Reyes-Muñoz E, Reyes-Mayoral C, Sandoval-Osuna NL, Lira-Plascencia J, Ramírez-Torres MA, Ortega-González C, Martínez-Cruz N, Arce-Sánchez L

Idioma: Español
Referencias bibliográficas: 22
Paginas: 298-305
Archivo PDF: 198.57 Kb.

RESUMEN

Objetivo: comparar la prevalencia y resultados perinatales adversos de la diabetes mellitus gestacional en mujeres embarazadas adolescentes utilizando tres criterios diagnósticos internacionales diferentes.
Material y Métodos: estudio comparativo y observacional de cohorte retrospectiva efectuado en adolescentes a quienes se tomó una curva de tolerancia oral a la glucosa de 75g-2 h, entre las 24 y 28 semanas de gestación. Se analizaron la prevalencia y los resultados perinatales adversos, con criterios del Fifth International Workshop-Conference on Gestational Diabetes Mellitus, International Association of Diabetes and Pregnancy Study Groups y National Institute for Health and Care Excellence.
Resultados: se estudiaron 493 adolescentes en quienes se obtuvo una prevalencia de diabetes mellitus gestacional de: 0.2, 6.3 y 1.8%, con los criterios del Fifth International Workshop-Conference on Gestational Diabetes Mellitus, International Association of Diabetes and Pregnancy Study Groups y National Institute for Health and Care Excellence, respectivamente. La prevalencia de diabetes mellitus gestacional fue significativamente mayor con los criterios de la International Association of Diabetes and Pregnancy Study Groups, sin diferencias significativas en los resultados perinatales adversos al utilizar cualquiera de los tres criterios.
Conclusión: la prevalencia de diabetes mellitus gestacional según los criterios de la International Association of Diabetes and Pregnancy Study Groups es 3 veces mayor que con los criterios del National Institute for Health and Care Excellence y 30 veces mayor con los criterios de la Fifth International Workshop-Conference on Gestational Diabetes Mellitus. No hubo riesgo incrementado de resultados perinatales adversos en adolescentes con diabetes mellitus gestacional; sin embargo, podrían tener mayor riesgo de padecer diabetes mellitus tipo 2 a largo plazo.

REFERENCIAS (EN ESTE ARTÍCULO)

1. American Diabetes Association. Classification and diagnosis of diabetes. Diabetes Care 2015;38: S8-S16.

2. World Health Organization. Adolescent pregnancy. Available in: http://www.who.int/maternal_child_adolescent/ topics/maternal/adolescent_pregnancy/en/ consulted January 18, 2016.

3. Statics vitals, INEGI 2015. Available in: http://www3. inegi.org.mx/sistemas/sisept/Default.aspx?t=m demo29&s=est&c=17528 consulted April 20, 2016.

4. Society of Obstetricians and Gynaecologists of Canada. Adolescent Pregnancy Guidelines. J Obstet Gynaecol Can. 2015; 37: 740-59.

5. Karcaaltincaba D, Buyukkaragoz B, Kandemir O, Yalvac S, Kiykac-Altinbaş S, Haberal A. Gestational Diabetes and Gestational Impaired Glucose Tolerance in 1653 Teenage Pregnancies: Prevalence, Risk Factors and Pregnancy Outcomes. J Pediatr Adolesc Gynecol. 2011; 24: 62-5.

6. International Association of Diabetes and Pregnancy Study Groups Consensus Panel. International Association of Diabetes and Pregnancy Study Groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010; 33: 676-82.

7. Metzger BE, Buchanan TA, Coustan DR, De Leiva A, Dunger DB, Hadden DR, et al. Summary and Recommendations of the Fifth International Workshop- Conference on Gestational Diabetes Mellitus. Diabetes Care. 2007; 30: 251-60.

8. Carpenter MW, Coustan DR. Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol 1982; 144: 768-73.

9. HAPO Study Cooperative Research Group. Hyperglycemia and Adverse Pregnancy Outcomes. N Engl J Med 2008; 358: 1991-2002.

10. Hod M, Kapur A, Sacks DA, Hadar E, Agarwal M, Di Renzo GC, et al. The International Federation of Gynecology and Obstetrics (FIGO) Initiative on gestational diabetes mellitus: A pragmatic guide for diagnosis, management, and care. Int J Gynaecol Obstet. 2015; 131: S173-211.

11. World Health Organization. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy: a World Health Organization Guideline. Diabetes Res Clin Pract. 2014: 103: 341-63.

12. National Institute for Health and Clinical Excellence. Diabetes in pregnancy: management from preconception to the postnatal period. Great Britain: The Royal College of Obstetricians and Gynaecologists 2015.

13. American College of Obstetricians and Gynecologists. Hypertension in Pregnancy. Obstet Gynecol. 2013; 122: 1122-31.

14. American College of Obstetricians and Gynecologists. ACOG Practice Bulletin 6, Thrombocytopenia in pregnancy. Int J Gynaecol Obstet 1999; 67: 117-28.

15. Figueras F, Gratacós E. Update on the diagnosis and classification of fetal growth restriction and proposal of a stage-based management protocol. Fetal Diagn Ther. 2014; 36: 86-98.

16. Petrozella LN, Dashe JS, Mclntire DD, Leveno KJ. Clinical significance of borderline amniotic fluid index and oligohydramnios in preterm pregnancy. Obstet Gynecol. 2011; 117: 338-42.

17. American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 76 Postpartum hemorrhage. Int J Gynecol Obstet 2006; 108: 1039-47.

18. Flores S, Martínez H. Peso al nacer de los niños y niñas derechohabientes del Instituto Mexicano del Seguro Social. Bol Med Hosp Infant Mex. 2012; 69: 30-9.

19. Aviña J, Tastekin A. Malformaciones congènitas: clasificación y bases morfogénicas. Rev Mex Pediatr 2008; 75: 71-4.

20. Khine ML, Winklestein A, Copel JA. Selective screening for gestational diabetes mellitus in adolescent pregnancies. Obstet Gynecol 1999; 93: 738-42.

21. Lao T, Ho LF. Obstetric Outcome of teenage pregnancies. Hum Reprod 1998; 13: 3228-32.

22. Reyes E, Parra A, Castillo A, Ortega C. Effect of the diagnostic criteria of the International Association of Diabetes and Pregnancy Study Groups on the prevalence of gestational diabetes mellitus in urban Mexican women: a crosssectional study. Endocr Pract. 2012;18:146-51.