Repercussões da pré-eclâmpsia grave nos desfechos perinatais

Abstract

Introduction: The analysis of neonatal and maternal health indicators is used globally as a marker of the effectiveness of health services in a country. The perinatal period requires special attention, since the vulnerability of the fetus and neonate in the face of exposure to obstetric pathologies that influence perinatal health, such as severe preeclampsia. Objective: To analyze the factors associated with the perinatal outcomes of pregnant women diagnosed with severe preeclampsia. Methodology: A cross-sectional study developed in a retrospective and prospective school maternity unit, whose population corresponded to the fetuses/ neonates of pregnant women diagnosed with severe preeclampsia. The sample corresponded to 157 records in a one-year cut. Fetuses / neonates of pregnant women diagnosed with severe preeclampsia were excluded, and the fetuses / neonates of pregnant women with diagnosis of other hypertensive syndromes were excluded. The pre-project was approved with opinion number: 2,013,851 and C. A. A. E: 64881817.5.0000.5537. The research followed Resolution 466/2012. SPSS 21.0 and R 3.3.2 were used for data analysis. Results: Vitality was associated with maternal, perinatal and neonatal variables. Intrauterine growth restriction had an influence on gestational age (p <0.001) and birth weight (p <0.01) of the neonate. Thus, a significant proportion of preterm infants (48.4%) and neonates classified as low birth weight (43.3%) were observed. Gestational age and birth weight were associated with fetal vitality (p <0.001 and p = 0.018), the need for resuscitation (p <0.001) and admission to the intensive care unit (p <0.01). Low APGAR values in the first and fifth minutes were related to neonatal death (p <0.01), need for resuscitation (p <0.01) and admission to the intensive care unit (p = 0.004 and p = 0.041). A higher number of prenatal consultations (0.30, p <0.001) and lower values of proteinuria (-0.30, p <0.001) were correlated with a higher gestational age of the neonate. The higher the number of weeks of gestation at admission (0.77, p <0.001), the greater the weight of the newborn at birth. Conclusions: Preeclampsia severity had a negative effect on perinatal outcomes with intrauterine growth restriction, fetal death, prematurity, low birth weight, need for neonatal resuscitation and admission to the intensive care unit.