Hypertension during pregnancy, particularly pre-eclampsia, is one of the major obstetrical problems in less-developed countries and the causes of most cases remain unknown4. Obstetricians are attempting to early recognize and diagnose this complication. However, biophysical and biochemical tests have been suggested to identify women who are at increased risk of developing of this complication in the future. Unfortunately, some of these tests are invasive whereas others require expensive techniques or special expertise that preclude their utility in routine screening4,5. In addition, the results of the pooled data for the various tests studied suggest that many of them have poor sensitivity and poor predictive value4,5.
Several risk factors have been described as predisponent to hypertensive disorders in pregnancy worldwide, such as: family history of preeclampsia4, preeclampsia in a previous pregnancy6,7, multifetal gestation6,8,9, obesity10,nulliparity11, diabetes11,12, chronic hypertension6,12, and extremes of maternal age4. The knowledge of the most important risk factors in our population could be useful to identify the patients who have higher chances to develop the hypertensive disorders, and, subsequently, adequate prenatal care could contribute to decrease this mortality ratio. However, reports designed to identify risk factors for hypertensive disorders of pregnancy in our country are scarce13,14. Therefore, the aim of the present study was to identify the frequency of risk factors for hypertensive disorders in Southern Brazil.Risk Factors of Gestational Hypertension Essay
METHODS
A prospective case-control study was developed considering 161 patients with hypertensive disorders and 169 control subjects matched by age and ethnicity. Subjects were recruited in the maternity of a tertiary public hospital in Southern Brazil (Hospital Nossa Senhora Conceição) and they were followed until 90 days postpartum (late puerperium), since PE can occur after childbirth. The hypertensive disorders in pregnancy were classified according to the proposal of the ACOG15. The outcome was the occurrence of mild preeclampsia, severe preeclampsia, non-proteinuric gestational hypertension, chronic hypertension with mild preeclampsia superimposed and chronic hypertension with severe preeclampsia superimposed. At enrollment, a standardized questionnaire provided informations on age, weight, height, schooling (divided by levels and if completed or not), ethnicity, smoking habits, and known risk factors for hypertension in pregnancy. Body mass index (BMI) was calculated considering the values of weight and height obtained at the first appointment, and results were described as mean BMI. All subjects gave their written informed consent to be included in the study, and protocol was approved by the ethics committee of Grupo Hospitalar Conceição and by the National Research Ethics Committee.Risk Factors of Gestational Hypertension Essay
The frequencies of risk factors were compared between groups by Fisher's exact test, chi-square and Student's t tests. A multivariate logistic regression analysis was performed by a backward conditional procedure to assess the independent role of clinical, social and demographic variables which were significantly associated with hypertensive disease in pregnancy in the univariate analysis, using the SPSS package. The variables tested in the univariate analysis included the family and the previous history of preeclampsia, multifetal gestation, BMI, nulliparity, diabetes, chronic hypertension, smoking (current smoker x non-smoker), schooling (women with at least complete fundamental level, according to Brazilian educational system, were considered as having high schooling) and prenatal care. The continuous variable (BMI) was entered as a linear factor after being tested for nonlinearity, using the SPSS package. The p-values < 0.05 were considered statistically significant
Order this paper