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Article ; Online: Maternal-fetal outcomes of pregnant women with type 1 diabetes treated with continuous subcutaneous insulin infusion or multiple daily injections during pregnancy – A Brazilian health care referral center cohort study

Juliana Ogassavara / Patricia Medici Dualib / Rosiane Mattar / Sérgio Atala Dib / Bianca de Almeida-Pititto

Archives of Endocrinology and Metabolism, Vol 67, Iss

2023 Volume 6

Abstract: ABSTRACT Objective: Pregnant women with type 1 diabetes (T1D) have an increased risk of maternal-fetal complications. Regarding treatment, continuous subcutaneous insulin infusion (CSII) has advantages compared to multiple daily injections (MDI), but ... ...

Abstract	ABSTRACT Objective: Pregnant women with type 1 diabetes (T1D) have an increased risk of maternal-fetal complications. Regarding treatment, continuous subcutaneous insulin infusion (CSII) has advantages compared to multiple daily injections (MDI), but data about the best option during pregnancy are limited. This study's aim was to compare maternal-fetal outcomes among T1D patients treated with CSII or MDI during pregnancy. Subjects and methods: This study evaluated 174 pregnancies of T1D patients. Variables of interest were compared between the groups (CSII versus MDI), and logistic regression analysis was performed (p < 0.05). Results: Of the 174 included pregnancies, CSII was used in 21.3% (37) and MDI were used in 78.7% (137). HbA1c values improved throughout gestation in both groups, with no difference in the first and third trimesters. The frequency of cesarean section was significantly higher in the CSII group [94.1 vs. 75.4%, p = 0.017], but there was no significant difference in the frequency of other complications, such as miscarriage, premature delivery and preeclampsia. The mean birth weight and occurrence of neonatal complications were also similar, except for the proportion of congenital malformations, which was significantly lower in the CSII group [2.9 vs. 15.6%, p = 0.048]. In regression analysis, the association of CSII with cesarean section and malformations lost significance after adjusting for HbA1c and other covariates of interest. Conclusion: In this study, we observed a higher frequency of cesarean section and a lower occurrence of congenital malformations in the CSII group, but the adjusted results might indicate that these associations are influenced by glycemic control.
Keywords	Continuous subcutaneous insulin infusion ; maternal-fetal outcomes ; multiple daily injections ; type 1 diabetes mellitus ; pregnancy in diabetics ; Medicine ; R ; Diseases of the endocrine glands. Clinical endocrinology ; RC648-665
Subject code	610
Language	English
Publishing date	2023-07-01T00:00:00Z
Publisher	Brazilian Society of Endocrinology and Metabolism
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Neck circumference as a predictor of gestational diabetes and risk of adverse outcomes in pregnancy of Brazilian woman with overweight and obesity

Camila Rodrigues de Souza Carvalho / Patricia Medici Dualib / Rosiane Mattar / Sérgio Atala Dib / Bianca de Almeida-Pititto

Archives of Endocrinology and Metabolism (2022)

2022

Abstract: ABSTRACT Objective: To evaluate the association of neck circumference (NC) with gestational diabetes (GDM) and adverse outcomes in women with overweight and obesity. Subjects and methods: This prospective study included 132 (BMI > 25 kg/m2) pregnant ... ...

Abstract	ABSTRACT Objective: To evaluate the association of neck circumference (NC) with gestational diabetes (GDM) and adverse outcomes in women with overweight and obesity. Subjects and methods: This prospective study included 132 (BMI > 25 kg/m2) pregnant women without and with GDM. Standardized questionnaire and biochemical/physical evaluation were performed during the 1st to 3rd trimester. Fifth-five women were evaluated regarding hypertension in pregnancy, type of delivery and neonatal complications (death, intensive care unit admission and hypoglycemia). Results: Women with (n = 61) and without (n = 71) GDM had similar mean (SD) pre-gestational BMI [30.3 (4.0) vs. 29.4 (3.5) kg/m2, p = 0.16]. Women with GDM were older [32 (6) vs. 28 (6) yrs, p < 0.001] and had greater NC [36.0 (2.7) vs. 34.5 (1.8) cm, p < 0.001]. NC was similar in women with GDM diagnosed in first or third trimester [p = 0.4] and was correlated with FPG [r 0.29, p = 0.01] and systolic [r 0.28, p = 0.001] and diastolic [r 0.25, p = 0.004] blood pressure. NC was associated with GDM [OR 1.25, 95%CI 1.03-1.52] adjusted for age, physical activity, education and familiar history of diabetes. In ROC analysis, the area under the curve was 0.655 and the cut-off value of 34.5 cm had 0.70 of sensitivity and 0.51 of specificity for GDM. Women who had NC ≥ 34.5 vs. < 34.5 cm had higher frequencies of hypertension [32.3 vs. 4.2%, p = 0.01]. Conclusions: In a group of pregnant women with overweight or obesity, NC can be a useful tool for identifying risk of GDM and obstetric adverse outcomes.
Keywords	Gestational diabetes mellitus ; neck circumference ; Medicine ; R ; Diseases of the endocrine glands. Clinical endocrinology ; RC648-665
Subject code	610
Language	English
Publishing date	2022-06-01T00:00:00Z
Publisher	Brazilian Society of Endocrinology and Metabolism
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A cerclagem para prevenção da prematuridade

Rosiane Mattar

Revista Brasileira de Ginecologia e Obstetrícia, Vol 28, Iss 3, Pp 139-

para quem indicar? Cerclage for the prevention of prematurity: for whom should it be indicated?

2006 Volume 142

Keywords	Gynecology and obstetrics ; RG1-991 ; Medicine ; R ; DOAJ:Gynecology and Obstetrics ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Language	Portuguese
Publishing date	2006-03-01T00:00:00Z
Publisher	Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Sexualidade na gestação

Teresa Cristina Barroso Vieira / Eduardo de Souza / Mary Uschiyama Nakamura / Rosiane Mattar

Revista Brasileira de Ginecologia e Obstetrícia, Vol 34, Iss 11, Pp 485-

os médicos brasileiros estão preparados para lidar com estas questões? Sexuality in pregnancy: are Brazilian physicians prepared to conduct these questions?

2012 Volume 487

Keywords	Gynecology and obstetrics ; RG1-991 ; Medicine ; R ; DOAJ:Gynecology and Obstetrics ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Language	Portuguese
Publishing date	2012-11-01T00:00:00Z
Publisher	Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Obesidade e gravidez Obesity and pregnancy

Rosiane Mattar / Maria Regina Torloni / Ana Pilar Betrán / Mario Merialdi

Revista Brasileira de Ginecologia e Obstetrícia, Vol 31, Iss 3, Pp 107-

2009 Volume 110

Keywords	Gynecology and obstetrics ; RG1-991 ; Medicine ; R ; DOAJ:Gynecology and Obstetrics ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Language	Portuguese
Publishing date	2009-03-01T00:00:00Z
Publisher	Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Neurofunctional Evaluation of Young Male Offspring of Rat Dams with Diabetes Induced by Streptozotocin

Carla Delascio Lopes / Rita Sinigaglia-Coimbra / Jacqueline Mazzola / Luiz Camano / Rosiane Mattar

ISRN Endocrinology , Vol

2011 Volume 2011

Keywords	Diseases of the endocrine glands. Clinical endocrinology ; RC648-665 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Internal medicine ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Language	English
Publishing date	2011-01-01T00:00:00Z
Publisher	Hindawi Publishing Corporation
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Female sexual function of overweight women with gestational diabetes mellitus - a cross-sectional study.

Meireluci Costa Ribeiro / Mary Uchiyama Nakamura / Maria Regina Torloni / Marco de Tubino Scanavino / Flávia Burin Scomparini / Rosiane Mattar

PLoS ONE, Vol 9, Iss 4, p e

2014 Volume 95094

Abstract: Obesity and gestational diabetes mellitus (GDM) are increasing worldwide and may compromise female sexual function. We hypothesize that among GDM patients in the third trimester of pregnancy, those with excess body fat would have worse female sexual ... ...

Abstract	Obesity and gestational diabetes mellitus (GDM) are increasing worldwide and may compromise female sexual function. We hypothesize that among GDM patients in the third trimester of pregnancy, those with excess body fat would have worse female sexual function scores than normal weight women. Our aim was to assess the sexual function of overweight compared to normal weight women with GDM. This was a cross-sectional survey involving 143 Brazilian women with GDM in the third trimester of pregnancy: 76 were overweight (pre-pregnancy body mass index-BMI≥25.0 Kg/m2) and 67 were normal weight (BMI 18.5-24.9 Kg/m2). Participants were recruited from March 2010 to April 2013 at the antenatal clinic of a single public tertiary teaching institution. The Female Sexual Function Index (FSFI) questionnaire was used to assess sexual function. Overall, 51.7% of the 143 participants were at risk for sexual dysfunction symptoms (FSFI scores ≤26); this rate was significantly higher among overweight compared to normal weight women (60.5% versus 41.8%, p = 0.038). Mean total FSFI scores were significantly lower in overweight compared to normal weight women (21.7±9.2 versus 24.9±8.0, p = 0.029). Compared to normal weight women, overweight participants had lower mean scores in desire (3.4±1.2 versus 4.0±1.4, p = 0.007) and lubrication (3.8±2.0 versus 4.5±1.6, p = 0.023). According to these results, overweight women with GDM in the third trimester of pregnancy have lower female sexual function scores than normal weight women with the same disorder.
Keywords	Medicine ; R ; Science ; Q
Subject code	150
Language	English
Publishing date	2014-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Ainda sobre o abortamento legal no Brasil e o conhecimento dos profissionais de saúde Legal abortion in Brazil and the knowledge of health professionals

Osmar Colas / Nicole Moraes Rego de Aquino / Rosiane Mattar

Revista Brasileira de Ginecologia e Obstetrícia, Vol 29, Iss 9, Pp 443-

2007 Volume 445

Keywords	Gynecology and obstetrics ; RG1-991 ; Medicine ; R ; DOAJ:Gynecology and Obstetrics ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Language	Portuguese
Publishing date	2007-09-01T00:00:00Z
Publisher	Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Caracterização da gravidez com insuficiência istmocervical Characterization of pregnancy with cervical incompetence

Liliane Costa Rodrigues / Rosiane Mattar / Luiz Camano

Revista Brasileira de Ginecologia e Obstetrícia, Vol 25, Iss 1, Pp 29-

2003 Volume 34

Abstract: OBJETIVO: identificar características comuns às portadoras de insuficiência istmocervical (IIC) que serviriam para reconhecê-las precocemente e auxiliariam no seguimento do ciclo gravídico-puerperal. PACIENTES E MÉTODOS: cinqüenta gestantes portadoras de ...

Abstract	OBJETIVO: identificar características comuns às portadoras de insuficiência istmocervical (IIC) que serviriam para reconhecê-las precocemente e auxiliariam no seguimento do ciclo gravídico-puerperal. PACIENTES E MÉTODOS: cinqüenta gestantes portadoras de IIC submetidas à circlagem uterina segundo a técnica de McDonald modificada foram analisadas em estudo descritivo observacional. Por meio dos dados dos prontuários, foram estudadas as seguintes variáveis: idade, antecedentes obstétricos, momento do diagnóstico de IIC, aspectos relativos à circlagem e incidência de prematuridade. RESULTADOS: em média, a idade materna foi de 29,2 anos e o número de gestações anteriores foi de 3,7. Quanto aos antecedentes obstétricos, tivemos 189 gestações anteriores; em 18 delas já se tinha o diagnóstico de IIC e a circlagem havia sido realizada, tendo resultado em 18 crianças vivas (8 nasceram prematuramente e 10 no termo). Das 171 prenhezes prévias em que o diagnóstico de IIC não estava firmado, 90 evoluíram para abortamentos, 68 foram partos pré-termos e 13 de termo. Em relação ao momento do diagnóstico de IIC, 30 (60%) pacientes tiveram-no firmado no intervalo entre os partos e 20 (40%) durante a gestação. A idade gestacional média em que as pacientes foram submetidas à circlagem foi de 18,2 semanas; 40% das circlagens foram de urgência e 60% eletivas. A incidência de prematuridade foi de 30% (15/50). CONCLUSÃO: a avaliação obstétrica cuidadosa de multigestas com perdas gestacionais recorrentes, no intervalo entre os partos e/ou no primeiro trimestre da gravidez, pode permitir o diagnóstico precoce e tratamento adequado da IIC, evitando a prematuridade. PURPOSE: to identify characteristics common to women who suffer from cervical incompetence (CI) allowing their early identification and helping in the follow-up of the gestational-postdelivery cycle. PATIENTS AND METHODS: fifty pregnant women suffering from CI and submitted to uterine cerclage according to modified McDonald's technique were analyzed in an observational descriptive study. The following variables of the medical records were evaluated: age, preceding obstetrical aspects, time of CI diagnosis, cerclage-related aspects and preterm delivery incidence. RESULTS: the average age of the mothers was 29.28 years and mean number of previous gestations was 3.76. As to the preceding obstetrical aspects, 189 gestations with a CI diagnosis were reported and cerclage had been applied to 18 of them, resulting in 18 babies who were born alive (8 preterm deliveries and 10 term deliveries). Of the 171 previous pregnancies in which CI diagnosis was not reported, 90 progressed to abortion, 68 were preterm and 13 were term deliveries. In 30 (60%) patients, CI was diagnosed during the intergestational interval, and 20 (40%) during gestation. The average gestational period in which patients were submitted to cerclage was 18.29 weeks; 40% of the cerclages were emergency procedures and 60% were elective. The incidence of prematurity was 30% (15/50). CONCLUSION: careful obstetrical evaluation of multiparous women, presenting recurrent miscarriages, during the intergestational interval and/or during the first trimester of pregnancy, may allow the early diagnosis and adequate treatment of CI, avoiding prematurity.
Keywords	Insuficiência istmocervical ; Prematuridade ; Circlagem ; Abortamento tardio ; Cervical incompetence ; Prematurity ; Cerclage ; Late abortion ; Gynecology and obstetrics ; RG1-991 ; Medicine ; R ; DOAJ:Gynecology and Obstetrics ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Language	Portuguese
Publishing date	2003-02-01T00:00:00Z
Publisher	Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Óbito fetal em microrregião de Minas Gerais

Nestor Nurdan / Rosiane Mattar / Luiz Camano

Revista Brasileira de Ginecologia e Obstetrícia, Vol 25, Iss 2, Pp 103-

causas e fatores associados Stillbirth in a microrregion of Minas Gerais State: causes and associated factors

2003 Volume 107

Abstract: OBJETIVOS: estudar as causas e fatores associados ao óbito fetal. MÉTODOS: estudo epidemiológico descritivo, que incluiu 190 casos de perdas fetais entre 11.825 gestantes que parturiram nos dois únicos hospitais (Casa de Saúde Divino Espírito Santo e ... ...

Abstract	OBJETIVOS: estudar as causas e fatores associados ao óbito fetal. MÉTODOS: estudo epidemiológico descritivo, que incluiu 190 casos de perdas fetais entre 11.825 gestantes que parturiram nos dois únicos hospitais (Casa de Saúde Divino Espírito Santo e Hospital Nossa Senhora Auxiliadora) de Caratinga, MG, no período de 1º de janeiro de 1995 a 30 de abril de 2000. As variáveis investigadas foram: o número de gestações, a idade gestacional no momento da internação hospitalar, a época de ocorrência do decesso fetal em relação ao parto e a causa do óbito fetal. Não havendo grupo controle comparativo, utilizou-se estatística descritiva com tabelas, porcentagens e médias aritméticas. RESULTADOS: dentre as 189 gestantes com morte fetal, 77 eram primigestas e 76 tinham entre 2 e 5 gestações. A idade gestacional variou de 20 a 37 semanas. Em relação ao parto, a perda fetal ocorreu no período anteparto em 164 dos 190 casos. As causas mais freqüentes encontradas para a morte foram: DPP em 35, anomalia fetal em 12 e síndrome hipertensiva em 8 casos. Todavia, em 117 conceptos não foi possível esclarecer a etiologia do óbito. CONCLUSÕES: a morte fetal esteve presente notadamente nas primigestas (40,74%) internadas no pré-termo (59,79%), e ocorreram no período anteparto (86,31%). Dentre as causas de morte fetal, a mais encontradiça foi o DPP (18,42%) e em 61,57% dos casos ela não pôde ser determinada. PURPOSE: to study the causes and associated factors of fetal death. METHODS: epidemiological descriptive study, composed of 190 cases of fetal loss amongst 11,825 pregnant women that gave birth at the two only hospitals (Casa de Saúde Divino Espírito Santo and Hospital Nossa Senhora Auxiliadora) of Caratinga City, in the State of Minas Gerais, Brazil, in the period from January 1, 1995 to April 30, 2000. The variables were the number of pregnancies, the timing of the pregnant women at the time of hospitalization, the occurrence of fetal death in relation to delivery and the cause of fetal death. Since there were no comparative groups, tables, percentages and arithmetical means were applied, following the guidelines of the Course of Statistics, of the "Universidade Federal de São Paulo". RESULTS: among the 189 pregnant women with fetal death, 77 were primigravidal and 76 had already been pregnant 2 to 5 times. The gestational age in 113 women was from 20 to 37 weeks. In relation to parturition, the fetal loss occurred during the antepartum period in 164 of 190 dead fetuses. The most frequently noticed death causes were: abruptio placentae in 35 cases, fetal anomaly in 12 cases, and hypertension syndrome in 8 cases. Nervertheless, there was no explanation for the etiology of 117 cases of fetal death. CONCLUSION: stillbirth has frequently been observed among the primigravidae (40.74%), in preterm period (59.79%), and in the antepartum period (86.31%). Among fetal death causes, the most frequent was a abruptio placentae (18.42%), and in 61.57% of the cases the fetal death could not be explained.
Keywords	Óbito fetal ; Descolamento prematuro da placenta ; Malformações fetais ; Hipertensão ; Fetal death ; Abruptio placentae ; Fetal anomaly ; Hypertension ; Gynecology and obstetrics ; RG1-991 ; Medicine ; R ; DOAJ:Gynecology and Obstetrics ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Language	Portuguese
Publishing date	2003-03-01T00:00:00Z
Publisher	Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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