Relação Entre Diabetes Gestacional e Desfechos Cardiovasculares na Prole: Uma Revisão Sistemática.
DOI:
10.52832/jesh.v5i3.550Palavras-chave:
Diabetes Mellitus Gestacional, Doenças do Aparelho Circulatório, Efeitos Tardios da Exposição Pré-Natal, Fatores de Risco CardiometabólicoResumo
Resumo: Investigar a associação entre a exposição pré-natal ao diabetes mellitus gestacional (DMG) e o desenvolvimento de doenças cardiovasculares e fatores de risco cardiometabólicos, da infância à idade adulta. Revisão sistemática realizada entre outubro e dezembro de 2024 nas bases Pubmed, Scielo, BVS e Cochrane. Os descritores “Cardiovascular disease”, “Diabetes, Gestational” e “Prenatal Exposure Delayed Effects” foram combinados pelo operador AND. Seguindo diretrizes PRISMA, foram incluídos ensaios clínicos e estudos observacionais publicados entre 2014 e 2024, sem restrição de idioma. A seleção foi conduzida por dois revisores independentes e discordâncias resolvidas por um terceiro revisor. De 63 artigos identificados, 43 foram excluídos pelos títulos e resumos. 20 seguiram para leitura completa. Nove foram incluídos após análise conforme o ACROBAT-NRSI.: No total, somaram-se 1.107.252 participantes (113.888 expostos vs 993.364 controle), abrangendo diversos tempos de seguimento. No grupo exposto, observou-se maior prevalência de obesidade, hipertensão e resistência insulínica. Foram observadas alterações precoces como perfis lipídicos aterogênicos, aumento da espessura da carótida e mudanças estruturais no ventrículo esquerdo, atribuídas à hiperglicemia intrauterina e intensificadas por fatores epigenéticos. O DMG está associado a impactos significativos na saúde cardiovascular e metabólica da prole, com início precoce de fatores de risco, destacando a importância de intervenções preventivas durante a gestação.
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