Characteristics of pregnant women at risk and relationship with type of delivery and complications

Salvetti, Marina de Góes; Lauretti, Luciana Garcia; Muniz, Roseni Carvalho; Dias, Thalyne Yuri Souza Farias; Oliveira, Amanda Aparecida Duarte Gomes de; Gouveia, Luciana Magnoni Reberte

doi:10.1590/0034-7167-2020-0319

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Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 74 (4) • 2021 • https://doi.org/10.1590/0034-7167-2020-0319 copy

Characteristics of pregnant women at risk and relationship with type of delivery and complications

Características de la gestante en riesgo y relación con tipo de parto y complicaciones

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to describe characteristics of pregnant women at risk and analyze the relationship with type of delivery and complications during pregnancy and puerperium.

Methods:

a retrospective study with secondary data of 1,574 at-risk pregnant women followed up in an educational intervention by telemedicine.

Results:

pregnant women with an average age of 35 years and high educational level participated. Preference for normal delivery was 43.1%, but only 17.3% had normal delivery. During pregnancy, 43.5% sought emergency care. In the postpartum period, 2.0% needed an ICU. Emergency room search was associated with age and contacts with the intervention. Cesarean delivery was associated with age, physical inactivity and overweight/obesity. ICU admission was associated with age and BMI.

Conclusion:

pregnant women were of high age and education, the younger and who had more contacts with the intervention sought more the emergency room. Older age, physical inactivity and overweight/obesity were factors associated with cesarean delivery.

Descriptors:
Prenatal Care; Pregnancy, High-Risk; Nursing; Health Promotion; Telemedicine

Variable	n	%
Age (years)
<30	218	13.8
30-34	380	24.1
35 - 39	731	46.4
40 - 44	230	14.6
45 and older	15	0.9
Education
Elementary school	6	0.38
High school^* * Complete/incomplete; ** Lato sensu and Stricto sensu; Alagoas, Amazonas, Amapá, Ceará, Espírito Santo, Goiás, Mato Grosso do Sul, Mato Grosso, Paraíba, Paraná, Rondônia, Roraima, Rio Grande do Sul, Santa Catarina.	179	11.4
Higher education^* * Complete/incomplete; ** Lato sensu and Stricto sensu; Alagoas, Amazonas, Amapá, Ceará, Espírito Santo, Goiás, Mato Grosso do Sul, Mato Grosso, Paraíba, Paraná, Rondônia, Roraima, Rio Grande do Sul, Santa Catarina.	1001	63.8
Graduate degree^* * Complete/incomplete; ** Lato sensu and Stricto sensu; Alagoas, Amazonas, Amapá, Ceará, Espírito Santo, Goiás, Mato Grosso do Sul, Mato Grosso, Paraíba, Paraná, Rondônia, Roraima, Rio Grande do Sul, Santa Catarina.	382	24.4
No information	6	0.4
Origin
São Paulo	1086	69.0
Rio de Janeiro	209	13.3
Minas Gerais	66	4.2
Pernambuco	52	3.3
Bahia	47	3.0
Federal District	39	2.5
Others***	42	4.8
Previous abortions
No	1222	77.6
Yes	352	22.4
‘Intercurrence during pregnancy
No	911	57.9
Yes	663	42.1

Variable	Number of contacts	p value^* * Wilcoxon-Mann-Whitney (p<0.001);
Type of delivery		0.194
Caesarean section	9.19
Forceps	9.00
Normal	9.68
Intercurrence		0.057
Yes	9.08
No	9.41
Emergency room during pregnancy		<0.001^* * Wilcoxon-Mann-Whitney (p<0.001);
Yes	9.68
No	8.95
Calls to the emergency room during pregnancy		<0.001^ Kruskal-Wallis (p<0.001).
None of the time	8.95
Once	9.55
Twice	9.87
Three times	9.01
4 times or more	10.02
Went to the Postpartum Intensive Care Unit		0.933
Yes	9.65
No	9.26

Variable	Type of delivery	p value^* * Wilcoxon-Mann-Whitney (p<0.001); *Brunner-Munzel (p<0.001).
Age (years)
35.1	Caesarean section	*<0.001^ * Wilcoxon-Mann-Whitney (p<0.001); Brunner-Munzel (p<0.001).*
34.3	Normal
Body Mass Index
27.4	Caesarean section	<0.001**
25.9	Normal	<0.001**

Variable	Intensive Care Unit Admission	p value	Calls to the Emergency Room	p value
Age (years)		<0.001**		*<0.001^ * Wilcoxon-Mann-Whitney (p<0.001); Brunner-Munzel (p<0.001).*
38.2	Yes		34.5
34.3	No		35.4
Body Mass Index		*<0.001^ * Wilcoxon-Mann-Whitney (p<0.001); Brunner-Munzel (p<0.001).*		0.143
28.6	Yes		27.4
27.1	No		26.9

Variable	Went to the emergency room during pregnancy				p value
	No		Yes
	n	%	n	%
Current pregnancy feeling					0.033^* * Teste Exato de Fisher;
Joy	822	56.9	622	43.1
Anxiety	49	55.1	40	44.9
Insecurity	05	45.5	6	54.5
Fear	01	11.1	8	88.9
Sadness	-	-	1	100.0
Feel lively					0.790
No	19	54.3	16	45.7
Yes	868	56.6	667	43.4
Feel emotional					0.013^* * Teste Exato de Fisher;
No	545	59.1	377	40.9
Cries more than before	337	52.7	302	47.3
Cries all the time	02	33.3	04	66.7
Cannot cry	03	100.0	-	-
Feel irritated					0.149
No	597	58.0	432	42.0
More than before	287	53.9	245	46.1
Not as much as before	01	50.0	01	50.0
All the time	02	28.6	05	71.4
Feel tired					0.036^* * Teste Exato de Fisher;
No	509	59.1	352	40.9
More than before	358	54.4	300	45.6
When doing anything	19	41.3	27	58.7
Too much to do anything	1	33.3	02	66.7
Work normally					0.018^ Qui-Quadrado de Pearson (p<0,005).
Yes	89	58.1	569	41.9
Need extra effort	05	38.5	08	61.4
Too much effort	01	25.0	03	75.0
Cannot work like before	78	50.0	78	50.0
Cannot work	14	38.9	22	61.1
Eat normally					0.294
Yes	826	57.2	619	42.8
Lower appetite	54	48.6	57	51.4
Much lower appetite	06	54.6	05	45.4
Lost appetite	01	33.3	02	66.7
Smoker					0.728
No	817	56.2	636	43.8
Former smoker	63	58.9	44	41.1
Yes	09	64.3	05	35.7
Drink alcoholic beverages					0.510
Never	791	56.3	613	43.7
Up to 3 doses	91	58.3	65	41.7
From 4 to 7 doses	05	41.7	07	58.3
More than 7 doses	02	100.0	-	-
Drink alcoholic beverages					0.510
Never	791	56.3	613	43.7
Up to 3 doses	91	58.3	65	41.7
From 4 to 7 doses	05	41.7	07	58.3
More than 7 doses	02	100.0	-	-
Physical activity during pregnancy					0.682
No	553	56.1	433	43.9
Yes	336	57.1	252	42.9
Sleep pattern					0.426
Normal	571	58.1	412	41.9
Do not sleep like they used to	240	53.7	207	46.3
Difficulty returning to sleep	29	56.9	22	43.1
Unable to go back to sleep	47	53.4	41	46.6

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[1] Corresponding author: Marina de Góes Salvetti E-mail: mgsalvetti@usp.br