NUTRITIONAL STATUS, DIETARY INTAKE, AND OCCURRENCE OF GESTATIONAL DIABETES MELLITUS AND GESTATIONAL HYPERTENSION IN PREGNANT WOMEN FOLLOWED AT A PRENATAL NUTRITION OUTPATIENT CLINIC

Abstract

Introduction: Gestational Diabetes Mellitus (GDM) and Gestational Hypertension (GH) are among the main pregnancy complications associated with increased maternal and perinatal morbidity and mortality. Pre-gestational excess weight, inadequate weight gain, and unfavorable dietary patterns contribute to unfavorable development during pregnancy, and nutritional assessment during prenatal care is an important strategy for identifying modifiable risk factors. Objective: To evaluate the nutritional status and food consumption of pregnant women followed in a prenatal nutrition outpatient clinic to investigate the relationship with the occurrence of Gestational Diabetes Mellitus and Gestational Hypertension. Methods: A retrospective observational study was conducted with 40 pregnant women aged 18 to 39 years who were followed at the prenatal nutrition outpatient clinic of the Fernandes Figueira National Institute of Women, Children and Adolescent Health (IFF/FIOCRUZ) in Rio de Janeiro in 2019. Sociodemographic, anthropometric, clinical, and dietary variables obtained from medical records and nutritional assessment forms were analyzed. Pre-pregnancy nutritional status was assessed using Body Mass Index (BMI), and dietary intake was estimated via 24-hour dietary recalls. Prevalence rates, prevalence ratios, and indicators of macro- and micronutrient intake adequacy were calculated. Results: A predominance of excess pre-pregnancy weight was observed, with a mean BMI falling within the overweight range. Among pregnant women with gestational diabetes mellitus (GDM), the prevalence of excess pre-pregnancy weight was 87.50%, while among those with hypertensive disorders of pregnancy (HDP), it was 83.33%. The prevalence ratios for excess weight associated with GDM and HDP were 1.65 and 1.48, respectively. Dietary assessment revealed a high incidence of nutritional inadequacy, characterized primarily by low intake of dietary fiber, folate, vitamin B12, calcium, potassium, and vitamin D, alongside high saturated fat consumption. Among pregnant women with HDP, inadequate sodium intake showed the strongest association, with a prevalence ratio of 2.27. Results: A predominance of pre-gestational excess weight was observed, with mean BMI values falling within the overweight range. Among pregnant women with gestational diabetes mellitus (GDM), the prevalence of pre-gestational excess weight was 87.50%, while among those with hypertensive disorders of pregnancy (HDP), it was 83.33%. Prevalence ratios for excess weight associated with GDM and HDP were 1.65 and 1.48, respectively. Dietary assessment revealed a high incidence of nutritional inadequacy, characterized primarily by low intake of dietary fiber, folate, vitamin B12, calcium, potassium, and vitamin D, alongside high saturated fat consumption. Among pregnant women with HDP, inadequate sodium intake showed the strongest association, with a prevalence ratio of 2.27. Conclusion: The results demonstrate a high frequency of pre-gestational excess weight and dietary inadequacies among the pregnant women evaluated. Additionally, a higher occurrence of GDM and HDP was observed among women with excess weight, suggesting that maternal nutritional status and diet quality may contribute to the development of these gestational complications. These findings underscore the importance of nutritional counseling during prenatal care to monitor nutritional status and promote healthy eating habits.