Maternal near miss and potentially life-threatening condition determinants in patients with type 1 diabetes mellitus at a university hospital in São Paulo, Brazil: a retrospective study
Abstract Background To date, the rates of potentially life-threatening condition (PTLC), maternal near miss (MNM) and maternal deaths in pregnant patients with type 1 diabetes mellitus (T1DM) and variables associated to it have not been studied. Methods This study was as a cross-sectional retrospect...
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| Format: | Article |
| Language: | English |
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BMC
2020-11-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | http://link.springer.com/article/10.1186/s12884-020-03392-y |
| _version_ | 1818530842494894080 |
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| author | Luiza Russo de Morais Beatriz Costa Patz Felipe Favorette Campanharo Patricia Médici Dualib Sue Yazaki Sun Rosiane Mattar |
| author_facet | Luiza Russo de Morais Beatriz Costa Patz Felipe Favorette Campanharo Patricia Médici Dualib Sue Yazaki Sun Rosiane Mattar |
| author_sort | Luiza Russo de Morais |
| collection | DOAJ |
| description | Abstract Background To date, the rates of potentially life-threatening condition (PTLC), maternal near miss (MNM) and maternal deaths in pregnant patients with type 1 diabetes mellitus (T1DM) and variables associated to it have not been studied. Methods This study was as a cross-sectional retrospective study conducted at São Paulo Hospital of Universidade Federal de São Paulo, a tertiary hospital that provides public medical care through the Brazilian unified health system to high-risk pregnancies. Inclusion criteria were T1DM pregnant women who delivered from January 2005 to December 2015. Three groups were established by the World Heath Organization criteria and associations were assessed using the chi-square test in between MNM and no morbidity or PLTC and no morbidity. A P value < 0.05 was considered statistically significant. Results The final sample included 137 patients, 8 MNM cases (5.84%), 51 PLTC (37.23%), no cases of maternal deaths and 78 patients (56.93%) did not present any complication. Moreover, there were 122 live births, resulting in a near miss rate of 65.5 per 1.000 live births in patients with T1DM. Two of the MNM cases were for clinical criteria (uncontrollable fit in both) and laboratory criteria for the other six: one patient with severe acute azotemia (creatinine > 300 μmol/ml), one patient with severe hypoperfusion (lactate > 5 mmol/L) and four of them with loss of consciousness and the presence of glucose and ketoacids in urine. PLTC criteria were studied in MNM and PLTC cases. Prolonged hospital stay was the most prevalent PLTC criteria in both groups (100% of MNM cases and 96% of PLTC), followed by renal failure in 50% of MNM cases and severe preeclampsia in 22% of PLTC cases. This study could not find any association between prenatal factors or sociodemographic characteristics with maternal morbidity. Conclusions MNM rate in T1DM was extremely high, and determined by complications of the primary disease or hypertensive disorders. No sociodemographic variables studied were related to maternal morbidity; therefore, we could not predict what increases MNM and PLTC in this specific population. |
| first_indexed | 2024-12-11T17:24:49Z |
| format | Article |
| id | doaj.art-d4c255d4fd624f8eb9426c887c4ca576 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-11T17:24:49Z |
| publishDate | 2020-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-d4c255d4fd624f8eb9426c887c4ca5762022-12-22T00:57:00ZengBMCBMC Pregnancy and Childbirth1471-23932020-11-012011610.1186/s12884-020-03392-yMaternal near miss and potentially life-threatening condition determinants in patients with type 1 diabetes mellitus at a university hospital in São Paulo, Brazil: a retrospective studyLuiza Russo de Morais0Beatriz Costa Patz1Felipe Favorette Campanharo2Patricia Médici Dualib3Sue Yazaki Sun4Rosiane Mattar5Obstetrics Department, Universidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaObstetrics Department, Universidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaObstetrics Department, Universidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaEndocrinology Department, Universidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaObstetrics Department, Universidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaObstetrics Department, Universidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaAbstract Background To date, the rates of potentially life-threatening condition (PTLC), maternal near miss (MNM) and maternal deaths in pregnant patients with type 1 diabetes mellitus (T1DM) and variables associated to it have not been studied. Methods This study was as a cross-sectional retrospective study conducted at São Paulo Hospital of Universidade Federal de São Paulo, a tertiary hospital that provides public medical care through the Brazilian unified health system to high-risk pregnancies. Inclusion criteria were T1DM pregnant women who delivered from January 2005 to December 2015. Three groups were established by the World Heath Organization criteria and associations were assessed using the chi-square test in between MNM and no morbidity or PLTC and no morbidity. A P value < 0.05 was considered statistically significant. Results The final sample included 137 patients, 8 MNM cases (5.84%), 51 PLTC (37.23%), no cases of maternal deaths and 78 patients (56.93%) did not present any complication. Moreover, there were 122 live births, resulting in a near miss rate of 65.5 per 1.000 live births in patients with T1DM. Two of the MNM cases were for clinical criteria (uncontrollable fit in both) and laboratory criteria for the other six: one patient with severe acute azotemia (creatinine > 300 μmol/ml), one patient with severe hypoperfusion (lactate > 5 mmol/L) and four of them with loss of consciousness and the presence of glucose and ketoacids in urine. PLTC criteria were studied in MNM and PLTC cases. Prolonged hospital stay was the most prevalent PLTC criteria in both groups (100% of MNM cases and 96% of PLTC), followed by renal failure in 50% of MNM cases and severe preeclampsia in 22% of PLTC cases. This study could not find any association between prenatal factors or sociodemographic characteristics with maternal morbidity. Conclusions MNM rate in T1DM was extremely high, and determined by complications of the primary disease or hypertensive disorders. No sociodemographic variables studied were related to maternal morbidity; therefore, we could not predict what increases MNM and PLTC in this specific population.http://link.springer.com/article/10.1186/s12884-020-03392-yMaternal near missType 1 diabetes mellitusSevere maternal morbidityPotentially life-threatening conditionMaternal health |
| spellingShingle | Luiza Russo de Morais Beatriz Costa Patz Felipe Favorette Campanharo Patricia Médici Dualib Sue Yazaki Sun Rosiane Mattar Maternal near miss and potentially life-threatening condition determinants in patients with type 1 diabetes mellitus at a university hospital in São Paulo, Brazil: a retrospective study BMC Pregnancy and Childbirth Maternal near miss Type 1 diabetes mellitus Severe maternal morbidity Potentially life-threatening condition Maternal health |
| title | Maternal near miss and potentially life-threatening condition determinants in patients with type 1 diabetes mellitus at a university hospital in São Paulo, Brazil: a retrospective study |
| title_full | Maternal near miss and potentially life-threatening condition determinants in patients with type 1 diabetes mellitus at a university hospital in São Paulo, Brazil: a retrospective study |
| title_fullStr | Maternal near miss and potentially life-threatening condition determinants in patients with type 1 diabetes mellitus at a university hospital in São Paulo, Brazil: a retrospective study |
| title_full_unstemmed | Maternal near miss and potentially life-threatening condition determinants in patients with type 1 diabetes mellitus at a university hospital in São Paulo, Brazil: a retrospective study |
| title_short | Maternal near miss and potentially life-threatening condition determinants in patients with type 1 diabetes mellitus at a university hospital in São Paulo, Brazil: a retrospective study |
| title_sort | maternal near miss and potentially life threatening condition determinants in patients with type 1 diabetes mellitus at a university hospital in sao paulo brazil a retrospective study |
| topic | Maternal near miss Type 1 diabetes mellitus Severe maternal morbidity Potentially life-threatening condition Maternal health |
| url | http://link.springer.com/article/10.1186/s12884-020-03392-y |
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