Risk factors and fetal outcomes for preeclampsia in a Colombian cohort

Abstract

In Latin America and the Caribbean, hypertensive pregnancy disorders are responsible for almost 26% of all maternal deaths [1] and, in Colombia, they account for 59% of all severe maternal morbidity (SMM) cases, and 59.7% of all SMM cases in adolescents [2]. One of the most important hypertensive pregnancy disorders is preeclampsia (PE). Lives can be saved, if PE is prevented, or detected early and properly managed. Prevention and detection depend on identifying the risk factors associated with PE, and, as these have been shown vary by population, they should be determined on a population-by-population basis. The following study utilized the nested case-control model to evaluate 45 potential PE risk factors of a cohort in Bogotá, Colombia, making it perhaps the most comprehensive study of its kind in Colombia. It found PE to have a statistically significant association with 7 of the 45 factors evaluated: 1) pre-gestational BMI >30 kg/m 2 , 2) pregnancy weight gain >12 kg, 3) previous history preeclampsia/eclampsia, 4) previous history of IUGR-SGA (Intrauterine Growth Restriction-Small for Gestational Age), 5) maternal age <20 or ≥35 years (20–34 was not associated), and 6) family history of diabetes. Finally, prenatal consumption of folic acid was found to lower the risk of PE. We recommend that, in Colombia, factors 1–6 be used to identify at risk mothers during pregnancy check-ups; that mothers be encouraged to take folic acid during pregnancy; and, that Colombia's health system and public policy address the problem of pregestational obesity.

Perinatal outcomes among births to women with infection during pregnancy

“…A similar pattern was found with other obstetric complications, such as pre-eclampsia. 33 We believe that, in the presence of severe clinical conditions, the effect of the complication outweighs that of demographic characteristics. ‡Infections with complications include an invasive procedure to treat the source of infection (vacuum aspiration, dilatation and curettage, wound debridement, drainage (incision, percutaneous, culdotomy) laparotomy, lavage and other surgery), admission to intensive care or high dependency unit or transfer to another facility.…”

Preeclampsia and neonatal outcomes in adolescent and adult patients

“…Regarding the newborn's outcomes, studies show that women with preeclampsia have newborns with lower birth weights [ 22 , 23 ]. In our study, 50% of adolescents gave birth to a newborn under 3000 grams compared to the control group, where only 16.67% of the newborns weighed under 3000 grams.…”

“…Studies show that adolescents tend to deliver newborns with lower birth weights than adults [ 2 , 14 , 24 ]. Also, a lower Apgar score is associated with women with preeclampsia [ 22 , 23 ]. In our study, in both groups, most of the newborns from patients with preeclampsia had an Apgar score of 9 and 10.…”

“…Preterm birth represents a well-known neonatal complication associated with preeclampsia [ 22 , 23 ]. In our study, there were no cases of prematurity in the control group, while in the study group, there were two cases (16.67%).…”

Comparison of zinc levels in mothers with and without abortion: A systematic review and meta-analysiss

“…Moreover, global Zn deficiency is ranked as the 11th highest risk factor for disease mortality and morbidity, contributing to nearly 20 % of perinatal mortalities worldwide [ 21 , 24 ]. Furthermore, the lack of Zn in late pregnancy can result in fetal growth retardation, congenital malformations, abortion, and fetal death [ 25 , 26 ]. Abortion, preterm delivery, stillbirth, intrauterine growth restriction, fetal malformations, premature rupture of membranes, and other adverse pregnancy outcomes may be linked to an imbalance of trace elements such as Zn.…”