CELLULAR IMPACT OF DIABETES IN PREGNANT WOMEN: A CYTOFLUORIMETRIC ANALYSIS.
Gestational diabetes; Annexins; Flow Cytometry; Immunological Tests.
In 2021, of the 14 million diagnosed cases of diabetes mellitus, 7% were of gestational diabetes mellitus (GDM), which represents around 980 thousand Brazilian pregnant women. This disease can result in important maternal-fetal outcomes such as pre-eclampsia, premature rupture of membranes in women and the development of macrosomia, jaundice, hypoglycemia, respiratory distress, polycythemia and hypocalcemia in fetuses. The inflammatory state and the increase in the gestational glycemic index cause cellular damage that culminates in the release of free radicals and/or reactive oxygen species, leading to oxidative stress and an increase in programmed cell death. Objective: To analyze whether the presence of cellular apoptosis and formation of micronuclei are associated with the inflammatory process of Diabetes Mellitus during pregnancy in a teaching maternity hospital as a potential diagnosis for Diabetes Mellitus. Methodology: This is an observational and descriptive study, with a quantitative approach, operationalized in two stages: cross-sectional study and case-control. At the moment, 118 of 210 pregnant women were enrolled, divided between groups of diabetic pregnant women and control. The sample calculation was performed using the G*Power 3.1.9.7 software (Universitat Dusseldorf, Dusseldorf, Germany). Biological samples are obtained by collecting peripheral blood to identify apoptotic cells by flow cytometry following the PeripheralBlood Mononuclear Cell protocol (PBMC). Qualitative data were collected through interviews with pregnant women and, when necessary, there was access to physical and/or electronic medical records and the descriptive analysis was carried out using the Statistical Package for the Social Science (SPSS). Results: To date, the monocyte population has not shown to be significant, while granulocytes and lymphocytes have shown significant expression. There was a predominance of brown pregnant women, with gestational diabetes, living in inland regions, with a high school diploma. Final considerations: Flow cytometry has been an important tool for the assessment of apoptosis and a deeper understanding of the underlying biological processes during pregnancy, whether in pregnant women with or without comorbidities. Therefore, a greater presence of recent and late apoptosis was observed in the population of diabetic pregnant women in relation to what was seen in the control group.