Análise do perfil epidemiológico e evolução hospitalar de gestantes com síndromes hipertensivas

Abstract

Introduction: Hypertensive disorders in pregnancy remain a global challenge for the reduction of maternal morbidity and mortality, especially in low and middle income countries. In Brazil, it is estimated that the prevalence is 10%, being the main cause of maternal deaths. Objective: is study aims to analyze the pro le of pregnant women with hypertensive disorders at childbirth and to associate them with maternal and perinatal outcomes. Methods: In a retrospective cross-sectional database analysis, all childbirth hospitalizations in a public maternity hospital were analyzed the period before the SARS-CoV-2 pandemic. Prenatal and perinatal factors were associated with maternal and neonatal outcomes by comparing women with or without hypertension in pregnancy. Results: In the period studied, 12,433 pregnant women were admitted to the maternity ward. For this study, 11,173 patients were eligible and 754 (6.8%) had some form of hypertension during pregnancy, and 10,409 (93.2%) were considered in control group. Factors associated with hypertension were: age of the woman (mean 32.5 years versus 31.5 years, p<0.001), diabetes (14.8% versus 10.6%, p=0.001), twin pregnancy (4.3% versus 2.3%, p<0.001), thrombocytopenia (1.6% versus 0.5%, p<0.001) with hypertensive and non-hypertensive, retrospectively. In relation to childbirth and immediate complications, a cesarean section it was more frequent in the hypertensive group (71.3%), as was premature birth (39.9%), near miss (9.5%) and ICU admission (5.6%), in relation to non-hypertensive women. Regarding the neonatal outcome, birth weight was lower (mean 2595 versus 2999 grams, p<0.001), Apgar at the 1st and 5th minutes was lower (p<0.001) and the need for Intensive Care Center (ICC) was higher in the nonhypertensive group (p<0.001). Conclusion: Hypertension in pregnancy remains associated with worse maternal and neonatal hospital outcomes compared to non-hypertensive women. E ective prenatal and delivery strategies are still essential policies for the prevention of complications and harm reduction in the target population.