Departamento de Enfermagem, Universidade Estadual de Maringá, Maringá, PR, Brazil.
Departamento de Estatística, Universidade Estadual de Maringá, Maringá, PR, Brazil.
Rev Esc Enferm USP. 2020;54:e03526. doi: 10.1590/s1980-220x2018042603526. Epub 2020 Jul 13.
To analyze the association between gestational risk factors and type of delivery in high-risk pregnancies.
A cross-sectional epidemiological study involving a retrospective analysis of secondary data from 4,293 medical records of high-risk pregnant women. The primary outcome was composed of risks associated with cesarean delivery and spontaneous abortion compared with normal delivery.
There were 3,448 women analyzed in the study. The primary outcome rates were cesarean delivery (72.8%), spontaneous abortion (0.9%) versus vaginal delivery (26.2%). Common risk factors for cesarean delivery and spontaneous abortion were age ≥35 years (OR = 1.4; 95% CI 1.1-1.7 / OR = 11.5; 95% CI 4.2-31.0), evangelical religion (OR = 1.4; 95% CI 1.2-1.7 / OR = 2.6; 95% CI 1.0-6.7), high blood pressure (OR = 1.4; 95% CI 1.1-1.8 / OR = 74.9; 95% CI 13.7-410.2) and twinning (OR = 3.1; 95% CI 1.9-5.0 / OR = 68.6, 95% CI 9.7-487.7).
Identifying the relationship of gestational risks with the type of delivery and abortion can contribute to developing strategies and assist in planning actions in women's healthcare networks, developing specific and individualized lines of care for each gestational risk.
分析高危妊娠中与分娩方式相关的妊娠风险因素。
这是一项涉及对 4293 例高危孕妇病历的二级数据进行回顾性分析的横断面流行病学研究。主要结局包括与剖宫产和自然流产相关的风险，与阴道分娩进行比较。
本研究共分析了 3448 名女性。主要结局的剖宫产率（72.8%）、自然流产率（0.9%）与阴道分娩率（26.2%）。剖宫产和自然流产的常见危险因素包括年龄≥35 岁（OR=1.4；95%CI 1.1-1.7/OR=11.5；95%CI 4.2-31.0）、福音派宗教（OR=1.4；95%CI 1.2-1.7/OR=2.6；95%CI 1.0-6.7）、高血压（OR=1.4；95%CI 1.1-1.8/OR=74.9；95%CI 13.7-410.2）和双胎妊娠（OR=3.1；95%CI 1.9-5.0/OR=68.6，95%CI 9.7-487.7）。
识别妊娠风险与分娩方式和流产的关系，有助于为妇女保健网络制定策略和辅助行动规划，为每个妊娠风险制定具体和个体化的护理方案。
