Influência do sobrepeso e da obesidade materna sobre a incidência de complicações maternas e neonatais em um município do Norte de Mato Grosso : um estudo coorte retrospectivo

Abstract

Obesity is a chronic condition characterized by the accumulation of adipose tissue, primarily visceral white adipose tissue, which can lead to the development of metabolic, inflammatory, hormonal, and psychosocial alterations. Obesity during pregnancy can trigger various maternal complications, such as gestational diabetes mellitus (GDM), and neonatal complications such as fetal macrosomia, serving as a significant risk factor that needs to be controlled. This study aims to analyze the influence of maternal overweight and obesity on the development of maternal and neonatal complications in a municipality in the North of Mato Grosso (MT). The research commenced after approval from the Ethics Committee on Human Research (Protocol n. 4,214,565). A retrospective cohort study was conducted utilizing data collected from the medical records of pregnants treated at the Basic Health Units (BHUs) and the Women's Health Reference Center (CRASM) in the city of Sinop-MT. Data from the Live Birth Declaration and the newborn care record of babies born at Santo Antônio Hospital were also evaluated. The data were divided into two groups: Eutrophic and Overweight/Obesity. Results were expressed as mean and standard deviation of the mean for continuous variables or as a percentage for categorical variables. Continuous variables were assessed using the Student's t-test, and categorical variables were assessed using the chi-square test (χ2), with statistical significance considered at p<0.05. A total of 446 pregnants and their respective newborns were evaluated. It was observed that 39.4% was eutrophic and 60.5% was overweight/obese. For pregants, the incidence of GDM and gestational hypertension was significantly higher in the overweight/obesity group. For newbors, no statistical difference was observed regarding variables such as glucose levels, gender, type of delivery, prematurity, low birth weight, small for gestational age (SGA), congenital anomalies, neonatal ICU admission, and perinatal mortality. However, the incidence of macrosomia, newborns with 4 kg or more, was significantly higher in pregnants with overweight/obesity (n=23; 8.6%) when compared to eutrophic pregnants (n=1; 0.6%) (p=0.0003; Relative risk (RR)= 14.99 (2.62-87.23). The cephalic, thoracic, and abdominal measurements was significantly higher in the overweight/obesity group and the incidence of large for gestational age (LGA; p=0,0001 and RR= 30.61 (5.50-174.9) was also meaningly higher in the overweight/obesity when compared to the eutrophic pregnants. In conclusion, these results demonstrated that the overweight/obesity significantly increase the incidence of maternal and neonatal complications, increasing the chances of a baby born present macrosomia and/or being LGA and the chaces for a pregnant present GDM and hypertension.