39-OR

Abstract

Objectives To determine the association between mode of delivery and perinatal outcomes in women with severe preeclampsia. Methods A prospective cohort study was conducted including cases of severe preeclampsia treated at IMIP, Northeast of Brazil, from August 2009 to July 2010. Exclusion criteria were eclampsia, hemorrhagic emergencies, coma and other clinical conditions associated. Statistical analysis included determination of Risk Ratio and multiple logistic regression to determine the adjusted risk of perinatal complications. Results The study included 479 newborns, 340 of whom born by cesarean section and 139 delivered vaginally, with a 42.4% rate of premature birth. We found association of cesarean delivery with increased risk of low Apgar scores at first minute (RR = 2.11, 95% CI = 1.18–3.79), birth asphyxia (RR = 2.59, CI = 95% 1.12–5.98), RDS (RR = 3.68, 95% CI = 1.49–9.07), TTN (RR = 3.52, 95% CI = 1.42 to 8.69), any respiratory complication (RR = 3.45, 95% CI = 1.78 to 6.69), ICU admission (RR = 3.07, 95% CI = 1.34–7.02), oxygen therapy (RR = 4.04, 95% CI = 1.34–7.02), hospitalization for more than seven days (RR = 1.98, 95% CI = 1.54- 2.55), composite neonatal morbidity (RR = 2.68, 95% CI = 1.70–4.22) and neonatal death (RR = 4.50, 95% CI = 1.07–18.87). Elective caesarean section persisted as a factor significantly associated with presence of composite neonatal morbidity in the multivariate analysis (OR = 2.47, 95% CI = 1.48–4.10). Conclusions When comparing the route of delivery, cesarean section carries a higher risk of perinatal complications, increased morbidity and perinatal death. Disclosures L. Katz: None. M.M. Amorim: None. A.S. Souza: None. S.B. Maia: None. A.H. Franca Neto: None. N.V. Leal: None. A. Faundes: None.