Perfil sociodemográfico de gestantes com diabetes e sua relação com mecanismos de morte celular

Abstract

Introduction: The gestational period is marked by complex physiological changes that seek to meet the demands between mother and baby. A pregnancy accompanied by Diabetes Mellitus potentiates oxidative stress mediated by the inflammatory response that culminates in the production of reactive oxygen and nitrogen species, generating a maternal and placental imbalance causing cellular damage. Objective: To analyze the sociodemographic profile and cell death along with the inflammatory process of Diabetes Mellitus during pregnancy. Materials and methods: This is an observational and descriptive study, with a quantitative approach, operationalized in two stages: cross-sectional study and case-control study. In the first, 240 diabetic and 12 nondiabetic pregnant women were characterized sociodemographically. In the second study, among the 240 diabetic pregnant women, 23 of them and 12 pregnant women without comorbidities had whole blood samples collected for analysis of the cell death profile by flow cytometry, in the populations of lymphocytes, monocytes and granulocytes of whole blood, through labeling with annexin V FIT-C and/or propidium iodide. Results: Of the population studied, 46.25% were between 30 and 39 years old, 57.08% were brown, 50% had a salary income ≤ 01 minimum wage, 57.08% had high school education. Regarding housing, 62.92% of the pregnant women lived in rural areas; 65.83% had sanitation, 97.92% had electricity and 71.25% lived on paved streets. Clinically, 67.74% of pregnant women did not notice symptoms of diabetes before diagnosis, 77.41% were diagnosed during pregnancy, 57.14% had a family history of diabetes and 67.86% had a family history of hypertension. Regarding the diabetes condition, among the 240 pregnant women studied, 79.17%, 5.83% and 15.00% had gestational diabetes, type 1 diabetes mellitus and type 2 diabetes mellitus, respectively. Cellular analysis showed greater cell viability in lymphocytes and granulocytes in the control population (p = 0.001) than in pregnant women with gestational diabetes mellitus (p = 0.04) and in pregnant women with type 1 and 2 diabetes (p = 0.04). Furthermore, a significant difference was observed regarding the degree of recent and late apoptosis in the lymphocyte population of pregnant women with gestational diabetes and control (p = 0.006). Likewise, there was a statistical difference when comparing the same cellular stages in the group of pregnant women with type 1 and 2 diabetes with the control group (p=0.03). Necrosis was more significant in the control group (p=0.03). In the monocyte population, no significant difference was observed between the groups of pregnant women analyzed. The gestational age of the participants was between the 12th and 38th weeks, with apoptosis levels present in all of them. Final considerations: Almost half of the pregnant women were over 32 years old, an age at which the risks of pregnancy such as preeclampsia and other aggravating factors must be taken into account. However, it is possible to have a healthy pregnancy at this age, paying attention to the necessary care. The cellular viability of lymphocytes and granulocytes was better identified in the group of women without diabetes (control group). Between the groups of women with only Gestational Diabetes Mellitus and the group of women with type 1 or 2 diabetes, no difference was observed in the level of apoptosis, suggesting that, regardless of the type of diabetes, the pregnant woman suffered cell loss during pregnancy, showing that Diabetes, especially gestational diabetes, can increase the level of oxidative stress and inflammation, causing excessive apoptosis, causing harm to mothers and babies.