Relationship between gestational risk and type of delivery in high risk pregnancy

Antunes, Marcos Benatti; Rossi, Robson Marcelo; Pelloso, Sandra Marisa

doi:10.1590/S1980-220X2018042603526

Brasil

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Original Article • Rev. esc. enferm. USP 54 • 2020 • https://doi.org/10.1590/S1980-220X2018042603526 linkcopy

Relationship between gestational risk and type of delivery in high risk pregnancy^*

Relación entre riesgo gestacional y tipo de parto en el embarazo de alto riesgo

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective: To analyze the association between gestational risk factors and type of delivery in high-risk pregnancies.

Method: 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.

Results: 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).

Conclusion: 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.

Descriptors: Pregnancy, High-Risk; Pregnancy Complications; Abortion, Spontaneous; Natural Childbirth; Cesarean Section; Obstetric Nursing; Maternal-Child Nursing

Factors	Cesarean vs. Normal birth			Spontaneous abortion vs. Normal birth
Factors	OR (95%CI)	p-value	OR (95%CI)	p-value
Age ≤ 19 years	0.7 (0.5-0.9)	0.0041	-	0.2195
Age ≥ 35 years	1.4 (1.1-1.7)	0.0015	11.5 (4.2-31.0)	<0.0001
Education > 8 years	0.8 (0.7- 0.9)	0.0053	-	0.5058
No religion	-	0.3759	-	0.3579
Evangelical religion	1.4 (1.2-1.7)	0.0008	2.6 (1.0-6.7)	0.0446
“Other” religions	-	0.9155	-	0.9949
SAH	1.4 (1.1-1.8)	0.0129	74.9 (13.7-410.2)	<0.0001
Endocrinopathies	-	0.2859	8.6 (2.3-32.6)	0.0016
Haemopathies	-	0.6482	36.2 (2.7-485.9)	0.0068
Epilepsy	-	0.4876	49.8 (2.3-1,091.8)	0.0131
Premature placental detachment	0.3 (0.1-0.8)	0.0193	-	0.9974
Eclampsia	3.3 (2.1-5.2)	<0.0001	-	0.6388
Previous Cerclage	0.5 (0.2-0.8)	0.0127	-	0.9902
Recent cesarean section <1 year	21.2 (2.9-155.1)	0.0026	-	0.9951
Preterm labor. OA	1.5 (1.0-2.2)	0.0331	-	0.7194
Premature birth	0.7 (0.6-0.9)	0.0023	-	0.4067
Complicated UTI	0.6 (0.5-0.8)	0.0011	-	0.6055
PSHD	1.4 (1.1-2.0)	0.0250	-	0.9837
Preterm Labor. CC	0.7 (0.5-0.9)	0.0048	2,441.8 (304.8-19,559.4)	<0.0001
Twinning	3.1 (1.9-5.0)	<0.0001	68.6 (9.7-487.7)	<0.0001

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Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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Relationship between gestational risk and type of delivery in high risk pregnancy*

Relación entre riesgo gestacional y tipo de parto en el embarazo de alto riesgo

Abstract

Relationship between gestational risk and type of delivery in high risk pregnancy^*