Resultados perinatales en gestantes diabéticas en instituciones prestadoras de servicios en salud de la ciudad de Bogotá

Objetivo: Evaluar los desenlaces perinatales en gestantes con diabetes gestacional (DG) según el tipo de tratamiento recibido (dieta, metformina o insulina) en cuatro instituciones de salud de Bogotá, Colombia. Materiales y métodos: Estudio de cohortes prospectivo. Se incluyeron gestantes con DG dia...

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Autores:
Fuentes Obando, Lina Paola
Tipo de recurso:
https://purl.org/coar/resource_type/c_7a1f
Fecha de publicación:
2025
Institución:
Universidad El Bosque
Repositorio:
Repositorio U. El Bosque
Idioma:
spa
OAI Identifier:
oai:repositorio.unbosque.edu.co:20.500.12495/15615
Acceso en línea:
https://hdl.handle.net/20.500.12495/15615
Palabra clave:
Diabetes
Gestacional
Insulina
Metformina
Dieta
Gestational
Diabetes
Diet
Metformin
Insulin
WQ 200
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closedAccess
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id UNBOSQUE2_89b935bdb6e52051fbf08db176a89d18
oai_identifier_str oai:repositorio.unbosque.edu.co:20.500.12495/15615
network_acronym_str UNBOSQUE2
network_name_str Repositorio U. El Bosque
repository_id_str
dc.title.none.fl_str_mv Resultados perinatales en gestantes diabéticas en instituciones prestadoras de servicios en salud de la ciudad de Bogotá
dc.title.translated.none.fl_str_mv Perinatal Outcomes in Diabetic Pregnant Women in Health Care Institutions in Bogotá
title Resultados perinatales en gestantes diabéticas en instituciones prestadoras de servicios en salud de la ciudad de Bogotá
spellingShingle Resultados perinatales en gestantes diabéticas en instituciones prestadoras de servicios en salud de la ciudad de Bogotá
Diabetes
Gestacional
Insulina
Metformina
Dieta
Gestational
Diabetes
Diet
Metformin
Insulin
WQ 200
title_short Resultados perinatales en gestantes diabéticas en instituciones prestadoras de servicios en salud de la ciudad de Bogotá
title_full Resultados perinatales en gestantes diabéticas en instituciones prestadoras de servicios en salud de la ciudad de Bogotá
title_fullStr Resultados perinatales en gestantes diabéticas en instituciones prestadoras de servicios en salud de la ciudad de Bogotá
title_full_unstemmed Resultados perinatales en gestantes diabéticas en instituciones prestadoras de servicios en salud de la ciudad de Bogotá
title_sort Resultados perinatales en gestantes diabéticas en instituciones prestadoras de servicios en salud de la ciudad de Bogotá
dc.creator.fl_str_mv Fuentes Obando, Lina Paola
dc.contributor.advisor.none.fl_str_mv Romero Infante , Ximena Carolina
Sarmiento , Diana Piedad
Uriel Calvo, María Montserrat
Gómez Cruz , Melissa
De la Hoz-Valle , José Antonio
Bastidas, Karina
Bonilla, Leonardo
Sánchez, Sandra
Beltrán, Sandra
Sarmiento, Andrés
Barón , Germán
Reyes Skinner, Carolina
Gonzalez, Ricardo
Reyes , Guillermo
dc.contributor.author.none.fl_str_mv Fuentes Obando, Lina Paola
dc.subject.none.fl_str_mv Diabetes
Gestacional
Insulina
Metformina
Dieta
topic Diabetes
Gestacional
Insulina
Metformina
Dieta
Gestational
Diabetes
Diet
Metformin
Insulin
WQ 200
dc.subject.keywords.none.fl_str_mv Gestational
Diabetes
Diet
Metformin
Insulin
dc.subject.nlm.none.fl_str_mv WQ 200
description Objetivo: Evaluar los desenlaces perinatales en gestantes con diabetes gestacional (DG) según el tipo de tratamiento recibido (dieta, metformina o insulina) en cuatro instituciones de salud de Bogotá, Colombia. Materiales y métodos: Estudio de cohortes prospectivo. Se incluyeron gestantes con DG diagnosticada según los criterios de la Asociación Internacional de Grupos de Estudio sobre Diabetes y Embarazo (IADPSG) y Carpenter y Coustan. Se recolectaron variables sociodemográficas, obstétricas y desenlaces materno-perinatales. Se aplicaron pruebas de Chi-cuadrado, test exacto de Fisher y Kruskal-Wallis. Se construyó un modelo de regresión logística multivariado para identificar predictores de desenlaces perinatales adversos (p < 0,05). Resultados: Se analizaron 385 gestantes, 92.7% completó el seguimiento. Al ingreso, 42.9% recibió dieta, 27.5% metformina y 29.6% insulina. El control metabólico adecuado fue más frecuente con insulina (90.0%; p = 0.018). Se observó mayor frecuencia de ingreso a UCIN (41.4%) y SDRA (25.9%) en el grupo insulina. En el modelo ajustado, aumentaron el riesgo de desenlaces adversos: insulina (OR: 14.86) , metformina (OR: 5.11), preeclampsia (OR: 2.34), fetopatía diabética (OR: 3.78) y menor peso fetal (OR: 0.99). El tratamiento instaurado al parto fue protector (metformina OR: 0.18; insulina OR: 0.11). AUC: 0.783; sensibilidad: 64.8%; especificidad: 75.5%. Conclusiones: La frecuencia de desenlaces maternos y perinatales en mujeres con DG varió según la estrategia terapéutica. La insulina se asoció con mejor control glucémico pero mayor riesgo perinatal. La preeclampsia, signos ecográficos de fetopatía diabética, menor peso fetal al nacer y la instauración temprana de tratamiento farmacológico fueron predictores de desenlace perinatal adverso.
publishDate 2025
dc.date.accessioned.none.fl_str_mv 2025-07-31T20:18:03Z
dc.date.available.none.fl_str_mv 2025-07-31T20:18:03Z
dc.date.issued.none.fl_str_mv 2025-07
dc.type.coar.fl_str_mv http://purl.org/coar/resource_type/c_7a1f
dc.type.local.spa.fl_str_mv Tesis/Trabajo de grado - Monografía - Especialización
dc.type.coar.none.fl_str_mv https://purl.org/coar/resource_type/c_7a1f
dc.type.driver.none.fl_str_mv info:eu-repo/semantics/bachelorThesis
dc.type.coarversion.none.fl_str_mv https://purl.org/coar/version/c_ab4af688f83e57aa
format https://purl.org/coar/resource_type/c_7a1f
dc.identifier.uri.none.fl_str_mv https://hdl.handle.net/20.500.12495/15615
dc.identifier.instname.spa.fl_str_mv instname:Universidad El Bosque
dc.identifier.reponame.spa.fl_str_mv reponame:Repositorio Institucional Universidad El Bosque
dc.identifier.repourl.none.fl_str_mv repourl:https://repositorio.unbosque.edu.co
url https://hdl.handle.net/20.500.12495/15615
identifier_str_mv instname:Universidad El Bosque
reponame:Repositorio Institucional Universidad El Bosque
repourl:https://repositorio.unbosque.edu.co
dc.language.iso.fl_str_mv spa
language spa
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spelling Romero Infante , Ximena CarolinaSarmiento , Diana PiedadUriel Calvo, María MontserratGómez Cruz , MelissaDe la Hoz-Valle , José AntonioBastidas, KarinaBonilla, LeonardoSánchez, SandraBeltrán, SandraSarmiento, AndrésBarón , GermánReyes Skinner, CarolinaGonzalez, RicardoReyes , GuillermoFuentes Obando, Lina Paola2025-07-31T20:18:03Z2025-07-31T20:18:03Z2025-07https://hdl.handle.net/20.500.12495/15615instname:Universidad El Bosquereponame:Repositorio Institucional Universidad El Bosquerepourl:https://repositorio.unbosque.edu.coObjetivo: Evaluar los desenlaces perinatales en gestantes con diabetes gestacional (DG) según el tipo de tratamiento recibido (dieta, metformina o insulina) en cuatro instituciones de salud de Bogotá, Colombia. Materiales y métodos: Estudio de cohortes prospectivo. Se incluyeron gestantes con DG diagnosticada según los criterios de la Asociación Internacional de Grupos de Estudio sobre Diabetes y Embarazo (IADPSG) y Carpenter y Coustan. Se recolectaron variables sociodemográficas, obstétricas y desenlaces materno-perinatales. Se aplicaron pruebas de Chi-cuadrado, test exacto de Fisher y Kruskal-Wallis. Se construyó un modelo de regresión logística multivariado para identificar predictores de desenlaces perinatales adversos (p < 0,05). Resultados: Se analizaron 385 gestantes, 92.7% completó el seguimiento. Al ingreso, 42.9% recibió dieta, 27.5% metformina y 29.6% insulina. El control metabólico adecuado fue más frecuente con insulina (90.0%; p = 0.018). Se observó mayor frecuencia de ingreso a UCIN (41.4%) y SDRA (25.9%) en el grupo insulina. En el modelo ajustado, aumentaron el riesgo de desenlaces adversos: insulina (OR: 14.86) , metformina (OR: 5.11), preeclampsia (OR: 2.34), fetopatía diabética (OR: 3.78) y menor peso fetal (OR: 0.99). El tratamiento instaurado al parto fue protector (metformina OR: 0.18; insulina OR: 0.11). AUC: 0.783; sensibilidad: 64.8%; especificidad: 75.5%. Conclusiones: La frecuencia de desenlaces maternos y perinatales en mujeres con DG varió según la estrategia terapéutica. La insulina se asoció con mejor control glucémico pero mayor riesgo perinatal. La preeclampsia, signos ecográficos de fetopatía diabética, menor peso fetal al nacer y la instauración temprana de tratamiento farmacológico fueron predictores de desenlace perinatal adverso.Hospital Universitario Clínica San RafaelCentro Policlínico del OlayaObgyn – Centro Diagnóstico Para La MujerSubred Sur Occidente de KennedyEspecialista en Medicina Materno-FetalEspecializaciónObjective: To evaluate perinatal outcomes in pregnant women with gestational diabetes (GD) according to the type of treatment received (diet, metformin, or insulin) in four healthcare institutions in Bogotá, Colombia. Materials and methods: Prospective cohort study. Pregnant women with GD were included based on the diagnostic criteria of the International Association of Diabetes and Pregnancy Study Groups (IADPSG) and Carpenter and Coustan. Sociodemographic, obstetric, and maternal-perinatal outcome variables were collected. Statistical analyses included Chi-square test, Fisher's exact test, and Kruskal-Wallis test. A multivariable logistic regression model was constructed to identify predictors of adverse perinatal outcomes (p < 0.05). Results: A total of 385 pregnant women were analyzed; 92.7% completed follow-up. At inclusion, 42.9% received dietary management, 27.5% metformin, and 29.6% insulin. Adequate metabolic control was more frequent in the insulin group (90.0%; p = 0.018). Admission to NICU (41.4%) and neonatal respiratory distress syndrome (NRDS, 25.9%) were more frequent in the insulin group. In the adjusted model, the following were associated with increased risk of adverse outcomes: insulin (OR: 14.86), metformin (OR: 5.11), preeclampsia (OR: 2.34), sonographic signs of diabetic fetopathy (OR: 3.78), and lower birthweight (OR: 0.99). Pharmacological treatment initiated at delivery was protective (metformin OR: 0.18; insulin OR: 0.11). AUC: 0.783; sensitivity: 64.8%; specificity: 75.5%. Conclusions: The frequency of maternal and perinatal outcomes in women with GD varied by treatment strategy. Insulin was associated with better glycemic control but higher perinatal risk. 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