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Master's Dissertation
DOI
https://doi.org/10.11606/D.6.2014.tde-20022014-103621
Document
Author
Full name
Marcel Robledo Queiroz
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2014
Supervisor
Committee
Diniz, Carmen Simone Grilo (President)
Schneck, Camilla Alexsandra
Tanaka, Ana Cristina D'Andretta
Title in Portuguese
Ocorrência das síndromes hipertensivas na gravidez e fatores associados na região sudeste do Brasil
Keywords in Portuguese
Eclampsia Saúde Pública
Fatores de risco
Hipertensão induzida pela gravidez
Morbidade
Pré-eclampsia
Saúde da mulher
Abstract in Portuguese
Introdução: A principal causa de mortes maternas no Brasil são as Síndromes Hipertensivas na Gravidez (SHG). Estudos têm focado nos fatores de risco para essas síndromes, entretanto são pequenos e localizados. Um estudo de maior abrangência poderia encontrar valores mais precisos e diferenças entre seus estratos. Objetivo: Estimar a frequência das SHG na região sudeste do Brasil. Descrever e analisar os fatores associados às síndromes hipertensivas na gravidez. Método: Este é um estudo transversal, parte integrante do Nascer no Brasil: Inquérito Nacional sobre Parto e Nascimento, cuja coleta de dados ocorreu entre Fevereiro de 2011 e Julho de 2012. A amostra do estudo foi composta por todas as mulheres entrevistadas pelo inquérito em toda a região Sudeste do Brasil, totalizando 10154 pares de mulheres e conceptos. Resultados: As mulheres tinham entre 10 e 54 anos, predominantemente pardas/mulatas/morenas, não possuíam ensino superior, pertenciam à classe econômica C, tiveram seus bebê em hospitais das capitais e possuíam companheiro(a). De todos os nascimentos, 52,1 por cento ocorreram por cesariana, e destas 69,2 por cento sem que a mulher entrasse em trabalho de parto. Quase metade (43,9 por cento) dos nascimentos aconteceram antes que a gestação completasse 39 semanas. 77,7 por cento das mulheres relatam ter um acompanhante ao seu lado em algum momento durante o trabalho de parto/parto. As SHG acometeram 17,6 por cento de todas as mulheres. Destas, 3,4 por cento possuíam hipertensão crônica e a incidência de eclâmpsia foi de 1,6 por cento. Após análise multivariada, permaneceram independentemente associadas às SHG as variáveis cor preta (OR 1,4), histórico pessoal de eclâmpsia (OR 2,8), primiparidade (OR 1,6), diabetes (OR 2,3), mulheres com sobrepeso (OR 1,8), obesidade (OR 4,4) e gestação múltipla (OR 2,9). As mulheres com baixo peso apresentaram associação protetora (OR 0,6) Conclusões: Pode-se concluir que o histórico pessoal de eclâmpsia, diabetes, obesidade e gestação múltipla foram as variáveis que apresentaram maior associação com as SHG
Title in English
The occurrence of hypertensive disorders in pregnancy and associated factors in Southeastern Brazil
Keywords in English
Eclampsia public health
Morbidity
Preeclampsia
Pregnancy-induced hypertension
Risk factors
women's health
Abstract in English
Introduction: The main cause of maternal deaths in Brazil is hypertensive syndromes in pregnancy (HSP). Studies have focused on risk factors for these syndromes, however most are small-scaled and localized. A population-based study on the other hand, could potentially find more accurate results and differences between strata. Objective: To describe and analyze the incidence of HSP and the occurrence of associated factors in the Southeast of Brazil. Method: This is a cross-sectional study, part of "Birth in Brazil: National Survey into Labor and Birth" a national epidemiological survey on birthing in Brazil. Data collection took place between February 2011 and July 2012. The study sample consisted of all women interviewed for the survey across the southeastern region of Brazil, totaling 10,154 pairs of women and fetuses. Results: The women were between 10 and 54 years of age, predominantly brown skinned, with no graduation, in economic class C, had their babies in the hospitals placed on the capital cities and had a partner. 52.1 per cent of births occurred by cesarean section, 36 per cent without the woman going into labor. Almost half (43.9 per cent) of births occurred before 39 weeks of completed gestation. 77.7 per cent of women reported having a companion only sometimes during labor/delivery. HSP occurred in 17.6 per cent of all women, 3.4 per cent had chronic hypertension and the incidence of eclampsia was 1.6 per cent. After multivariate analysis, the independent variables associated with HSP is black skin (OR 1.4), personal history of preeclampsia (OR 2.8), primiparity (OR 1.6), diabetes (OR 2.3), underweight (OR 0.6), overweight (OR 1.8), obesity (OR) and multiple gestations (OR 2.9). Conclusion: The population-based data shows that a personal history of eclampsia, diabetes, obesity and multiple pregnancies were the variables with greater association with HSP
 
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Publishing Date
2014-02-21
 
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