The severity of the clinical expression of preeclampsia determines maternal-fetal repercussions. Recognize indicators of severity may guide the adoption of behaviors in a timely manner.
To relate ...maternal characteristics and perinatal outcomes in patients with severe preeclampsia and without signs of severity.
Cross-sectional study. Location: Hospital Guilherme Álvaro-Santos/Brazil, January/2015-May/2016. Patients with preeclampsia (NHBPEP/2000) were divided into two groups: no signs of severity (control) and severe (study). Maternal variables: age, body mass index (BMI), parity, prenatal care, gestational age at birth, serum creatinine, aspartate aminotransferase (AST) and alanine (ALT); and neonatal: weight and admission to the Intensive Care Unit (ICU). Statistical analysis: Fisher’s exact test (p significant <0.05).
The preeclampsia group presented more commonly than women without signs of severity: age ⩾40 years (6%), obesity (56.5%) and nulliparity (38%) against 0%, 61.5%, 6.7%, respectively. Absence of prenatal care 24% against 6.7%. The childbirth occurred between 29–346/7weeks in 36% in the group with severe preeclampsia, whereas in the preeclampsia without signs of severity: 6.7%. Average weight of newborns of 3205 g and 02 (13.3%) ICU admissions, against 2528 g and 21 (42.9%). The average creatinine level was similar; AST and ALT was 18.67 and 12.53 in the control group compared to 22.63 and 15.65.
Similar rates of severe preeclampsia were found in the literature. (Batista, 2009). The severe expression of preeclampsia was associated with women in the extremes of age, with previous gestation, obesity and with worse perinatal performance. Noting that these women lack counseling and qualified care. Inadequate follow-up of prenatal care may be explained by the greater number of hospital admissions in severity. It is proposed a reflection on strategies to increase vaginal parturition in this group. The variations of AST-ALT indicate hepatic involvement anterior to the renal, which will be clearer with the continuation of the study.
The WHO recommends calcium supplementation in pregnant with low calcium intake as part of the care for the prevention of preeclampsia.
Investigate the intake and calcium supplementation in pregnant.
...The study was performed involving pregnant women seen for their prenatal care at the Guilherme Alvaro Hospital, Santos, Brazil. Calcium intake was estimated through Food Frequency Questionnaire (FFQ) proposed by Fisberg et al. (2005) adapted. The Body Mass Index (BMI), calculated as kg/m2, was classified according Atalah et al. (1997). Data were compared using Mann–Whitney U or Kruskal–Wallis test (post hoc Dunn), p< 0.05 was considered significant. Spearman correlations were used to measure associations among variables.
We studied 72 pregnant, mean±standard deviation age of 30,7±6,8years, gestational age of 26,5±8,2 and BMI=32,7±6,9kg/m2 that characterizes 47,3% the sample as obesity pattern and 29,1% as overweight. Mean daily calcium intake from food records was low (723,4±372,5mg/day), 84,7% had lower average consumption that the WHO recommendation. The relationship between BMI classification and calcium intake mean not differed. It was found that milk was the most common (72,7%) among pregnant women with adequate dietary calcium intake (15,3%; 1353,4±119,5mg/day). Calcium supplementation with or without vitamin D was reported by 9,7% (n=7).The calcium intake from the group calcium supplementation (1000mg elemental calcium/day) said use was higher (median 1691,4mg/day; p<0,001) than the not used supplement (626,2mg/day) and not exceed UL.
Calcium supplementation was needed to the adequacy of calcium intake in this group of pregnant women, it is could contributes with reduced preeclampsia development.
Introduction This project is part of a line of research aimed at identifying possible laboratory and anthropometric markers in the mediate postpartum period, compared to healthy women. It observes ...the behavior of these effectors in the maternal organism, collaborating with the prediction and prevention of preeclampsia. Objective Identify in the mediate postpartum period, lipotoxicity markers and anthropometric profile in postpartum women with preeclampsia compared with control group. Methods Cross-sectional study developed at the Guilherme Álvaro Hospital – Santos/Brazil. It was collected blood samples and anthropometric data of 132 women (56 cases and 76 controls) in the mediate postpartum during January 2015 to May 2016. Laboratory markers were analyzed to possibly associate with preeclampsia. Case group: patients with preeclampsia according to the criteria of NHBPEP – National High Blood Pressure Education Program (2000). Control group: women after vaginal delivery with term newborn, without hypertension and/or other comorbidities. Variables analyzed: maternal age, gestational age, body mass index (BMI), neck, arm and abdominal circumferences and newborn weight. Laboratory variables: total cholesterol and High Density Lipoprotein (HDL) fraction, triglycerides, serum creatinine, uric acid, alanine aminotransferase (ALT), total protein, albumin, C-reactive protein (CRP), fasting glucose and HOMA-IR index. Exclusion criteria for both groups: previously diagnosed diabetes mellitus, collagen diseases, smoking, twin pregnancy and fetal malformations. For the numerical variables of the research it was used the Student’s t test and for the statistical analysis the Fisher’s exact test. The significance level was p < 0.05. Results The results allow us to affirm that the groups differ from each other in the variables: maternal age, gestational age, newborn weight, BMI, abdominal, arm and neck circumferences, albumin, CRP, ALT, uric acid, glucose, and HOMA-IR. Conclusion The present study shows that women with preeclampsia have higher body mass index, larger body circumferences, they are older and have an increased insulin resistance than normal ones. Analyzing the study group individually, we can observe that those patients have premature babies and lower birth weight more often. It is also notice increased levels in the study group compared to the control group in non-specific inflammatory (CRP), hepatic (ALT) and renal (uric acid) markers. Albumin was higher in the control group.
This project is part of a line of research aimed at identifying possible laboratory and anthropometric markers in the mediate postpartum period, compared to healthy women. It observes the behavior of ...these effectors in the maternal organism, collaborating with the prediction and prevention of preeclampsia.
Identify in the mediate postpartum period, lipotoxicity markers and anthropometric profile in postpartum women with preeclampsia compared with control group.
Cross-sectional study developed at the Guilherme Álvaro Hospital – Santos/Brazil. It was collected blood samples and anthropometric data of 132 women (56 cases and 76 controls) in the mediate postpartum during January 2015 to May 2016. Laboratory markers were analyzed to possibly associate with preeclampsia. Case group: patients with preeclampsia according to the criteria of NHBPEP – National High Blood Pressure Education Program (2000). Control group: women after vaginal delivery with term newborn, without hypertension and/or other comorbidities. Variables analyzed: maternal age, gestational age, body mass index (BMI), neck, arm and abdominal circumferences and newborn weight. Laboratory variables: total cholesterol and High Density Lipoprotein (HDL) fraction, triglycerides, serum creatinine, uric acid, alanine aminotransferase (ALT), total protein, albumin, C-reactive protein (CRP), fasting glucose and HOMA-IR index. Exclusion criteria for both groups: previously diagnosed diabetes mellitus, collagen diseases, smoking, twin pregnancy and fetal malformations. For the numerical variables of the research it was used the Student’s t test and for the statistical analysis the Fisher’s exact test. The significance level was p<0.05.
The results allow us to affirm that the groups differ from each other in the variables: maternal age, gestational age, newborn weight, BMI, abdominal, arm and neck circumferences, albumin, CRP, ALT, uric acid, glucose, and HOMA-IR.
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The present study shows that women with preeclampsia have higher body mass index, larger body circumferences, they are older and have an increased insulin resistance than normal ones. Analyzing the study group individually, we can observe that those patients have premature babies and lower birth weight more often. It is also notice increased levels in the study group compared to the control group in non-specific inflammatory (CRP), hepatic (ALT) and renal (uric acid) markers. Albumin was higher in the control group.
Introduction The WHO recommends calcium supplementation in pregnant with low calcium intake as part of the care for the prevention of preeclampsia. Objective Investigate the intake and calcium ...supplementation in pregnant. Methods The study was performed involving pregnant women seen for their prenatal care at the Guilherme Alvaro Hospital, Santos, Brazil. Calcium intake was estimated through Food Frequency Questionnaire (FFQ) proposed by Fisberg et al. (2005) adapted. The Body Mass Index (BMI), calculated as kg/m2 , was classified according Atalah et al. (1997). Data were compared using Mann–Whitney U or Kruskal–Wallis test (post hoc Dunn), p < 0.05 was considered significant. Spearman correlations were used to measure associations among variables. Results We studied 72 pregnant, mean ± standard deviation age of 30,7 ± 6,8 years, gestational age of 26,5 ± 8,2 and BMI = 32,7 ± 6,9kg/m2 that characterizes 47,3% the sample as obesity pattern and 29,1% as overweight. Mean daily calcium intake from food records was low (723,4 ± 372,5 mg/day), 84,7% had lower average consumption that the WHO recommendation. The relationship between BMI classification and calcium intake mean not differed. It was found that milk was the most common (72,7%) among pregnant women with adequate dietary calcium intake (15,3%; 1353,4 ± 119,5 mg/day). Calcium supplementation with or without vitamin D was reported by 9,7% ( n = 7).The calcium intake from the group calcium supplementation (1000 mg elemental calcium/day) said use was higher (median 1691,4 mg/day; p < 0,001) than the not used supplement (626,2 mg/day) and not exceed UL. Conclusion Calcium supplementation was needed to the adequacy of calcium intake in this group of pregnant women, it is could contributes with reduced preeclampsia development.
Introduction The onset of preeclampsia is related to diet. The nutritional status is determined mainly by nutrient intake, if taken in excess or shortage causes disturbance. Objectives To analyze ...daily food intake in pregnancies with and without preeclampsia. Methods A transversal study, case-control, developed at the Guilherme Álvaro Hospital located at Santos/Brazil. Data on the food intake were collected from January 2015 to May 2016, from 157 women (72 cases and 85 controls) in the mediate postpartum. The case group was composed by women with preeclampsia (PE) according to the criteria of NHBPEP (2000) and the control group (C) was enrolled by women without hypertension and/or other comorbidities after vaginal delivery with newborn to term. Exclusion criteria for both groups: diabetes mellitus previously diagnosed as well as collagen diseases, smoking, twin pregnancy and fetal malformations. After recruitment and acceptance to participate in the study, the patients signed an informed consent. To assess food consumption was applied a food frequency questionnaire, including four account options for frequency of consumption: daily, weekly, monthly and never. For this current analysis only the data for daily consumption was considered; the data were expressed as percentages of patients in each group analyzed. Results The table shows the profile of the daily food intake among the groups C and PE. Although the values found were similar between both groups, there was lower intake of protein foods (meat, eggs, viscera), as well as fruits, tubers and roots among PE group when compared do the control group. It was also noted in the PE group the lower daily consumption of natural juices. Conclusions Applying a simple questionnaire to assess food frequency, showed that patients in the PE group had lower intake of proteic food. The PE group showed higher consumption canned food and coffee and lower ingestion of natural juice.This could lead to impairment of nutritional status.
The onset of preeclampsia is related to diet. The nutritional status is determined mainly by nutrient intake, if taken in excess or shortage causes disturbance.
To analyze daily food intake in ...pregnancies with and without preeclampsia.
A transversal study, case-control, developed at the Guilherme Álvaro Hospital located at Santos/Brazil. Data on the food intake were collected from January 2015 to May 2016, from 157 women (72 cases and 85 controls) in the mediate postpartum. The case group was composed by women with preeclampsia (PE) according to the criteria of NHBPEP (2000) and the control group (C) was enrolled by women without hypertension and/or other comorbidities after vaginal delivery with newborn to term. Exclusion criteria for both groups: diabetes mellitus previously diagnosed as well as collagen diseases, smoking, twin pregnancy and fetal malformations. After recruitment and acceptance to participate in the study, the patients signed an informed consent. To assess food consumption was applied a food frequency questionnaire, including four account options for frequency of consumption: daily, weekly, monthly and never. For this current analysis only the data for daily consumption was considered; the data were expressed as percentages of patients in each group analyzed.
The table shows the profile of the daily food intake among the groups C and PE. Although the values found were similar between both groups, there was lower intake of protein foods (meat, eggs, viscera), as well as fruits, tubers and roots among PE group when compared do the control group. It was also noted in the PE group the lower daily consumption of natural juices. Display omitted
Applying a simple questionnaire to assess food frequency, showed that patients in the PE group had lower intake of proteic food. The PE group showed higher consumption canned food and coffee and lower ingestion of natural juice.This could lead to impairment of nutritional status.
Systematic delivery term in preeclampsia can reduce risks, identify maternal and neonatal outcomes contributing to the adoption of this strategy worldwide.
Evaluate maternal and perinatal outcomes at ...37 – 39 weeks with systematic delivery in preeclampsia with no signs of severity, comparing pregnancies with no comorbidities.
A retrospective study of 1471 women who gave birth at the Guilherme Álvaro Hospital (Santos / Brazil), from January/2014 to January/2015. Data were collected from records of all deliveries. The inclusion criteria for the study group were: pregnancies with a single live fetus, gestational age 37–39 weeks in patients with “pure” or superimposed preeclampsia with no signs of severity (NHBPEP, 2000). Exclusion criteria were multiple births, gestational age less than 37 or more than 39 weeks, with severe preeclampsia and incomplete records. The control group included: pregnancies with a single live fetus, gestational age 38 – 40 weeks with no hypertension or other comorbidities, after normal deliveries of spontaneous onset. Exclusion criteria were twin pregnancies, gestational age less than 38 or more than 40 weeks, cesarean sections, forceps deliveries, induced vaginal deliveries, incomplete records, presence of collagen, clinical or gestational diabetes, smoking, fetal malformations, alloimmunization and infections. For the numerical variables of the research the Student’s t test was used and for the statistical analysis the Fisher’s exact test. The significance level was p <0.05.
88 records were selected (44 in the study group/44 in the control group). Both differed regarding the variables: maternal age and gestational age at delivery, previous cesarean, type of delivery, days of hospitalization and maternal complications in the postpartum period. 50% of the women in the study group were induced at the beginning of labor but only ten pregnancies evolved to normal delivery. The following neonatal complications weren’t present: sepsis, periventricular hemorrhage, meconium aspiration syndrome, bronchopulmonary dysplasia, and any need for intubation or cardiac massage. There was just one case of pathological jaundice in each group.
Introduction Systematic delivery term in preeclampsia can reduce risks, identify maternal and neonatal outcomes contributing to the adoption of this strategy worldwide. Objective Evaluate maternal ...and perinatal outcomes at 37 – 39 weeks with systematic delivery in preeclampsia with no signs of severity, comparing pregnancies with no comorbidities. Method A retrospective study of 1471 women who gave birth at the Guilherme Álvaro Hospital (Santos / Brazil), from January/2014 to January/2015. Data were collected from records of all deliveries. The inclusion criteria for the study group were: pregnancies with a single live fetus, gestational age 37–39 weeks in patients with “pure” or superimposed preeclampsia with no signs of severity (NHBPEP, 2000). Exclusion criteria were multiple births, gestational age less than 37 or more than 39 weeks, with severe preeclampsia and incomplete records. The control group included: pregnancies with a single live fetus, gestational age 38 – 40 weeks with no hypertension or other comorbidities, after normal deliveries of spontaneous onset. Exclusion criteria were twin pregnancies, gestational age less than 38 or more than 40 weeks, cesarean sections, forceps deliveries, induced vaginal deliveries, incomplete records, presence of collagen, clinical or gestational diabetes, smoking, fetal malformations, alloimmunization and infections. For the numerical variables of the research the Student’s t test was used and for the statistical analysis the Fisher’s exact test. The significance level was p <0.05. Results 88 records were selected (44 in the study group/44 in the control group). Both differed regarding the variables: maternal age and gestational age at delivery, previous cesarean, type of delivery, days of hospitalization and maternal complications in the postpartum period. 50% of the women in the study group were induced at the beginning of labor but only ten pregnancies evolved to normal delivery. The following neonatal complications weren’t present: sepsis, periventricular hemorrhage, meconium aspiration syndrome, bronchopulmonary dysplasia, and any need for intubation or cardiac massage. There was just one case of pathological jaundice in each group.
Objectives Analyze epidemiological data and the relation with potential markers of lipotoxicity in pregnancies with and without preeclampsia in a reference hospital. Methods A case-control study, 110 ...blood samples were collected from (August 2011–2013) in the immediate postpartum and biological potential markers of lipotoxicity analyzed which can be related to preeclampsia. Inclusion for the study group followed the NHBPEP – 2000: systolic blood pressure (⩾140 mmHg) and/or diastolic blood pressure (>−90 mmHg) two times, associated to proteinuria/24 h ⩾2 g/dL or tape reagent ⩾1 cross. Inclusion for the control group: healthy women, vaginal birth, newborn term. Exclusion criteria for all postpartum women were: comorbidities such as collagen diseases, diabetes, smoking, gemelarity and fetal malformations. Data analyzed: maternal age, body mass index (BMI) weight/(height)2, high urine protein, HDL (high density lipoprotein), VLDL (very low-density lipoprotein), triglycerides, mode of delivery, maternal clinical outcome, gestational age, birth weight, Apgar newborn score at one and five minutes and admission to the neonatal Intensive Care Unity (ICU). For the numerical variables of the research we used the Student t test, the Pearson’s Qui-square test and Fisher’s exact test and categorical variables. Data analysis was performed by calculating odds ratio adoption hypothesis rejection level of 0.05. Results The total of 110 blood samples (55 from the study group and 55 from the control group). Comparing the results analyzed biological potential markers of lipotoxicity (∗ p < 0,05) Variable Control Group Study Group Variable Control Group Study Group Maternal age (average/years) 25 30∗ Neonatal ICU admission 4% 9.1%∗ Cesarean section 42.6% 77.3%∗ VLDL (mg/dl) 29 35∗ Comorbidities 19.6% 77.3%∗ Triglyderides (mg/dl) 150 185∗ Gestation age 40 35∗ HDL (mg/dl) 65 57∗ Weight newborn average 3150g 2500g∗ High urine protein (mg) 185 500∗ BMI 27 33∗ Conclusions The present study shows that the potential markers of lipotoxicity are related to preeclampsia, and eventually may indicate likely prognostics associated with clinical expressions. Additional studies can clarify this correlation and these results might be useful to orientate the adoption of practices which are able to decrease maternal/fetal risks. Disclosures B. Zeiger: None. A. Bergamo: None. D. Vidal: None. F. Aires: None. D. Ferreira: None. M. Scarpelini: None. J. Garcia: None. H. Korkes: None. M. Paltronieri: None. S. de Toledo: None. W. Chaiwangyen: None. F. Sousa: None. N. Sass: None.
