DIABETES IN PREGNANCY AND FETAL CARDIAC RISK: LITERATURE REVIEW

Abstract

Gestational diabetes mellitus (MGD) is associated with poor cardiac malformation in the fetus. It is related to changes in the clinical course of the disease and pre-gestational periods. The prevalence and incidence of MGD have been increasing worldwide. Early screening, diagnosis, and lifestyle change, such as physical exercise and healthy eating, provide better outcomes for children's health. This study aims to analyze the data concerning gestational diabetes and fetal malformations and to group the various protocols for diagnosis, highlighting the risk factors associated with MGD and their prevention. A systematic review of the literature was conducted with the PubMed, Scielo, Medline databases with English, Portuguese, and Spanish articles. The studies gathered clinical trials, randomized clinical trials, and original articles. In 12 articles analyzed maternal alterations, while 11 articles analyzed fetal alterations, and 9 articles analyzed how to diagnose cardiac changes in the fetus. The patient with MGD should be inserted in multidisciplinary activities seeking the change of lifestyle, physical exercises, and food reeducation, intending to give the fetus the appropriate nutrients and optimize the drug treatment; cardiac malformations are among the most severe and recurrent complications. However, they can be avoided with the control of pre-gestational diabetes (stricter follow-up from the moment the patient feels the desire to become pregnant) and the diagnosis and treatment of early gestational diabetes, as strict control of maternal blood glucose during pregnancy reduces morbidities and mortality. The study showed that hyperglycemic status during pregnancy is related to increased mortality and morbidity, even if it is asymptomatic. Therefore, it is necessary to guide the diabetic woman to plan her pregnancy in a euglycemic period because only this control can guarantee health to the fetus. The diagnosis of pregnant women with gestational diabetes needs to be early to optimize treatment.