Fatores sociodemográficos e sua relação com as condições de risco gestacional e resultados perinatais

Abstract

High-risk pregnancy is one in which the pregnant woman has risk factors related to pre-existing medical conditions and to obstetric and clinical complications which put the lives of the mother and / or fetus at risk. The health authorities of the state of Paraná, Brazil, established the Rede Mãe Paranaense which focuses on an early approach to pregnant women and monitors specialized prenatal care so that the occurrence of high-risk pregnancies could be avoided. Risk clinics were established to provide special attention, with specialized visits to the doctor´s in risk conditions and ensuring a reference to delivery. Current study analyzes the monitoring of prenatal care provided to high-risk pregnant women and its relationship with pregnancy-risk conditions and maternal, fetal and neonate outcome. The exploratory, retrospective, descriptive analysis with a quantitative approach was directed towards a population of 920 high-risk pregnant women in a reference clinic in southern Brazil, linked to a philanthropic hospital and to the Brazilian National Health System. The pregnant women who participated in current research visited the doctor during the clinic´s first year, between September 2012 and September 2013. Data were collected between March and May 2014 and Chi-square and Fisher´s tests were performed for data analysis. Results showed that that 36-year old women or older had higher risks for hypertension (28.8%), endocrine disorders (20.6%), uterine myoma (6.9%) and more than three caesarian surgeries (6.9%) . Low schooling indicated high risks for women with hypertension (25.0%), epilepsy (6.4%), more than three caesarian surgeries (10.8%) and multiple births (10.8%). When perinatal results of pregnant women suffering from hypertension were analyzed, unfavorable results were received with regard to fetal death, premature birth, low birth weight, low Apgar scores and cesarean delivery. Results reveal that high-risk pregnant women, especially those over the reproductive age indicated by the literature and those suffering from hypertension, should be assisted by a multidisciplinary team. It should be underscored that in-depth analysis of the clinical history of high risk pregnant women gives to health professionals and managers the necessary indications on the possible outcome of such pregnancies. Specialized protocols and care should be updated in the new assistance model to improve maternal and perinatal results and the subsequent reduction in maternal, fetal and neonatal morbidity and mortality rates.