Relación entre la Diabetes Gestacional y los Resultados Cardiovasculares en la Descendencia: Una Revesión Sistemática.
DOI:
10.52832/jesh.v5i3.550Palabras clave:
Diabetes Mellitus Gestacional, Enfermedades del sistema circulatorio, Efectos tardíos de la exposición prenatal, Factores de Riesgo CardiometabólicoResumen
Resumen: Investigar la asociación entre la exposición prenatal a la diabetes mellitus gestacional (DMG) y el desarrollo de enfermedades cardiovasculares y factores de riesgo cardiometabólico desde la infancia hasta la edad adulta. Revisión sistemática realizada entre octubre y diciembre de 2024 en las bases de datos Pubmed, Scielo, BVS y Cochrane. Los descriptores “Cardiovascular disease”, “Diabetes, Gestational” y “Prenatal Exposure Delayed Effects” se combinaron mediante el operador AND. Siguiendo las directrices PRISMA, se incluyeron ensayos clínicos y estudios observacionales publicados entre 2014 y 2024, sin restricciones de idioma. La selección fue realizada por dos revisores independientes y los desacuerdos fueron resueltos por un tercer revisor. De los 63 artículos identificados, 43 se excluyeron en función de sus títulos y resúmenes. 20 se leyeron en su totalidad. Nueve se incluyeron tras ser analizados según ACROBAT-NRSI. En total, había 1.107.252 participantes (113.888 expuestos frente a 993.364 de control), que abarcaban diferentes tiempos de seguimiento. En el grupo expuesto, hubo una mayor prevalencia de obesidad, hipertensión y resistencia a la insulina. Se observaron cambios precoces como perfiles lipídicos aterogénicos, aumento del grosor de la carótida y cambios estructurales en el ventrículo izquierdo, atribuidos a la hiperglucemia intrauterina e intensificados por factores epigenéticos. La DMG se asocia a importantes repercusiones en la salud cardiovascular y metabólica de la descendencia, con una aparición precoz de los factores de riesgo, lo que pone de relieve la importancia de las intervenciones preventivas durante el embarazo.
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