Systematic revision and meta-analysis: prevalence of gestational diabetes pregnant women who had overweight during the pregnancy

Introduction: During pregnancy, a woman's body undergoes numerous morphophysiological changes. To facilitate the transport of glucose to the fetus, the release of certain placental anti-insulin hormones leads to insulin resistance in the pregnant woman. This metabolic adaptation of the expectant mother is linked to the development of gestational diabetes, a metabolic disorder associated with reduced insulin sensitivity in the mother's body, leading to hyperglycemia in the mother and increased glucose supply to the fetus. Uncontrolled hyperglycemia can result in fetal hyperglycemia, leading to various negative effects on the baby. This situation can be connected to excessive weight gain during pregnancy. In obese women or those who gain excessive weight during pregnancy, this phenomenon is more pronounced. In the case of increased body fat (especially visceral fat) due to excess weight, visceral fat exhibits a high rate of lipolysis, releasing a large number of fatty acids. It is also highly metabolic and stimulates the release of pro-inflammatory cytokines such as TNF-alpha and IL-6, all of which are factors related to insulin resistance. In Brazil, a prevalence of 18% for this syndrome was observed in the Unified Health System in 2020, showing a 10% increase compared to 2011. Objectives: To conduct a systematic review for a meta-analysis on the topic "Relationship between Gestational Diabetes and Excess Weight and Obesity," aiming to provide scientific evidence that assists in identifying risk factors and developing appropriate prevention and treatment strategies for the disease. Methodology: This involves a systematic review with a meta-analysis of the obtained data. Each of the 6 reviewers will independently select scientific articles using research platforms such as Google Scholar, Scielo, Medline, and PubMed, with the keywords: obesity, gestational diabetes, excess weight, cohort, case-control, pregnancy. Only observational studies were selected, and cross-sectional articles were excluded. All selected articles will be evaluated according to the Newcastle-Ottawa Scale (NOS) method, considering only those with a score higher than 6. Results: For better analysis of the results, the reviewers compiled a table containing information from all 27 articles, including title, authors, year, study type, sample size, statistical data, conclusion, Newcastle-Ottawa Scale score. Additionally, there is a forest plot graph showing the odds ratio of some articles that relate obesity to the development of gestational diabetes, where all articles had an OR greater than 1. Conclusion: It can be concluded that there is a positive association between obesity and excessive weight gain during pregnancy with the development of gestational diabetes mellitus, exacerbation of the disease's symptoms, higher insulin doses for treatment, and fetal effects such as high birth weight and fetal macrosomia.