heterogeneidade das estimativas. Métodos. Realizou-se uma revisão sistemática com metanálise de estudos observacionais que relatam a prevalência de desfechos maternos e perinatais adversos em populações da América Latina e do Caribe, publicados entre 2000 e 2019 em inglês, espanhol ou português. Os bancos de dados PubMed, Embase e LILACS foram pesquisados. Estimou-se a prevalência pontual e avaliou-se a heterogeneidade geral, bem como, em análises de subgrupo, a heterogeneidade por delineamento do estudo e o nível de viés. Resultados. De 1 087 registros encontrados, 50 artigos foram incluídos na revisão: dois sobre distúrbios hipertensivos da gravidez, 14 sobre pré-eclâmpsia, seis sobre diabetes gestacional, nove sobre baixo peso ao nascer e 19 sobre parto prematuro. Não foi possível realizar metanálise para distúrbios hipertensivos da gravidez devido ao pequeno número de estudos. As estimativas de prevalência pontual e intervalos de confiança de 95% (IC) para pré-eclâmpsia, diabetes gestacional, baixo peso ao nascer e parto prematuro foram: 6,6%; (IC 95%: 4,9-8,6%), 8,5% (IC 95%: 3,9-14,7%), 8,5% (IC 95%: 7,2-9,8%) e 10,0% (IC 95%: 8,0-12,0%), respectivamente. Observou-se heterogeneidade considerável, tanto em geral como por delineamento de estudo. Não foram observadas diferenças importantes nas estimativas por nível de viés. Conclusões. Os resultados deste estudo fornecem estimativas atualizadas de alguns dos desfechos gestacionais e perinatais adversos mais prevalentes na América Latina e no Caribe. Destacam a existência de uma importante heterogeneidade nas estimativas de prevalência, o que pode refletir a diversidade das populações da região.