Diabetes nos partos hospitalares em sistemas de saúde público e privado

Abstract

OBJETIVE:To analyze trends of diagnoses of diabetes mellitus in hospital deliveries. METHODS:Transversal study analyzing data on hospital deliveries for pregnant women living in Ribeirao Preto, SP, from 1998 to 2007. The data on diabetes mellitus in pregnancy were obtained from the Faculdade de Medicina de Ribeirao Preto of the Universidade de São Paulo Hospital Data Processing Center. The data analyzed were: age group, type of delivery (vaginal or cesarean), length of hospitalization and type of care: public (SUS) or private (private and supplemented health care). RESULTS:There was a 3.9 fold increase in the proportion of deliveries with a record of diabetes in relation to the total number of births (p = 0.01). This increase was of 4.5 times in deliveries in the public health care system (p = 0.01) and 3 times in private care. An increase in the presence of diabetes was observed in all age groups, proportionally larger in lower age groups. The frequency of cesarean delivery in pregnancies which recorded diabetes fell from 64.5% in 1998/1999 to 39.8% in 2006/2007 in the public system; in the private system the frequency remained over 90%. CONCLUSIONS:The presence of diabetes mellitus in hospital deliveries increased throughout the two year periods, despite a fall in the overall number of deliveries and an increase in the number of women of childbearing age living in Ribeirao Preto. This trend means that not only diagnosis and treatment, but also pre-pregnancy interventions which may reverse it are called for.

Review of profile and prenatal care for women with gestational diabetes mellitus

“…This study demonstrated a significant frequency of cesarean delivery. Similar results were identified in pregnant women with gestational diabetes mellitus in Ribeirão Preto-SP and previous studies conducted in the maternity ward of current research (8)(9)(10)(11) .…”

“…The glucose monitoring is an essential care to improve the obstetric prognosis of diabetes pregnancies, since hyperglycemia is considered the most important determinant of obstetrical risks (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) .…”

“…The condition of high risk pregnancies requires guidance from professionals with diverse approaches to change behaviour related to lifestyle. Approaches require strategies such as health education for better understanding about the pathology of diabetic pregnant women, increasing the level of confidence and motivation for self-care (5)(6)(7)(8)(9)(10)(11)(12)(13) .…”

Review of profile and prenatal care for women with gestational diabetes mellitus

“…This study demonstrated a significant frequency of cesarean delivery. Similar results were identified in pregnant women with gestational diabetes mellitus in Ribeirão Preto-SP and previous studies conducted in the maternity ward of current research (8)(9)(10)(11) .…”

A portrait of gestational diabetes mellitus in Brazil: A systematic review and meta-analysis

“…We evaluated the 21 studies according to the method they used to assess the occurrence of GDM, i.e., primary data with laboratory measurements (FPG, OGTT, or a combination of both; n = 10) (8,20-28), self-reported GDM diagnosis (n = 3) (29-31), self-reported diabetes during pregnancy without specifying the type of diabetes (n = 1) (32), medical records with previous diagnostic tests (such as a medical chart or prenatal card; n = 6) (31,(33)(34)(35)(36)(37), and data collected using other systems (including the International Classification of Diseases [ICD]), for which specific criteria could not be identified (n = 2) (38,39). We considered the studies using the two latter methods as having poorly defined criteria.…”