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Perfil de risco gestacional e metabólico no servi?o de pré-natal de maternidade pública do Nordeste do Brasil

DOI: 10.1590/S0100-72032012000300002

Keywords: risk factors, pregnancy outcome, pre-eclampsia, fetal weight, overweight.

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Abstract:

purpose: to assess the prevalence of obstetric risk factors and their association with unfavorable outcomes for the mother and fetus. methods: a longitudinal, descriptive and analytical study was conducted on 204 pregnant women between may 2007 and december 2008. clinical and laboratory assessments followed routine protocols. risk factors included socio-demographic aspects; family, personal and obstetric history; high pre-gestational body mass index (bmi); excessive gestational weight gain and anemia. adverse outcomes included pre-eclampsia (4.5%), gestational diabetes mellitus (3.4%), premature birth (4.4%), caesarian birth (40.1%), high birth weight (9.8%) and low birth weight (13.8%). results: the average age was 26±6.4 years; the mothers were predominantly non-white (84.8%), 51.8% had incomplete or complete secondary level schooling, 67.2% were in a stable marital relationship and 51.0% had a regular paid job; 63.7% were admitted to the prenatal clinic during the second trimester and 16.7% during the first, with 42.6% being primiparous. a past history of chronic hypertension was reported by 2.9%, pre-eclampsia by 9.8%, excessive gestational weight gain by 15.2% and former gestational diabetes mellitus by 1.0%. in the current pregnancy, elevated pre-gestational bmi was found in 34.6%; 45.5% presented with excessive gestational weight gain, 25.3% with anemia and 47.3% with dyslipidemia. of the 17.5% of cases with altered blood glucose, gestational diabetes mellitus was confirmed in 3.4% and proteinuria occurred in 16.4% of all cases. adverse maternal fetal outcomes included pre-eclampsia (4.5%), gestational diabetes mellitus (3.4%), premature birth (4.4%), caesarean birth (40.1%) and high and low birth weight (9.8% and 13.8%, respectively). independent predictors of adverse maternal fetal outcomes were identified by poisson multivariate regression analysis: pre-gestational bmi>25 kg/m2 was a predictor for pre-eclampsia (rr=17.17; 95%ci 2.14-137.46) and caesarian o

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