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BIBTEX RIS

Altered maternal metabolism during mild gestational hyperglycemia as a predictor of adverse perinatal outcomes: A comprehensive analysis

2019; Elsevier BV; Volume: 1866; Issue: 2 Linguagem: Inglês

10.1016/j.bbadis.2019.05.014

1879-260X

Marilza Vieira Cunha Rudge, Angélica Mércia Pascon Barbosa, Luis Sobrevía, Rafael Bottaro Gelaleti, Raghavendra L. S. Hallur, João Paulo Castro Marcondes, Daisy Maria Fávero Salvadori, Caroline Baldini Prudêncio, Cláudia Garcia Magalhães, Roberto Costa, Joélcio Francisco Abbade, José Eduardo Corrente, Iracema de Mattos Paranhos Calderon, Marilza Vieira Cunha Rudge, Iracema de Mattos Paranhos Calderon, Ana Paula Barbosa, Joélcio Francisco Abbade, Roberto Costa, Cláudia Garcia Magalhães, Daisy Maria Fávero Salvadori, Rafael Bottaro Gelaleti, Raghavendra L. S. Hallur, J. P. C. Marcondes, Juliana Ferreira Floriano, David Rafael Abreu Reyes, Luis Sobrevía, Caroline Baldini Prudêncio, Fernanda Pículo, G Marini, Giovana Vesentini, Glilciane Morceli, Carlos Antônio Negrato, H.D. Prazeres, S. Molina, Marina Donária Chaves Arantes, Ana Cláudia Molina Cavassini, Luciane Teresa Rodrigues Lima Kerche, Ana Karina C. De Luca, Simone Corrêa-Silva, Estela Bevilacqua, Jusciéle Brogin Moreli, Luciana Pietro, Sílvia Daher, S. Fabio, Adenilda Cristina Honório‐França, Adriele Ataídes de Queiroz, Cristiane Castro Pernet Hara, C.A.L. Boraschi, T.A.V.L. Pauletti, Lois Jovanovič, Adriano Días, Álvaro Nagib Atallah, María Dolores Burguete Ramos, Maria Aparecida Mourão Brasil, Cibele Vieira Cunha Rudge, Aparecida Tristão, Ulisses Del Nero, Marina Mendonça, Steven S. Witkin, Carlos Izaias Sartorão Filho, Sthefanie K. Nunes, Fabiane A. Pinheiro, S.V. Quiroz, T. Pascon, T. D. Caldeirão, A.P. Oliveira, Bianca F. Nicolosi, Cláudia Vicari Bolognani, Danny Laura Gomes Fagundes, Isabel Cristina Franco Salem Llanos, Joice Monaliza Vernini, L.B.S.M. Reis, Mariana Pinto Sirimarco, Nicola Basso, N.A.Q. Maquesim, S.A.L.C. Silva, S.C. Silva, T.T. Scudeller, Wilson Ayach, Ana Paula Moura de Almeida, Bianca F. Nicolosi, Camille Pinto de Lima, Daniele Luminoso, Fabiano Candal Vasconcellos, Rafael Augusto Ferraz, H. Migiolaro, Luciane Pires de Camargo, M MACEDO, Meline Rossetto Kron Rodrigues, P.H.O. Anézio,

Birth, Development, and Health

Mild gestational hyperglycemia (MGH), as assessed using the normal oral glucose tolerance test (OGTT) and detection of an altered glycemic profile, is associated with adverse perinatal outcome. This study described the results of 40 years of research conducted at the Perinatal Diabetes Research Centre at São Paulo State University (UNESP), Brazil, on the maternal MGH environment and placental markers. This study also described the unidirectional relationship between MGH and excessive fetal growth, also supplying moderator analysis. In addition to hyperglycemia, MGH is associated with an increased incidence of hypertension, metabolic syndrome, persistent insulin resistance after pregnancy, and high risk of developing type 2 diabetes mellitus (T2DM) after pregnancy. Structural changes and functional abnormalities resulting from MGH were observed in placenta. The fully adjusted model concluded that the predictor variable (MGH), which creates a complex environment for the fetus, has a direct effect on excessive birth weight and produces a z-score for ratios of birth weight to gestational age of ≥2. Maternal age, pre-pregnancy BMI, number of previous pregnancies, numbers of prenatal visits, and 1 h OGTT are moderator variables that impact MGH and excessive fetal growth. These results show that maternal MGH has some characteristics associated with similar long-term T2DM development and similar adverse perinatal results to those of gestational diabetes mellitus (GDM) mothers, making it an intermediate maternal and placental marker between normoglycemic and GDM mothers.