Maternal near miss and potentially life-threatening condition determinants in patients with type 1 diabetes mellitus at a university hospital in Sao Paulo, Brazil: a retrospective study

Autor(es)

de Morais, Luiza Russo ^[1] ; Patz, Beatriz Costa ^[1] ; Campanharo, Felipe Favorette ^[1] ; Dualib, Patricia Medici ^[2] ; Sun, Sue Yazaki ^[1] ; Mattar, Rosiane ^[1]

Afiliação do(s) autor(es)

^[1] Univ Fed Sao Paulo UNIFESP, Escola Paulista Med, Obstet Dept, BR-04021001 Sao Paulo - Brazil

^[2] Univ Fed Sao Paulo UNIFESP, Escola Paulista Med, Endocrinol Dept, BR-04021001 Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: BMC PREGNANCY AND CHILDBIRTH; v. 20, n. 1 NOV 10 2020.
• Citações Web of Science: 0

Resumo

Background: To date, the rates of potentially life-threatening condition (PTLC), maternal near miss (MNM) and maternal deaths in pregnant patients with type 1 diabetes mellitus (T1DM) and variables associated to it have not been studied. Methods: This study was as a cross-sectional retrospective study conducted at Sao Paulo Hospital of Universidade Federal de Sao Paulo, a tertiary hospital that provides public medical care through the Brazilian unified health system to high-risk pregnancies. Inclusion criteria were T1DM pregnant women who delivered from January 2005 to December 2015. Three groups were established by the World Heath Organization criteria and associations were assessed using the chi-square test in between MNM and no morbidity or PLTC and no morbidity. A P value < 0.05 was considered statistically significant. Results: The final sample included 137 patients, 8 MNM cases (5.84%), 51 PLTC (37.23%), no cases of maternal deaths and 78 patients (56.93%) did not present any complication. Moreover, there were 122 live births, resulting in a near miss rate of 65.5 per 1.000 live births in patients with T1DM. Two of the MNM cases were for clinical criteria (uncontrollable fit in both) and laboratory criteria for the other six: one patient with severe acute azotemia (creatinine > 300 mu mol/ml), one patient with severe hypoperfusion (lactate > 5 mmol/L) and four of them with loss of consciousness and the presence of glucose and ketoacids in urine. PLTC criteria were studied in MNM and PLTC cases. Prolonged hospital stay was the most prevalent PLTC criteria in both groups (100% of MNM cases and 96% of PLTC), followed by renal failure in 50% of MNM cases and severe preeclampsia in 22% of PLTC cases. This study could not find any association between prenatal factors or sociodemographic characteristics with maternal morbidity. Conclusions: MNM rate in T1DM was extremely high, and determined by complications of the primary disease or hypertensive disorders. No sociodemographic variables studied were related to maternal morbidity; therefore, we could not predict what increases MNM and PLTC in this specific population. (AU)

• Processo FAPESP: 15/21553-3 - Near Miss materno em gestantes diabéticas do tipo 1
• Beneficiário: Luiza Russo de Morais
• Modalidade de apoio: Bolsas no Brasil - Iniciação Científica