Fatores associados à síndrome hipertensiva da gestação em adolescentes e adultas jovens da Região Nordeste do Brasil

Abstract

Pregnancy in adolescence, especially in younger age groups and vulnerable population groups, can lead to health risks due to clinical and obstetric complications for pregnant, mother and newborn, as well as psychological and socioeconomic repercussions. Objective: To evaluate the possible associations between Hypertensive Syndrome in Pregnancy (HSP) and socio-demographic, pre-natal, and delivery characteristics of teenage and young adults attended to in the public and private health system of Brazil. Methods: An epidemiologic cross-sectional study, hospital-based data and regional level, using data from 54 municipalities of the Northeast region of Brazil from 2011-2012. The records used were obtained from the database of the National Survey on Labor and Delivery, “Born in Brazil”. The theoretical model used had a three-level hierarchy, and HSP. The distal level included socio-demographic variables: age range, marital status, race/skin color, adequate schooling for age, paid employment, funding for pre-natal visits. The intermediate level included pre-natal variables: Adequacy of prenatal care, previous clinical risk factors and smoking in the first five months. The proximal level consisted of variables related to delivery characteristics: Source of payment of the birth. A multivariate analysis was performed, based on the results of the bivariate analysis and respective p-values with a significance level of <0.20 using the Wald test. Results: Of the 2960 adolescents and young adults, 4,6% (135) presented with Hypertensive syndromes in pregnancy. The mothers without a partner had 1.5 times the odds of developing one of the types of HSP (OR=1.52); those with inadequate schooling had a 1.9 times greater chance of developing HSP (OR = 1.86); and having a previous clinical risk factor resulted in over 21 times the odds of HSP in teenagers and young adults (OR=21.72). Conclusions: These results indicate that HSP may be associated with several determinants. Social (marital status and schooling) and biological (previous clinical risk factors) risk factors were identified. This underscores the importance of guaranteeing women, family support and access to healthcare aiming to guarantee access to pre-natal and delivery care with early diagnosis and treatment, in order to avoid complications and consequently maternal and neonatal morbidity and mortality.