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Previous issue date: 2017-03-31 / Introduction: Gestational diabetes is a potentially harmful disease for the mother and fetus during pregnancy. It is associated with higher risk of developing a hypertensive syndrome during pregnancy and maternal cardiovascular diseases, but also with increased risk of adverse fetal outcomes such as macrosomia and fetal death. Objectives: the aim was to evaluate endothelial function in pregnancies with and without gestational diabetes mellitus (GDM). Methods: this case control study measured endothelial function trough brachial artery flow mediated dilatation (FMD) using ultrasound, evaluating pregnant women between twenty and thirty six weeks gestation. Sample size was calculated to detect a difference of one standard deviation in FMD (90% power and alpha 0.05) between groups. Results: The study sample consisted of thirty-six patients in each group. The clinical and demographic characteristics were similar in both groups, although the glucose status and the basal body mass index (BMI) were significantly higher in the group of pregnant women with diabetes. Median FMD was significantly reduced in gestational diabetes group (18.3%, IQR: 11.9-23.3%) compared to the control group (9.7%, IQR: 5.7-14.1%; p<0.001), indicating impaired endothelial function. Cohen's d was 0.90 and the effect-size r was 0.41, which is considered a large Cohen?s Standard effect. Conclusions: Gestational diabetes is associated with endothelial dysfunction. / Introdu??o: A diabetes gestacional ? uma doen?a potencialmente lesiva ? m?e e ao feto durante a gesta??o, est? associada a maior risco de desenvolvimentos de s?ndrome hipertensivas na gesta??o, aumento de doen?as cardiovasculares e desfechos adversos fetais como macrossomia e morte fetal. Objetivos: Analisar a fun??o endotelial em gesta??es com e sem diabetes mellitus gestacional (DMG). M?todos: Estudo caso-controle que avaliou a fun??o endotelial atrav?s da dilata??o mediada por fluxo (DMF) da art?ria braquial, aferida atrav?s de um m?todo ecogr?fico entre vinte e trinta e seis semanas de gesta??o, em pacientes com e sem DMG. A amostra foi calculada para detectar uma diferen?a de um desvio padr?o na DMF, com poder de 90%, e erro alfa de 0,05. Resultados: Foram selecionadas trinta e seis (36) pacientes em cada grupo, as caracter?sticas cl?nicas e demogr?ficas foram semelhantes nos dois grupos, apenas o status da glicose e o ?ndice de massa corporal basal (IMC) foram diferentes entre eles. A mediana da DMF da art?ria braquial foi significativamente menor no grupo diabetes gestacional (18,3%, IQR: 11,9-23,3% e 9,7%, IQR: 5,7-14,1%;nos grupos-controle e GDM respectivamente, p <0,001), indicando comprometimento na fun??o endotelial. O d de ?Cohen`s? foi de 0,90 e o tamanho do efeito r foi de 0,41, considerado grande de acordo com a escalada de efeitos de Cohen. Conclus?es: Diabetes gestacional esteve associado ? disfun??o endotelial neste estudo, com a metodologia proposta.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/7626 |
| Date | 31 March 2017 |
| Creators | Oliveira, Daniele Sparemberger |
| Contributors | Figueiredo, Carlos Eduardo Poli de, Costa, Bartira Erc?lia Pinheiro da, Cunha, Edson Vieira da |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Medicina e Ci?ncias da Sa?de, PUCRS, Brasil, Escola de Medicina |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 7620745074616285884, 500, 500, 500, -224747486637135387, -969369452308786627 |
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