Banca de QUALIFICAÇÃO: EDAILNA MARIA DE MELO DANTAS

Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.
DISCENTE: EDAILNA MARIA DE MELO DANTAS
DATA: 26/03/2012
HORA: 09:00
LOCAL: CCS-sala de aula da pós-graduação
TÍTULO:

Increased risk of hypertension in women with history of preeclampsia

PALAVRAS-CHAVES:

Key words: Preeclampsia, BMI, obesity, hypertension, pregnancy.         

PÁGINAS: 50
GRANDE ÁREA: Ciências da Saúde
ÁREA: Medicina
SUBÁREA: Saúde Materno-Infantil
RESUMO:

Objective: To determine the frequency of preeclampsia and the risk of hypertension after preeclampsia.

Design: Cohort study of pregnancy outcomes.

Setting: A public health clinic in Natal, Brazil.

Population: A total 242 women were recruited at the beginning of their pregnancy, 11 had spontaneous abortion and 13 were lost to follow up, with 218 women followed at the end of their pregnancy. A subgroup was reexamined 5 years after the end of the pregnancy.

Methods: A prospective study was conducted between 2005 and 2007 to determine the frequency of preeclampsia. Maternal body weight, height, blood pressure, cholesterol and triglycerides. The follow up study after 5 years included measurement of C reactive protein, urea, creatinine, microalbuminuria and Ambulatory Blood Pressure Monitoring (ABPM). Crude and adjusted odds ratios were calculated using multiple logistic regression analysis to determine risk factors for preeclampsia.

Main Outcome: Rate of preeclampsia and hypertensive disorders of pregnancy and the risk of hypertension after preeclampsia onset.

Results: The incidence of hypertensive disorder of pregnancy was 16.5% (36 into 218) and of preeclampsia was 13.8% (30 into 218). Women with preeclampsia had a higher body mass index (BMI), with mean of 25.3 (±4.8) compared to 23.5 (±3.7) of non-hypertensive women. The risk of preeclampsia increased with age (Odds Ratio 1.084 and p=0.0034) and family history of hypertension (OR 2.6, p=0.01) and preeclampsia (OR=1.8, p=0.03). Of the 30 preeclampsia cases, 6 progressed to severe preeclampsia and 1 developed HELLP syndrome. Fifty percent of the women with preeclampsia were still hypertensive one year after delivery, and their mean weight was 65.0 Kg (±7.5), whereas the non-hypertensive group was 56.9 (±10.8), p=0.0090. The BMI was 26.7 (±3.1) for the former and 23.6 (±4.2) for the latter group (p=0.0172).

Conclusions: Higher BMI, older age and excessive weight gain were associated with hypertension in pregnancy. Women who developed preeclampsia had a family history of preeclampsia (OR 2.361, p<0.05). Preeclampsia increases the risk of hypertension in women who developed preeclampsia.

MEMBROS DA BANCA:
Presidente - 1149381 - ANA CRISTINA PINHEIRO FERNANDES DE ARAUJO
Interno - 346138 - ALDO DA CUNHA MEDEIROS
Externo ao Programa - 1346630 - LARA DE MELO BARBOSA ANDRADE