Ganho ponderal, adiposidade, perfil lipídico e glicêmico na gestação em cidade do Nordeste do Brasil: estudo de coorte.

Abstract

To evaluate during pregnancy and postpartum maternal weight gain, maternal adiposity, lipid and glycemic profile and their correlations. Methods: Prospective observational cohort study between June 2013 and September 2015, the advisability sample of 187 pregnant women, initiated in First Quarter of pregnancy and ended in immediate postpartum. Were assessed different maternal variables such as anthropometric, ultrasound and laboratory. Analysis: It was held in Epi-Info 7.1.5 and Medcalc version 16.4.2, calculating measures of central tendency and dispersion for maternal weight gain, visceral and subcutaneous maternal adiposity, lipid and glycemic profile levels. We used the Student T test comparing the variables in two stages (first trimester and immediate postpartum period). At the end it was performed multiple linear regression analysis to identify variables correlated to the accumulation of visceral and subcutaneous adiposity in the first trimester and postpartum. Results: The nutritional classification found a prevalence of 38.6% overweight or obese before pregnancy and 41% were overweight or obese in postpartum period. When comparing BMI and weight on both occasions, there was a statistically significant difference (p < 0.001). The visceral adiposity (VA) averaged in the first quarter was 5.24 ± 1.3 and 5.64cm ± 1.6cm in postpartum (p = 0.005). Subcutaneous Fat Tissue (TFS) in the first quarter and post pregnancy period averaged 2.32 ± 0.84 and 2.52 ± 0.91 in both periods, respectively (p = 0.03). After multiple linear regression analysis, only fasting insulin level (p = 0.004) persisted positively correlated with visceral adiposity in early pregnancy. Relative to subcutaneous adiposity in the same period, they remained positively correlated with fasting insulin levels (p < 0.0001) and triglycerides (p = 0.02). Visceral adiposity in immediate postpartum remained correlated with cholesterol levels (p = 0.01), LDL (p = 0.01) and insulin (p = 0.01) evaluated in the beginning of pregnancy and glycated hemoglobin measured in postpartum (p = 0.03). For subcutaneous fat, correlation was maintained with cholesterol levels (p = 0.04), HDL (p = 0.02) and triglycerides (p = 0.0006) analyzed in the first visit. Conclusion: there were high prevalence of obesity and overweight in the first quarter pregnancy and immediate postpartum. During pregnancy were excessive weight gain, increase of lipids and accumulation of TFS and VA. TFS and VA was positively correlated with changes of lipid and glucose profile.