Ocorrência das síndromes hipertensivas na gravidez e fatores associados na região sudeste do Brasil

Abstract

Queiroz MR. The occurrence of hypertensive disorders in pregnancy and associated factors in Southeastern Brazil. [Dissertation]. Faculdade de Saude Publica, Universidade de Sao Paulo, 2014. Introduction: The main cause of maternal deaths in Brazil is hypertensive syndromes in pregnancy (HSP). Studies have focused on risk factors for these syndromes, however most are small-scaled and localized. A population-based study on the other hand, could potentially find more accurate results and differences between strata. Objective: To describe and analyze the incidence of HSP and the occurrence of associated factors in the Southeast of Brazil. Method: This is a cross-sectional study, part of in Brazil: National Survey into Labor and Birth a national epidemiological survey on birthing in Brazil. Data collection took place between February 2011 and July 2012. The study sample consisted of all women interviewed for the survey across the southeastern region of Brazil, totaling 10,154 pairs of women and fetuses. Results: The women were between 10 and 54 years of age, predominantly brown skinned, with no graduation, in economic class C, had their babies in the hospitals placed on the capital cities and had a partner. 52.1 % of births occurred by cesarean section, 36% without the woman going into labor. Almost half (43.9%) of births occurred before 39 weeks of completed gestation. 77.7% of women reported having a companion only sometimes during labor/delivery. HSP occurred in 17.6% of all women, 3.4% had chronic hypertension and the incidence of eclampsia was 1.6%. After multivariate analysis, the independent variables associated with HSP is black skin (OR 1.4), personal history of preeclampsia (OR 2.8), primiparity (OR 1.6), diabetes (OR 2.3), underweight (OR 0.6), overweight (OR 1.8), obesity (OR) and multiple gestations (OR 2.9). Conclusion: The population-based data shows that a personal history of eclampsia, diabetes, obesity and multiple pregnancies were the variables with greater association with HSP.