Prevalência de diabetes gestacional no Brasil: revisão sistemática e metanálise

Mocellin, Lucas Pitrez; Gomes, Hewellynn de Azeredo; Sona, Lincoln; Giacomini, Gabrielle Maria; Pizzuti, Eduarda Pires; Nunes, Gabriéli Borges; Zanchet, Túlio Marcos; Macedo, Juliana Lopes de

Lucas Pitrez Mocellin

contributed with the study conception and design, data analysis

interpretation, writing, and critical review

approved the final version

Universidade Federal do Pampa, Uruguaiana, Brasil.

https://orcid.org/0000-0002-1766-9857

Hewellynn de Azeredo Gomes

contributed with the study conception and design, data analysis

interpretation, writing, and critical review

approved the final version

Universidade Federal do Pampa, Uruguaiana, Brasil.

https://orcid.org/0000-0003-3748-2202

Lincoln Sona

contributed with the study conception and design, data analysis

interpretation, writing, and critical review

approved the final version

Universidade Federal do Pampa, Uruguaiana, Brasil.

https://orcid.org/0000-0002-7962-470X

Gabrielle Maria Giacomini

contributed with the study conception and design, data analysis

interpretation, writing, and critical review

approved the final version

Universidade Federal do Pampa, Uruguaiana, Brasil.

https://orcid.org/0000-0003-1914-1164

Eduarda Pires Pizzuti

contributed with the study conception and design, data analysis

interpretation, writing, and critical review

approved the final version

Universidade Federal do Pampa, Uruguaiana, Brasil.

https://orcid.org/0000-0002-1579-9957

Gabriéli Borges Nunes

contributed with the study conception and design, data analysis

interpretation, writing, and critical review

approved the final version

Universidade Federal do Pampa, Uruguaiana, Brasil.

https://orcid.org/0000-0003-4267-2350

Túlio Marcos Zanchet

contributed with the study conception and design, data analysis

interpretation, writing, and critical review

approved the final version

Universidade Federal do Pampa, Uruguaiana, Brasil.

https://orcid.org/0000-0001-9043-6825

Juliana Lopes de Macedo

contributed with the study conception and design, data analysis

interpretation, writing, and critical review

approved the final version

Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brasil.

https://orcid.org/0000-0002-7080-048X

Correspondence
L. P. Mocellin Universidade Federal do Pampa. BR 472, Km 585, Uruguaiana, RS 97501-970, Brasil. lucasmocellin@unipampa.edu.br

Conflict of interests

The authors declare no conflict of interest.

Additional information

ORCID: Lucas Pitrez Mocellin (0000-0002-1766-9857); Hewellynn de Azeredo Gomes (0000-0003-3748-2202); Lincoln Sona (0000-0002-7962-470X); Gabrielle Maria Giacomini (0000-0003-1914-1164); Eduarda Pires Pizzuti (0000-0002-1579-9957); Gabriéli Borges Nunes (0000-0003-4267-2350); Túlio Marcos Zanchet (0000-0001-9043-6825); Juliana Lopes de Macedo (0000-0002-7080-048X).

Study (Year)	State/Region	Investigation period	Study design	Full sample	Sample studied	Prevalence (%)	Diagnostic criteria	Gestational age
Pinheiro et al. ⁴³43. Pinheiro TV, Goldani MZ; IVAPSA group. Maternal pre-pregnancy overweight/obesity and gestational diabetes interaction on delayed breastfeeding initiation. PLoS One 2018; 13:e0194879. (2018)	Rio Grande do Sul	NI	Prospective cohort	295	219	31.9	IADPSG adapted	NI
do Nascimento et al. ⁴⁴44. do Nascimento GR, Borges MC, Figueiroa JN, Alves LV, Alves JG. Physical activity pattern in early pregnancy and gestational diabetes mellitus risk among low-income women: a prospective cross-sectional study. SAGE Open Med 2019; 7:2050312119875922. (2019)	Pernambuco	November 2012/February 2014	Prospective cohort	907	544	17.4	IADPSG	24-28 weeks
Nunes et al. ⁴⁵45. Nunes RD, Flôres ME, Seemann M, Traebert E, Traebert J. Two criteria of oral glucose tolerance test to diagnose gestational diabetes mellitus. Rev Assoc Méd Bras 2020; 66:139-45. (2020) *	Santa Catarina	NI	Retrospective cohort	NI	120	18.3	IADPSG	24-28 weeks
dos Santos et al. ⁴⁶46. dos Santos PA, Madi JM, Silva ER, Vergani DOP, de Araújo BF, Garcia RMR. Gestational diabetes in the population served by Brazilian public health care. Prevalence and risk factors. Rev Bras Ginecol Obstet 2020; 42:12-8. (2020)	Rio Grande do Sul	January/December 2016	Cross-sectional	3,411	2,313	5.4	IADPSG adapted	NI
Alves et al. ⁴⁷47. Alves JG, Souza ASR, Figueiroa JN, Leal de Araújo CA, Guimarães A, Ray JG. Visceral adipose tissue depth in early pregnancy and gestational diabetes mellitus - a cohort study. Sci Rep 2020; 10:2032. (2020)	Pernambuco	March 2016/September 2018	Prospective cohort	627	518	16.8	IADPSG adapted	24-28 weeks
Nicolosi et al. ⁴⁸48. Nicolosi BF, Souza RT, Mayrink J, Feitosa FE, Rocha Filho EA, Leite DF, et al. Incidence and risk factors for hyperglycemia in pregnancy among nulliparous women: a Brazilian multicenter cohort study. PLoS One 2020; 15:e0232664. (2020)	Pernambuco, Ceará, São Paulo, Rio Grande do Sul	July 2015/July 2018	Prospective cohort	1,373	1,008	14.1	IADPSG adapted	NI
Zhao et al. ⁴⁹49. Zhao P, Liu E, Qiao Y, Katzmarzyk PT, Chaput JP, Fogelholm M, et al. Maternal gestational diabetes and childhood obesity at age 9-11: results of a multinational study. Diabetologia 2016; 59:2339-48. (2016)	São Paulo	September 2011/December 2013	Cross-sectional	4,740	354	3.1	WHO 1999	NI
Guttier et al. ³²32. Guttier MC, Barcelo RS, Ferreira RW, Bortolotto CC, Dartora WJ, Schmidt MI, et al. Repeated high blood pressure at 6 and 11 years at the Pelotas 2004 birth cohort study. BMC Public Health 2019; 19:1260. (2019)	Rio Grande do Sul	January/December 2004	Prospective cohort	4,261	3,182	3.3	NI	NI
Sirimarco et al. ⁵⁰50. Sirimarco MP, Guerra MH, Lisboa EG, Vernini JM, Cassetari BN, de Araujo Costa RA, et al. Diagnostic protocol for gestational diabetes mellitus (GDM) (IADPSG/ADA, 2011): influence on the occurrence of GDM and mild gestational hyperglycemia (MGH) and on the perinatal outcomes. Diabetol Metab Syndr 2017; 9:2. (2017)	São Paulo	January 2008/December 2014	Cross-sectional	482	482	40.2	ADA 2010	NI
Santos et al. ⁵¹51. Santos EMF, Amorin LP, Costa OLN, Oliveira N, Guimarães AC. Profile of gestational and metabolic risk in the prenatal care service of a public maternity in the Brazilian Northeast. Rev Bras Ginecol Obstet 2012; 34:102-6. (2012)	Northeast	May 2007/May 2008	Prospective cohort	204	183	3.4	GTDG 2001	NI
Fagundes et al. ⁵²52. Fagundes DLG, França EL, da Silva Fernandes RT, Hara CC, Morceli G, Honorio-França AC, et al. Changes in T-cell phenotype and cytokines profile in maternal blood, cord blood and colostrum of diabetic mothers. J Matern Fetal Neonatal Med 2016; 29:998-1004. (2016)	São Paulo	NI	Cross-sectional	58	58	22.4	IADPSG	24-28 weeks
Siqueira et al. ¹⁹19. Siqueira F, Ferreira EM, de Matos Calderon I, Dias A. Prevalence of colonisation by group B streptococcus in pregnant patients in Taguatinga, Federal District, Brazil: a cross-sectional study. Arch Gynecol Obstet 2019; 299:703-11. (2019)	Federal District	June 2013/June 2015	Cross-sectional	519	337	28.2	NI	NI
de Lima et al. ³⁴34. de Lima MC, Santos IS, Crivellenti LC, Sartorelli DS. A better quality of maternal dietary fat reduces the chance of large for gestational age infants: a prospective cohort study. Nutrition 2021; 91-92:111367. (2021)	São Paulo	2011/2012	Prospective cohort	783	734	18.1	IADPSG adapted	24-39 weeks
Neto et al. ⁵³53. Neto MBC, Silva-Souza KP, Maranhão VF, Botelho KVG, Heimer MV, Santos-Junior VE. Enamel defects in deciduous dentition and their association with the occurrence of adverse effects from pregnancy to early childhood. Oral Health Prev Dent 2020; 18:741-6. (2020)	Pernambuco	NI	Cross-sectional	NI	152	5.3	NI	NI
Nehab et al. ⁵⁴54. Nehab SRG, Villela LD, Abranches AD, Rocha DM, da Silva LML, Amaral YNV, et al. Influence of gestational and perinatal factors on body composition of full-term newborns. J Pediatr (Rio J.) 2020; 96:771-7. (2019)	Rio de Janeiro	March 2016/August 2017	Cross-sectional	NI	124	16.1	IADPSG adapted	Any
Ferreira et al. ⁵⁵55. Ferreira LAP, Piccinato CA, Cordioli E, Zlotnik E. Pregestational body mass index, weight gain during pregnancy and perinatal outcome: a retrospective descriptive study. Einstein (São Paulo) 2019; 18:eAO4851. (2020)	São Paulo	March 2015/March 2016	Retrospective cohort	229	151	13.9	NI	NI
Trujillo et al. ⁸8. Trujillo J, Vigo A, Reichelt A, Duncan BB, Schmidt MI. Fasting plasma glucose to avoid a full OGTT in the diagnosis of gestational diabetes. Diabetes Res Clin Pract 2014; 105:322-6. (2015) **	São Paulo, Rio de Janeiro, Rio Grande do Sul, Ceará, Bahia, Amazonas	May 1991/August 1995	Prospective cohort	5,564	4,926	18.0	IADPSG adapted	24-28 weeks
Barbieiri et al. ⁵⁶56. Barbieiri P, Nunes JC, Torres AG, Nishimura RY, Zuccolotto DC, Crivellenti LC, et al. Indices of dietary fat quality during midpregnancy is associated with gestational diabetes. Nutrition 2016; 32:656-61. (2016)	São Paulo	March 2011/November 2012	Cross-sectional	1,446	799	19.0	ADA 2010	After 24 weeks
Renz et al. ¹⁸18. Renz PB, Cavagnolli G, Weinert LS, Silveiro SP, Camargo JL. HbA1c test as a tool in the diagnosis of gestational diabetes mellitus. PLoS One 2015; 10:e0135989. (2015) ***	Rio Grande do Sul	September 2009/July 2012	Cross-sectional	283	262	15.3	IADPSG adapted	After 28 weeks
Rocha et al. ⁵⁷57. Rocha AS, Bernardi JR, Matos S, Kretzer DC, Schoffel AC, Goldani MZ, et al. Maternal visceral adipose tissue during the first half of pregnancy predicts gestational diabetes at the time of delivery - a cohort study. PLoS One 2020; 15:e0232155. (2020)	Rio Grande do Sul	October 2016/December 2017	Prospective cohort	154	133	13.5	IADPSG adapted	NI
Peixoto et al. ⁵⁸58. Peixoto AB, Caldas TMRC, Santos RO, Lopes KS, Martins WP, Araujo Júnior E. The impact of gestational diabetes and hypothyroidism on the third trimester ultrasound parameters and in adverse perinatal outcomes: a retrospective cohort study. J Matern Fetal Neonatal Med 2016; 29:3416-20. (2016)	Minas Gerais	February 2012/March 2015	Retrospective cohort	1,740	817	8.6	IADPSG	24-28 weeks
Chume et al. ⁵⁹59. Chume FC, Renz PB, Hernandez MK, Freitas PAC, Camargo JL. Is there a role for glycated albumin in the diagnosis of gestational diabetes mellitus? Endocrine 2021; 72: 681-7. (2021)	Rio Grande do Sul	September 2009/July 2012	Cross-sectional	149	149	18.8	IADPSG adapted	24-28 weeks
Ayach et al. ³⁸38. Ayach W, Paranhos-Calderon IM, Rudge MVC, Araújo-Costa RAA. Comparison between two gestational diabetes screening tests and the perinatal outcome. Rev Bras Ginecol Obstet 2010; 32:222-8. (2010)	Mato Grosso do Sul	NI	Prospective cohort	341	279	4.3	Imprecise criteria	24-28 weeks
Possa & Oliveira ⁶⁰60. Possa GOK, Oliveira TL. Occurrence of gestational diabetes mellitus in users of the unified health system of the city of Ponta Grossa/PR. Visão Acadêmica 2019; 20:92-102. (2019)	Paraná	2016	Retrospective cohort	700	700	6.2	IADPSG adapted	24-28 weeks
Foratori-Junior et al. ⁶¹61. Foratori-Junior GA, Missio ALT, Orenha ES, de Carvalho Sales-Peres SH. Systemic condition, periodontal status, and quality of life in obese women during pregnancy and after delivery. Int Dent J 2021; 71:420-8. (2021) ^#	São Paulo	February 2019/November 2019	Prospective cohort	73	60	10.0	IADPSG adapted	32-36 weeks
Silva de Morais et al. ⁶²62. Silva de Morais N, Ayres Saraiva D, Corcino C, Berbara T, Schtscherbyna A, Moreira K, et al. Consequences of iodine deficiency and excess in pregnancy and neonatal outcomes: a prospective cohort study in Rio de Janeiro, Brazil. Thyroid 2020; 30:1792-801. (2020)	Rio de Janeiro	September 2014/February 2017	Prospective cohort	243	214	14.9	NI	NI
Morais et al. ⁶³63. Morais AM, Rempel C, Delving LKOB, Moreschi C. Profile and knowledge of pregnant women about gestational diabetes mellitus. Rev Epidemiol Controle Infecç 2019; 9:134-41. (2019)	Rio Grande do Sul	April/May 2017	Cross-sectional ^##	28	20	5.0	NI	NI
Pereira et al. ³⁷37. Pereira DO, Ferreira TLS, de Araújo DV, Melo KDF, de Andrade FB. Evaluation of prenatal consultations: prenatal access and complications in maternal-child health. Rev Ciênc Plur 2017; 3:2-15. (2017)	Rio Grande do Norte	2013	Cross-sectional ^##	NI	200	1.6	NI	NI
Zapelini et al. ⁶⁴64. Zapelini RM, Martinelli MT, João RM, Iser BPM. Diagnostic criteria and prevalence of gestational diabetes mellitus in a hospital in south Santa Catarina, Brazil. Rev AMRIGS 2015; 59:177-81. (2015) ^###	Santa Catarina	August 2013/April 2014	Cross-sectional	NI	506	14.4	IADPSG	24-28 weeks
Oliveira et al. ⁶⁵65. Oliveira ACM, Graciliano NG. Hypertensive disorders of pregnancy and gestational diabetes mellitus in a public maternity hospital of a Northeastern Brazilian capital, 2013: prevalence and associated factors. Epidemiol Serv Saúde 2015; 24:441-51. (2015)	Alagoas	2013	Cross-sectional	NI	217	6.5	IADPSG adapted	NI
Alves et al. ³¹31. Alves AS, Coutinho I, Mendes-Segatto JC, Silva LA, Sousa-Silva MD, Katz L. Evaluation of the adequacy of tracking and diagnosis of gestational diabetes mellitus in pregnant women attending a hospital unit in two municipalities in the São Francisco Valley Region - Northeast Brazil. Rev Bras Saúde Matern Infant 2014; 14:39-46. (2014)	Bahia, Pernambuco	April 2011/January 2012	Cross-sectional ^##	1,459	1,340	20.8	WHO 1999	NI
Nascimento et al. ³³33. Nascimento GR, Alves LV, Fonseca CL, Figueiroa JN, Alves JG. Dietary patterns and gestational diabetes mellitus in a low income pregnant women population in Brazil - a cohort study. Arch Latinoam Nutr 2016; 66:301-8. (2016)	Pernambuco	November 2011/February 2014	Prospective cohort	974	841	10.8	IADPSG adapted	24-28 weeks

Study (Year)	External validity					Internal validity					Total “yes” answers	Risk of bias summary *
Study (Year)	Representative sample?	Representative sampling frame?	Random selection or by census?	Response rate ≥ 75%?	Data collection through subjects?	Acceptable diagnostic criteria?	Reliable/ Validated test for gestational diabetes mellitus?	Same method used for all?	G estational diabetes mellitus test adequate for gestational age?	Appropriate prevalence calculation?
Pinheiro et al. ⁴³43. Pinheiro TV, Goldani MZ; IVAPSA group. Maternal pre-pregnancy overweight/obesity and gestational diabetes interaction on delayed breastfeeding initiation. PLoS One 2018; 13:e0194879. (2018)	No	No	No	No	Yes	Yes	Yes	Yes	No	Yes	5	High
do Nascimento et al. ⁴⁴44. do Nascimento GR, Borges MC, Figueiroa JN, Alves LV, Alves JG. Physical activity pattern in early pregnancy and gestational diabetes mellitus risk among low-income women: a prospective cross-sectional study. SAGE Open Med 2019; 7:2050312119875922. (2019)	No	No	No	No	Yes	Yes	Yes	Yes	Yes	Yes	6	Moderate
Nunes et al. ⁴⁵45. Nunes RD, Flôres ME, Seemann M, Traebert E, Traebert J. Two criteria of oral glucose tolerance test to diagnose gestational diabetes mellitus. Rev Assoc Méd Bras 2020; 66:139-45. (2020)	No	Yes	No	No	No	Yes	Yes	Yes	Yes	No	5	High
dos Santos et al. ⁴⁶46. dos Santos PA, Madi JM, Silva ER, Vergani DOP, de Araújo BF, Garcia RMR. Gestational diabetes in the population served by Brazilian public health care. Prevalence and risk factors. Rev Bras Ginecol Obstet 2020; 42:12-8. (2020)	No	Yes	No	No	No	Yes	Yes	Yes	No	Yes	5	High
Alves et al. ⁴⁷47. Alves JG, Souza ASR, Figueiroa JN, Leal de Araújo CA, Guimarães A, Ray JG. Visceral adipose tissue depth in early pregnancy and gestational diabetes mellitus - a cohort study. Sci Rep 2020; 10:2032. (2020)	No	No	No	Yes	Yes	Yes	Yes	Yes	Yes	Yes	7	Moderate
Nicolosi et al. ⁴⁸48. Nicolosi BF, Souza RT, Mayrink J, Feitosa FE, Rocha Filho EA, Leite DF, et al. Incidence and risk factors for hyperglycemia in pregnancy among nulliparous women: a Brazilian multicenter cohort study. PLoS One 2020; 15:e0232664. (2020)	No	No	No	No	Yes	Yes	Yes	Yes	No	Yes	5	High
Zhao et al. ⁴⁹49. Zhao P, Liu E, Qiao Y, Katzmarzyk PT, Chaput JP, Fogelholm M, et al. Maternal gestational diabetes and childhood obesity at age 9-11: results of a multinational study. Diabetologia 2016; 59:2339-48. (2016)	No	Yes	Yes	No	Yes	Yes	Yes	Yes	Yes	Yes	8	Low
Guttier et al. ³²32. Guttier MC, Barcelo RS, Ferreira RW, Bortolotto CC, Dartora WJ, Schmidt MI, et al. Repeated high blood pressure at 6 and 11 years at the Pelotas 2004 birth cohort study. BMC Public Health 2019; 19:1260. (2019)	Yes	Yes	Yes	Yes	Yes	No	No	Yes	No	Yes	7	Moderate
Sirimarco et al. ⁵⁰50. Sirimarco MP, Guerra MH, Lisboa EG, Vernini JM, Cassetari BN, de Araujo Costa RA, et al. Diagnostic protocol for gestational diabetes mellitus (GDM) (IADPSG/ADA, 2011): influence on the occurrence of GDM and mild gestational hyperglycemia (MGH) and on the perinatal outcomes. Diabetol Metab Syndr 2017; 9:2. (2017)	No	Yes	No	Yes	No	Yes	Yes	Yes	No	Yes	6	Moderate
Santos et al. ⁵¹51. Santos EMF, Amorin LP, Costa OLN, Oliveira N, Guimarães AC. Profile of gestational and metabolic risk in the prenatal care service of a public maternity in the Brazilian Northeast. Rev Bras Ginecol Obstet 2012; 34:102-6. (2012)	No	No	No	Yes	Yes	Yes	Yes	Yes	No	Yes	6	Moderate
Fagundes et al. ⁵²52. Fagundes DLG, França EL, da Silva Fernandes RT, Hara CC, Morceli G, Honorio-França AC, et al. Changes in T-cell phenotype and cytokines profile in maternal blood, cord blood and colostrum of diabetic mothers. J Matern Fetal Neonatal Med 2016; 29:998-1004. (2016)	No	No	No	Yes	Yes	Yes	Yes	Yes	Yes	Yes	7	Moderate
Siqueira et al. ¹⁹19. Siqueira F, Ferreira EM, de Matos Calderon I, Dias A. Prevalence of colonisation by group B streptococcus in pregnant patients in Taguatinga, Federal District, Brazil: a cross-sectional study. Arch Gynecol Obstet 2019; 299:703-11. (2019)	No	No	No	No	No	No	No	No	No	No	0	High
de Lima et al. ³⁴34. de Lima MC, Santos IS, Crivellenti LC, Sartorelli DS. A better quality of maternal dietary fat reduces the chance of large for gestational age infants: a prospective cohort study. Nutrition 2021; 91-92:111367. (2021)	No	No	No	Yes	Yes	Yes	Yes	Yes	Yes	Yes	7	Moderate
Neto et al. ⁵³53. Neto MBC, Silva-Souza KP, Maranhão VF, Botelho KVG, Heimer MV, Santos-Junior VE. Enamel defects in deciduous dentition and their association with the occurrence of adverse effects from pregnancy to early childhood. Oral Health Prev Dent 2020; 18:741-6. (2020)	No	Yes	Yes	No	Yes	No	No	Yes	No	Yes	5	High
Nehab et al. ⁵⁴54. Nehab SRG, Villela LD, Abranches AD, Rocha DM, da Silva LML, Amaral YNV, et al. Influence of gestational and perinatal factors on body composition of full-term newborns. J Pediatr (Rio J.) 2020; 96:771-7. (2019)	No	No	No	No	Yes	Yes	Yes	Yes	No	Yes	5	High
Ferreira et al. ⁵⁵55. Ferreira LAP, Piccinato CA, Cordioli E, Zlotnik E. Pregestational body mass index, weight gain during pregnancy and perinatal outcome: a retrospective descriptive study. Einstein (São Paulo) 2019; 18:eAO4851. (2020)	No	No	No	No	No	No	No	Yes	No	No	1	High
Trujillo et al. ⁸8. Trujillo J, Vigo A, Reichelt A, Duncan BB, Schmidt MI. Fasting plasma glucose to avoid a full OGTT in the diagnosis of gestational diabetes. Diabetes Res Clin Pract 2014; 105:322-6. (2015)	No	No	No	Yes	Yes	Yes	Yes	Yes	No	No	5	High
Barbieiri et al. ⁵⁶56. Barbieiri P, Nunes JC, Torres AG, Nishimura RY, Zuccolotto DC, Crivellenti LC, et al. Indices of dietary fat quality during midpregnancy is associated with gestational diabetes. Nutrition 2016; 32:656-61. (2016)	No	No	No	No	Yes	Yes	Yes	Yes	No	Yes	5	High
Renz et al. ¹⁸18. Renz PB, Cavagnolli G, Weinert LS, Silveiro SP, Camargo JL. HbA1c test as a tool in the diagnosis of gestational diabetes mellitus. PLoS One 2015; 10:e0135989. (2015)	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	10	Low
Rocha et al. ⁵⁷57. Rocha AS, Bernardi JR, Matos S, Kretzer DC, Schoffel AC, Goldani MZ, et al. Maternal visceral adipose tissue during the first half of pregnancy predicts gestational diabetes at the time of delivery - a cohort study. PLoS One 2020; 15:e0232155. (2020)	Yes	Yes	Yes	Yes	No	Yes	Yes	Yes	No	Yes	8	Low
Peixoto et al. ⁵⁸58. Peixoto AB, Caldas TMRC, Santos RO, Lopes KS, Martins WP, Araujo Júnior E. The impact of gestational diabetes and hypothyroidism on the third trimester ultrasound parameters and in adverse perinatal outcomes: a retrospective cohort study. J Matern Fetal Neonatal Med 2016; 29:3416-20. (2016)	No	No	No	No	No	Yes	Yes	Yes	Yes	Yes	5	High
Chume et al. ⁵⁹59. Chume FC, Renz PB, Hernandez MK, Freitas PAC, Camargo JL. Is there a role for glycated albumin in the diagnosis of gestational diabetes mellitus? Endocrine 2021; 72: 681-7. (2021)	No	No	No	Yes	Yes	Yes	Yes	Yes	Yes	Yes	7	Moderate
Ayach et al. ³⁸ (2010)	No	No	No	Yes	Yes	Yes	Yes	Yes	Yes	Yes	7	Moderate
Possa & Oliveira ⁶⁰60. Possa GOK, Oliveira TL. Occurrence of gestational diabetes mellitus in users of the unified health system of the city of Ponta Grossa/PR. Visão Acadêmica 2019; 20:92-102. (2019)	No	No	No	Yes	Yes	Yes	Yes	Yes	Yes	Yes	7	Moderate
Foratori-Junior et al. ⁶¹61. Foratori-Junior GA, Missio ALT, Orenha ES, de Carvalho Sales-Peres SH. Systemic condition, periodontal status, and quality of life in obese women during pregnancy and after delivery. Int Dent J 2021; 71:420-8. (2021)	No	No	No	Yes	No	Yes	Yes	Yes	No	Yes	5	High
Silva de Morais et al. ⁶²62. Silva de Morais N, Ayres Saraiva D, Corcino C, Berbara T, Schtscherbyna A, Moreira K, et al. Consequences of iodine deficiency and excess in pregnancy and neonatal outcomes: a prospective cohort study in Rio de Janeiro, Brazil. Thyroid 2020; 30:1792-801. (2020)	No	No	No	Yes	No	No	No	Yes	No	Yes	3	High
Morais et al. ⁶³63. Morais AM, Rempel C, Delving LKOB, Moreschi C. Profile and knowledge of pregnant women about gestational diabetes mellitus. Rev Epidemiol Controle Infecç 2019; 9:134-41. (2019)	No	Yes	No	No	Yes	No	No	Yes	No	Yes	4	High
Pereira et al. ³⁷37. Pereira DO, Ferreira TLS, de Araújo DV, Melo KDF, de Andrade FB. Evaluation of prenatal consultations: prenatal access and complications in maternal-child health. Rev Ciênc Plur 2017; 3:2-15. (2017)	No	Yes	Yes	No	Yes	No	No	Yes	No	Yes	5	High
Zapelini et al. ⁶⁴64. Zapelini RM, Martinelli MT, João RM, Iser BPM. Diagnostic criteria and prevalence of gestational diabetes mellitus in a hospital in south Santa Catarina, Brazil. Rev AMRIGS 2015; 59:177-81. (2015)	No	Yes	No	No	No	Yes	Yes	Yes	Yes	Yes	6	Moderate
Oliveira et al. ⁶⁵65. Oliveira ACM, Graciliano NG. Hypertensive disorders of pregnancy and gestational diabetes mellitus in a public maternity hospital of a Northeastern Brazilian capital, 2013: prevalence and associated factors. Epidemiol Serv Saúde 2015; 24:441-51. (2015)	Yes	Yes	No	No	Yes	Yes	Yes	Yes	Yes	Yes	8	Low
Alves et al. ³¹31. Alves AS, Coutinho I, Mendes-Segatto JC, Silva LA, Sousa-Silva MD, Katz L. Evaluation of the adequacy of tracking and diagnosis of gestational diabetes mellitus in pregnant women attending a hospital unit in two municipalities in the São Francisco Valley Region - Northeast Brazil. Rev Bras Saúde Matern Infant 2014; 14:39-46. (2014)	Yes	Yes	No	Yes	Yes	Yes	Yes	Yes	Yes	Yes	9	Low
Nascimento et al. ³³33. Nascimento GR, Alves LV, Fonseca CL, Figueiroa JN, Alves JG. Dietary patterns and gestational diabetes mellitus in a low income pregnant women population in Brazil - a cohort study. Arch Latinoam Nutr 2016; 66:301-8. (2016)	No	No	No	Yes	Yes	Yes	Yes	Yes	Yes	No	6	Moderate

QUALITY ASSESSMENT
Studies	Study design	Risk of bias	Inconsistency	Imprecision	Indirectness	Publication bias	Other considerations
32	Observational studies	Not serious *	Serious **	Not serious ***	Serious ^#	Not serious ^##	NA
Prevalence (95%CI): 0.14 (0.11; 0.16)				Quality: Low ⊕⊕○○

Subgroup	Studies	Full sample	Prevalence (95%CI)	Heterogeneity
Subgroup	Studies	Full sample	Prevalence (95%CI)	Q value	I²	p-value *
Risk of bias						0.870
High	15	11,460	0.14 (0.10; 0.18)	584.33	97.60
Moderate	12	7,515	0.14 (0.10; 0.19)	557.04	98.03
Low	5	1,645	0.12 (0.03; 0.20)	163.34	97.55
Diagnostic criteria						0.450
IADPSG	5	2,862	0.15 (0.10; 0.20)	32.74	87.78
IADPSG adapted	14	9,803	0.14 (0.11; 0.18)	437.36	97.03
Other criteria **	6	3,699	0.15 (0.06; 0.24)	421.41	98.81
Not informed	7	4,256	0.10 (0.05; 0.15)	143.20	95.81
Country region						0.170
Northeast	7	3,754	0.11 (0.05; 0.18)	244.71	97.55
Central-West	2	780	0.09 (0.07; 0.11)	-	-
Southeast	9	1,991	0.14 (0.09; 0.18)	146.04	94.52
South	10	8,653	0.13 (0.09; 0.16)	203.66	95.58

[1] Correspondence
L. P. Mocellin Universidade Federal do Pampa. BR 472, Km 585, Uruguaiana, RS 97501-970, Brasil. lucasmocellin@unipampa.edu.br

Brasil

Brasil

Prevalência de diabetes gestacional no Brasil: revisão sistemática e metanálise

Resumo: