Cardiovascular Consequences in Newborn to Pregnant Women With Gestational Diabetes Mellitus: An Integrative Review

Abstract

Among maternal physiological changes during the gestational period, one of the most favorable characteristics to be developed is hyperglycemia which, in the case of mothers with a predisposition to Diabetes Mellitus, can generate Gestational Diabetes Mellitus (GMD) which can negatively affect fetal development in as a result of metabolic changes. Objective: To identify possible cardiovascular alterations in the offspring as a consequence of Gestational Diabetes Mellitus in pregnant women. Methodology: An integrative literature review was carried out, based on the following databases: National Library of Medicine and National Institutes of Health (PUBMED), Embase via PUBMED and Cochrane Library, selecting articles from the last 7 years, of the type of studies randomized and randomized clinical trials, with the full text freely available, except for two articles, one from 2007 and 2015, which contributed to the discussion of this integrative review. Not including reviews, duplicates, studies that did not fit the guiding question or with inconclusive results. The following descriptors in English were used: "Effects", "Results", "Consequences", "Associations", "Cardiac", "Children", "Newborn", "Offspring", "Gestational diabetes" and "Gestational diabetes mellitus" In the search, 11,227 articles were found, of which 9 studies were considered relevant to answer the guiding question. Results and Discussion: For discursive purposes, the research highlighted the indispensability of glycemic control in pregnant women and proposed that the alteration in the offspring of diabetic mothers has very significant consequences on the cardiovascular development of the intrauterine fetus and the newborn, resulting in dysfunctions in the cardiac cycle. Changes in myocardial contractility and delay in conduction of electrocardiographic waves converge the significance of the relationship between Gestational Diabetes Mellitus and cardiovascular pathologies to be evolved with child development. Furthermore, the association between cardiac morbidities and the birth of larger-for-gestational-age fetuses, both as a result of MGD, is extremely relevant, as macrosomia is found to be a precursor factor for heart disease. Final considerations: Therefore, clinical trials showed the importance of glycemic monitoring during pregnancy, in which the present research gathered studies with scientific relevance that intersect with the understanding of the increased risk of morbidity and mortality due to cardiovascular metabolic changes due to the occurrence of Diabetes Mellitus during pregnancy. Therefore, it is important that the newborns of mothers with this clinical condition are assisted, in addition to greater foundation of the theme with prospective scientific data for the evaluation of other possible cardiovascular alterations that children may acquire posteriori as a result of cardiac alterations in physiology of the newborn.