Desfechos materno-fetais nas síndromes hipertensivas da gravidez

Abstract

Hypertensive Pregnancy Syndromes (SHGs) are an important cause of maternal and perinatal mortality.. We aim to evaluate and compare maternal-fetal outcomes related to SHGs. This research is a hospital-based realized in the largest maternity hospital in the state of Northeastern Brazil. The study was conducted between Maio 2020 to Maio 2022. To compose the study population were included women older than 18 years that were at least at their 20th week of pregnancy and were admitted to the emergency room with the diagnosis of HPS. Data were analyzed using Stata 11.0 (Stata Corporation, Texas, USA). Categorical variables were compared using the Chisquare (χ2) or Fisher’s exact tests as appropriate, while continuous variables were compared using student t-tests. 501 women with HPS in pregnancy were studied. There was no difference between the groups G1 (Pre-eclampsia/Eclampsia)and G2 (chronic hypertension) as sociodemographic and reproductive data. Theresult of pre term labor was (66% vs 48; adjusted RR 1.3995; 95% CI 0.5586-0.6422; p= 0.0002) to G1 and G2 respectively. Cesarean section (79.4% vs 65%; adjusted RR, 2,139; 95% CI, 1,386-3,302; p = <0.001). The risks of prolonged maternal hospitalization were (59.4% vs 50.3%; adjusted RR 1.126; 95% CI, 0.757–1.677; p = 0.556). Regarding the risk estimates for adverse fetal outcomes between the groups, prematurity birth <34 weeks' gestation the results were 20.5% vs 6%; adjusted RR, 2.505; 95% CI, 1.194–5.257; p = 0.015. Apgar (<7) at 1 minute was: 15.1% vs 8.8%; adjusted RR,1.967; 95% CI; 1.112 - 3.477; p =0,020 and the risk of Apgar (<7) at 5 minutes: 7% vs 2.5%; adjusted RR,3.477; 95% CI; 1,5 - 9.356; p =0.006. NICU admission the results were 22.7% vs 6%; adjusted RR, 2.567; 95% Cl, 1.296-5.088; p= 0.007, and perinatal mortality was % vs 2.2%; adjusted RR, 0.423; 95% Cl, 0.101- 1.770; p= 0.239. In conclusion, the results of this study highlight the importance of HPG as a major cause of adverse maternal and neonatal outcomes. Specifically, women with eclampsia, had the worst health outcomes including an increased oddsof having a low birth weight baby, delivering a stillbirth, and were more likely to die due to complications of pregnancy.