Effect of Prenatal Care on Perinatal Outcomes of Pregnant Women with Diabetes Mellitus: A Systematic Review.

Objective: to evaluate the effect of prenatal care (PC) on perinatal outcomes of pregnant women with diabetes mellitus (DM). Methods: systematic review developed according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 guidelines and conducted through the population, intervention, control, and outcomes (PICO) strategy. Clinical trials and observational studies were selected, with adult pregnant women, single-fetus pregnancy, diagnosis of DM, or gestational DM and who had received PC and/or nutritional therapy (NT). The search was carried out in PubMed, Scopus, and BIREME databases. The quality of the studies was evaluated using the tools of the National Heart, Lung and Blood Institute-National Institutes of Health (NHLBI-NIH). Results: We identified 5972 records, of which 15 (n=47 420 pregnant women) met the eligibility criteria. The most recurrent outcomes were glycemic control (14 studies; n=9096 participants), hypertensive disorders of pregnancy (2; n=39 282), prematurity (6; n=40 163), large for gestational age newborns (4; n=1556), fetal macrosomia (birth weight >4kg) (6; n=2980) and intensive care unit admission (4; n=2022). Conclusions: The findings suggest that PC interferes with the perinatal outcome, being able to reduce the risks of complications associated with this comorbidity through early intervention, especially when the NT is an integral part of this assistance.

Nutritional influences on oral infections: the oral microbiota modulation

Introduction: The oral microbiota has approximately 700 symbiotic microorganisms responsible for oral health homeostasis. However, changes in oral microbiota can generate dysbiotic processes that favor the worsening of infections such as caries and periodontal disease. These oral infections, in addition to systemic involvement, can compromise the teeth integrity as well as oral health. Thus, inadequate nutrition proves to be a risk factor influencing the prevention and treatment of these oral infections. Objective: This study aims to evidence the nutritional influence on the oral microbiota modulation affecting, in the longterm, the gut microbiota, highlighting the use of probiotics and prebiotics in the treatment of oral infections by a literature review. Synthesis of data : Supplements of certain nutrients and the intake of an adequate diet in macronutrients and micronutrients directly influence nutritional status and consequently in the maintenance of oral-systemic homeostasis. In addition, due to microbial multidrug resistance, therapies using probiotics and prebiotics have been adopted as aids to the treatment of oral infections. Conclusion: Personalized Dentistry must integrate multidisciplinary knowledge of attention for health care. This in addition to knowingwhen to refer and work together with a Nutritionist.

Introdução: A microbiota oral possui aproximadamente 700 microrganismos simbiontes responsáveis pela homeostase da saúde bucal. Contudo, alterações na microbiota oral podem gerar processos disbióticos que favorecem o agravamento de infecções como a cárie e a doença periodontal. Essas infecções orais, além do acometimento sistêmico, podem comprometer a integridade dos dentes e também da saúde bucal. Dessa forma, a alimentação inadequada mostra-se um fator de risco que influência na prevenção e no tratamento dessas infecções orais. Objetivo: Este estudo visa evidenciar a influência nutricional na modulação da microbiota oral afetando a longo prazo a microbiota intestinal, destacando o uso de probióticos e prebióticos no tratamento de infecções orais através de uma revisão de literatura. Síntese de dados: A suplementação de determinados nutrientes e a ingestão de uma dieta adequada em macronutrientes e micronutrientes influenciam diretamente no estado nutricional e consequentemente na manutenção da homeostase oral-sistêmica. Além disso, devido à multirresistência microbiana, terapias com probióticos e prebióticos têm sido adotadas como auxiliares no tratamento de infecções orais. Conclusão: A Odontologia Personalizada deve integrar conhecimentos multidisciplinares de atenção à saúde. Isso além de saber quando encaminhar e trabalhar junto com o Nutricionista.