Risk factors for hypertensive disorders of pregnancy in southern Brazil / Fatores de risco para distúrbios hipertensivos durante a gravidez no Sul do Brasil

OBJECTIVE:The aim of the study was to identify the frequency of risk factors for hypertensive disorders in pregnancy in Southern Brazil. METHODS: The study included 161 patients with hypertensive disorders and 169 control subjects matched by age and ethnicity. The frequency of the risk factors was compared by Fisher's exact test, chi-square and Student's t test. A multivariate logistic regression analysis assessed the independent role of clinical, social and demographic factors which were associated with occurrence of the hypertensive disease in pregnancy in the univariate analysis. RESULTS: Patients enrolled in the study were predominantly Caucasian (73 percent) and the mean age was 29. In the multivariate analysis, the variables associated were: family history of preeclampsia (p = 0.001; OR = 3.88; 95 percent CI = 1.77-8.46), diabetes (p = 0.021; OR = 3.87; 95 percent CI = 1.22-12.27) and chronic hypertension (p = 0.002; OR = 7.05; 95 percent CI = 1.99-24.93). CONCLUSION: The risk factors associated with hypertensive disorders in pregnancy appear to be similar to those reported in other countries. The knowledge of the risk factors could be helpful in a prenatal care.

OBJETIVO: Identificar a frequência dos fatores de risco para distúrbios hipertensivos durante a gravidez na região Sul do Brasil. MÉTODOS: O estudo incluiu 161 pacientes com distúrbios hipertensivos e 169 controles, compatíveis em idade e etnia. A frequência dos fatores de risco foi comparada a partir do teste exato de Fisher, teste qui-quadrado e teste t de Student. Uma análise logística multivariacional de regressão avaliou a influência de fatores clínicos, sociais e demográficos, associados com a ocorrência de doenças hipertensivas durante a gravidez na análise univariada. RESULTADOS: Os pacientes envolvidos no estudo eram predominantemente caucasianos (73 por cento) e a idade média foi 29 anos. Na análise multivariada as variáveis associadas foram: histórico de pré-eclâmpsia na família (p = 0,001; OR = 3,88; 95 por cento IC = 1,77-8,46), diabetes (p = 0,021; OR = 3,87; 95 por cento IC = 1,22-12,27) e hipertensão crônica (p = 0,002; OR = 7,05; 95 por cento IC = 1,99-24,93). CONCLUSÃO: Os fatores de risco associados a distúrbios hipertensivos durante a gravidez parecem ser similares àqueles relatados em outros países. O conhecimento sobre os fatores de risco pode ser útil durante o acompanhamento pré-natal.

Risk factors for hypertensive disorders of pregnancy in southern Brazil.

OBJECTIVE: The aim of the study was to identify the frequency of risk factors for hypertensive disorders in pregnancy in Southern Brazil. METHODS: The study included 161 patients with hypertensive disorders and 169 control subjects matched by age and ethnicity. The frequency of the risk factors was compared by Fisher's exact test, chi-square and Student's t test. A multivariate logistic regression analysis assessed the independent role of clinical, social and demographic factors which were associated with occurrence of the hypertensive disease in pregnancy in the univariate analysis. RESULTS: Patients enrolled in the study were predominantly Caucasian (73%) and the mean age was 29. In the multivariate analysis, the variables associated were: family history of preeclampsia (p = 0.001; OR = 3.88; 95% CI = 1.77-8.46), diabetes (p = 0.021; OR = 3.87; 95% CI = 1.22-12.27) and chronic hypertension (p = 0.002; OR = 7.05; 95% CI = 1.99-24.93). CONCLUSION: The risk factors associated with hypertensive disorders in pregnancy appear to be similar to those reported in other countries. The knowledge of the risk factors could be helpful in a prenatal care.

Association between mannose-binding lectin gene polymorphisms and pre-eclampsia in Brazilian women.

PROBLEM: Mannose-binding lectin (MBL) is involved in the maintenance of an inflammatory environment in uterus. High MBL levels have been associated with successful pregnancies whereas low levels are involved in pre-eclampsia (PE) development. Here, we evaluated MBL2 gene polymorphisms in the structural and promoter regions addressing their association with PE. METHOD OF STUDY: DNA samples from 162 control pregnant women and 157 pregnant PE women were genotyped and data compared with demographic and clinical characteristics. RESULTS: High frequency of C and D alleles (related to low MBL levels) was observed in PE women when compared to controls (C: 0.08 versus 0.03, P = 0.006; D: 0.10 versus 0.05, P = 0.009). Grouping the MBL genotypes according to phenotype, a higher frequency of OO genotype was observed in PE women when compared to control women (0.15 versus 0.04, P = 0.007). CONCLUSION: Our data suggest that women with genotypes associated with low MBL levels could be potential PE developers.

Immunogenetics of pregnancy: role of a 14-bp deletion in the maternal HLA-G gene in primiparous pre-eclamptic Brazilian women.

The etiology and pathogenesis of pre-eclampsia (PE) involve a combination of maternal-fetal genetic and immunologic factors. The immunologic maladaptation theory of PE predicts that the maternal immune system does not tolerate the semi-allogeneic fetus. Human leukocyte antigen-G (HLA-G) is expressed in some types of immune cells as well as in the fetal-maternal interface by trophoblasts, playing an immunoregulatory role. Here we have evaluated a 14-bp deletion polymorphism in the 3'-untranslated region of exon 8 of HLA-G gene in pregnant PE women and controls. HLA-G genotypes in both control and PE women were in Hardy-Weinberg equilibrium. The healthy pregnant and PE women had similar genotype frequencies (p = 0.789). This was similarly observed when PE women were subgrouped accordingly to severity of disease (p = 0.646). However, the primiparous PE women presented a tendency toward higher frequency of the 14-bp deletion allele (0.442) compared with the primiparous healthy women (0.286), p = 0.09. Our data suggest that the maternal 14-bp deletion of HLA-G is not associated with the risk for PE but that it could affect the development of PE in primiparous women.