El exceso y el bajo peso corporal al nacimiento en hijos de madres con diabetes / Excess and low body weight at birth in diabetic-mother infants

Introducción: el hijo de madre con diabetes (HMD) puede sufrir alteraciones durante el embarazo por la enfermedad materna. Cuando aparece en la segunda mitad de la gestación hablamos de fetopatía diabética, más frecuente en mujeres con descontrol metabólico y en la diabetes mellitus gestacional (DMG). La edad, paridad, obesidad, ganancia de peso durante el embarazo, grado de intolerancia a la glucosa, entre otros, pueden influir como determinantes del crecimiento fetal. Los autores se propusieron conocer la relación de estos factores con el peso del neonato. Objetivo: identificar factores modificables en las embarazadas con diabetes que permitan aumentar la frecuencia de recién nacidos de adecuado peso según edad gestacional. Métodos: se analizaron los resultados en 2 038 nacidos vivos hijos de madres con diabetes (350 diabéticas pregestacionales y 1 688 diabéticas gestacionales), durante 14 años. Resultados: la frecuencia de exceso de peso corporal neonatal resultó 11,83 porciento, se alcanzó su reducción, pero sin aumento del bajo peso. No existieron diferencias significativas en frecuencia de exceso de peso corporal entre las diabéticas pregestacionales y las gestacionales. El exceso de peso neonatal se relacionó con: multiparidad, exceso de peso materno pregestacional, ganancia de peso excesiva y grado de control metabólico durante el embarazo. El bajo peso se relacionó con: bajo peso materno pregestacional, enfermedad hipertensiva gravídica y lesión vascular materna a nivel glomerular. Conclusión: los recién nacidos con exceso o bajo peso para la edad gestacional se relacionaron con factores de riesgo diferentes

Introduction: the child of a diabetic mother (CDM) can suffer alterations during pregnancy by this maternal disease. When it appears in the second half of gestation, we talk of diabetic foetopathy, which is more frequent in women with uncontrolled metabolic and gestational diabetes mellitus (GDM). Age, parity, obesity, weight gain during pregnancy, degree of glucose intolerance, among others, can influence fetal growth determinants. The research sought to understand the relationship of these factors with birth weight. Objective: to identify modifiable factors, which increase the frequency of newborns with appropriate weight for gestational age in diabetic pregnant women. Methods: results are analyzed in 2 038 live births born from diabetic mothers (350 diabetic pre-gestational and diabetic gestational 1 688), during 14 years. Results: occurrence of excess neonatal weight was 11.83 percent, its reduction was achieved, but with no increase in weight. No significant differences were observed in the frequency of excess body weight among pre-gestational and gestational diabetic patients. Neonatal overweight is associated with parity, maternal pre- pregnancy overweight, excessive weight gain and degree of metabolic control during pregnancy. Underweight was associated with low maternal weight before pregnancy, gestational hypertensive disease and mother vascular glomerular injury. Conclusion: the excess or low weights in infants in relation with their gestational age were associated with different risk factors

Desenvolvimento global e de linguagem em crianças nascidas grandes para idade gestacional: relato de três casos / Global and language development in children born large for gestacional age: three cases report

Objetivo: avaliar e descrever o desenvolvimento global e de vocabulário em sujeitos nascidos grandespara idade gestacional (GIG). Métodos: foram aplicados a escala de desenvolvimento segundo Gesell,(1947) para avaliar o desenvolvimento global e o ABFW - Teste de Linguagem Infantil na área vocabuláriopara verificação da competência lexical, em três sujeitos nascidos grandes para a idade gestacionalsem outro fator de risco, na faixa etária de dois anos e seis meses a dois anos e oito meses. Osresultados foram descritos em forma de relato de caso e discutidos comparativamente. Resultados:foi encontrado um perfil diferenciado entre os sujeitos, sendo que o sujeito 1 apresentou desenvolvimentonormal, o sujeito 2 defasagem nas áreas adaptativa e linguagem e o sujeito 3 defasagem específicaem linguagem. Conclusão: o desenvolvimento global e lingüístico nos casos avaliados apontoudiversidade nas performances, com um quadro de normalidade e dois quadros de defasagens emgraus distintos. Embora o número de sujeitos tenha sido pequeno (três), os dados obtidos indicam anecessidade de se observar a população GIG com maior atenção, visando o estabelecimento decondutas preventivas nesta população.

Purpose: to evaluate and describe the global development of vocabulary in children born large forgestational age. Methods: the scale used to evaluate the global development was according to Gesell,and to evaluate the lexical competence the scale used was of ABFW test, in three children born largefor gestational age without other risk factor, among two years and six months and two years and eightmonths old. The results were described as case report and then, they were discussed comparatively.Results: the profile among the children was different. The child number one had a normal development;the child number two had a large divergence among adaptive and language areas, and the child numberthree had a specific divergence in language. Conclusion: the global and linguistic development in theevaluated cases show diversity in the results, with one normal patient’s condition, and two divergenceconditions in different grades. Although the number of children has been small (three), the informationobtained about global and linguistic development indicate that these children should be observed withlarger attention, seeking to set up preventive conducts for this population.