[Diabetic pregnancy: outpatient follow-up in a Brazilian University Hospital].
In this study we assessed neonatal complications of diabetic in 50 pregnant women at a University Hospital during 2001-2002: 13 (26%) with type 1 diabetes (DM1), 16 with DM2, and 21 (42%) with gestational DM (GDM). The mean outpatient follow-up was at 16.3+/-8 wk for patients with DM1, 22.9+/-7.5 wk for DM2, and 26.0+/-8.9 wk for GDM. Mean HbA1c, fasting and 2-h post-prandial glycemia on first attendance were respectively: 6.1+/-1,1% (RV: 2.6-6.2%), 132+/-39 mg/dL and 190+/-54 mg/dL. 22 patients were on insulin and 15 were on oral antidiabetic agents (OA) at first evaluation. OA were taken on conception and during the first pregnancy trimester and no malformations were seen in the children. Their metabolic profile was similar to other pregnant women. Caesarean section was needed in 54.5% of deliveries.


RESULTS
56.1% were macrosomic babies, with a mean fetal weight of 3.48+/-0.73 Kg, with no differences according to treatment (insulin vs. OA). We conclude that diabetic pregnant women begin their prenatal care at a later period, often taking OA that are not officially advised to be used during pregnancy and are not in a regular metabolic control. As a result, they have macrosomic infants. Even though we have found no complications related to the OA use during pregnancy, we should not encourage their use until more safety studies are available.
Corrêa
Fernanda H S
FH
Departamento de Medicina Interna, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ. mspfhc@uninet.com.br
Gomes
Marília de Brito
MB
D000328:Adult; D001938:Brazil; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D016640:Diabetes, Gestational / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome