Fatores preditivos de hipertensão gestacional em adolescentes primíparas: análise do pré-natal, da MAPA e da microalbuminúria

Abstract

objective: To quantify PH prevalence in primiparous adolescents; define predictive factors for the occurrence of PH and its impact on newborns. Methods:We followed 29 primiparous adolescents from the prenatal period through the 12th week of the puerperium, with a mean of sixteen years of age, served at the Outpatient Facility for Adolescents of Maternidade Escola Assis Chateaubriand (MEAC) of Universidade Federal do Ceará (Fortaleza, Brazil). The pregnant adolescents were divided into two groups, that is, those who remained normotensive (Group I) and those who developed PH (Group II). The variables investigated in the assessment of the value of predictability for the development of PH were anthropometric measures, socioeconomic aspects, smoking habit, inheritance for SAH (father/mother), prenatal tests requested in the first prenatal care visit in addition to microalbuminuria and ambulatory blood pressure monitoring (ABPM) in the 28th week of gestation. The pregnant adolescents were followed up at delivery and late puerperium (12th week after the puerperium). The newborns to the mothers included in our study were assessed at birth according to the Apgar score and the Capurro method, for weight, height and perinatal hypoxia. results:The prevalence of PH was 51.7%. Inheritance for SAH presented the highest predictive value for PH with an odds ratio of 10.99. Diastolic arterial pressure equal to or above 70 mmHg at the gestational age of 35 weeks was statistically significant as a predictive value for PH. At ABPM we found a predictive value for PH: diastolic pressure load during alertness, diastolic and systolic pressure load during night sleep, pressure variability and maximum diastolic pressure during sleep. Specifically a maximum diastolic arterial pressure (DAP) at ABPM during the period of night sleep ³64 mmHg presented an odds ratio of 6 for PH with a sensitivity of 80% and a specificity of 60% for the development of PH. conclusion:The research for PH predictive factors in primiparous adolescents showed to be easy to apply and useful to stratify high-risk pregnant women as regards the development of PH.

Complications in adolescent pregnancy: systematic review of the literature

“…From the biological point of view, among the consequences of pregnancy in adolescence are the high rates of hypertensive disorders of pregnancy, anemia, gestational diabetes, delivery complications, determining an increase in maternal and fetal mortality. ( 4 - 6 ) It is important to note that some studies showed an increased trend of prenatal, intrapartum, and postpartum intercurrent events among pregnant adolescents. ( 7 , 8 )…”

“…Do ponto de vista biológico, dentre as consequências da gravidez para a adolescente, citam-se maiores incidências de síndrome hipertensiva da gravidez (SHG), anemia, diabetes gestacional, complicações no parto, determinando aumento da mortalidade materna e infantil. ( 4 - 6 ) É importante notar que alguns estudos têm demonstrado aumento na incidência de intercorrências pré-natais, intraparto e pós-parto entre gestantes adolescentes. ( 7 , 8 )…”

Ebola Virus Disease-Induced Teenage Pregnancy and the Health Support System in the Masuba Community, Bombali District, Sierra Leone

“…From the biological point of view, among the consequences of pregnancy in adolescence are the high rates of hypertensive disorders of pregnancy, anemia, gestational diabetes, delivery complications, and determining an increase in maternal and fetal mortality (Azevedo and Sampaio, 2003). It is important to note that some studies showed an increased trend of prenatal, intrapartum, and postpartum intercurrent events among pregnant adolescents (de Carvalho et al, 2006). In Table 3, number of teenage pregnancies with complications was highest in the last six months (July -December, 2015) of the EVD outbreak, that is, 498 pregnancies which account for 41.23% of all recorded pregnancies at the Masuba Health Center.…”

Adolescence and Preeclampsia

“…From a biological viewpoint, some of the consequences of adolescent pregnancy include hypertensive disease of pregnancy, anemia, gestational diabetes, and complications during childbirth that lead to an increase in maternal and fetal mortality [4]; complications in the newborn include higher rates of low birth weight, premature delivery, respiratory diseases, dystocia, and an increased frequency of neonatal complications and greater infant mortality [5].…”