Patricia Severino, Hospital Dr Salvador B Gautier, Cardiología, Santo Domingo, Dominican Republic
Fulgencio Severino, Hospital Dr Salvador B Gautier, Cardiología, Santo Domingo, Dominican Republic
Rosa Cueto, Sociedad Dominicana de Cardiología, Santo Domingo, Dominican Republic
Background: Hypertensive disorders of pregnancy complicate 5%-10% of pregnancies and account for 23%-38% of maternal deaths in the Dominican Republic. Objective: To identify factors associated with the development of preeclampsia and evaluate their relationship with maternal and perinatal morbidity and mortality. Methods: This multicenter, prospective, observational, cross-sectional, analytical study included 469 parturients from 17 hospitals across the Dominican Republic over a 30-day period. Statistical significance was set at p < 0.05. Results: Preeclampsia was significantly associated with chronic hypertension (44.15% vs 16.87%; odds ratio [OR], 3.91; 95%CI, 2.51-6.09), previous preeclampsia (44.64% vs 18.60%; OR, 3.53; 95%CI, 2.24-5.56), and a family history of preeclampsia (42.0% vs 19.38%; OR, 3.01; 95%CI, 1.96-4.62). Preeclampsia was also associated with prematurity (54.6% vs 33.4%; OR, 2.40; 95%CI, 1.62-3.55), low birth weight (37.6% vs 18.5%; OR, 2.65; 95%CI, 1.73-4.07), and placental abruption (5.0% vs 2.4%; OR, 2.14; 95%CI, 0.81-5.62). Maternal and fetal mortality were not significantly associated with preeclampsia. In the multivariable logistic regression analysis, chronic hypertension (adjusted OR [AOR], 3.64; 95%CI, 2.25–5.88), a family history of preeclampsia (AOR, 2.86; 95%CI, 1.85-4.42), and pregestational obesity (AOR, 2.26; 95%CI, 1.52-3.36) emerged as independent predictors of preeclampsia (all p < 0.05). Conclusion: Preeclampsia is associated with an increased risk of adverse maternal and neonatal outcomes, particularly prematurity and low birth weight.
Keywords: Pre-Eclampsia. Pregnancy-Induced Hypertension. Maternal Mortality. Premature Infant. Low Birth Weight Infant. Dominican Republic.