Diabetes mellitus gestacional na atenção primária à saúde: análise da prevalência e da relação com desfechos neonatais e infantis

Abstract

Objective: To analyze the prevalence of gestational diabetes mellitus (GDM) and its relationship with neonatal and infant outcomes among users of Primary Health Care. Methods: Cross-sectional study conducted from December 2022 to December 2024 in five Basic Health Units (UBS) in Passo Fundo, RS. The study included women aged 12 years or older with children up to 24 months old who were receiving pediatric follow-up care at the mentioned UBS. The main exposure of interest was the self-reported prevalence of gestational diabetes mellitus by the participants at the time of the interview. The evaluated outcomes were fetal macrosomia, mode of delivery, prematurity, and propensity to childhood obesity. Data analysis used descriptive statistics (n, %) and the chi-square test to verify the distribution of outcome prevalences according to exposures, adopting a statistical significance level of p < 0.05. Results: The sample consisted of 382 participants, with 378 questionnaires answered exclusively by mothers and 4 by fathers or guardians. The total number of child records was 392, considering that 5 pairs of twins were included in the sample. Most mothers selfidentified as White (51.9%), were aged 19 to 35 years (81.5%), had completed high school (37.0%), had a family income of 1 to 3 minimum wages (60.6%), and were physically inactive during leisure time in the postpartum period (77.3%). The prevalence of GDM was 10.6% (95% CI). There was a 50.0% cesarean delivery rate, 12.6% prematurity, 4.1% fetal macrosomia, and 0.6% propensity to childhood obesity. No statistically significant associations were found between GDM and the evaluated outcomes in the studied sample. Conclusion: The prevalence of GDM found in the sample was consistent with frequencies reported in national and international literature. There was no significant relationship between neonatal and infant outcomes and GDM, which may be explained by the effectiveness of prenatal care provided in Primary Health Care. The findings reinforce the importance of qualified prenatal care and the role it plays in reducing pregnancy-related complications. They also indicate the need to expand the sample for greater statistical robustness.