Síndrome hipertensiva induzida pela gravidez : risco futuro de desenvolver doenças renal crônica e cardiovascular

• Ano de defesa: 2017
• Autor(a) principal: Facca, Thais Alquezar [UNIFESP]
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Hypertension; Kidney diseases; Hypertension, pregnancy-induced; Obesity; Cardiovascular diseases; Doenças cardiovasculares; Hipertensão induzida pela gravidez; Nefropatias; Obesidade; Hipertensão
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5398689; http://repositorio.unifesp.br/handle/11600/50066

Objectives: Long-term postpartum assessment of the clinical, anthropometric, epidemiological, laboratory profile, risk stratification of CKD and CVD, angiogenic factors and podocyturia in women with a history of pregnancy-induced hypertensive syndrome, comparing them with women who had normal gestation. Methods: This is a retrospective cohort study. The clinical, anthropometric and epidemiological profile were investigated, laboratory tests were performed for metabolic and renal evaluation, risk stratification of CKD/CVD, podocyturia and serum angiogenic factors. Statistical analysis was performed using Pearson's Chi-square test, Fisher's exact test, or its extension, Student's t-test, Mann-Whitney test, Pearson's linear correlation coefficient, 1-factor ANOVA and Kruskall-Wallis test, with significance level α equal to 5%. Results: Total of 85 women divided into case (n=25) and control group (n=60). The case group presented a higher incidence of chronic arterial hypertension (p=0.003), a shorter time between its diagnosis and the end of gestation (p<0.001) and also a lower age of diagnosis (p=0.033); higher weight (p<0.001), body mass index (p<0.001), waist to height ratio (p=0.001), brachial (p=0.001), abdominal (p<0.001) and hip circumferences (p<0.001); higher fat percentage (p=0.004) and metabolic rate (p<0.001) and lower weight percent (p=0.003); lower estimated glomerular filtration rate by CKD EPI (p=0.021) and MDRD (p=0.003), greater difference between actual age and estimated vascular age according to Framingham RS (2008) (p=0.008) and higher frequency of metabolic syndrome (p<0.001). No significant difference was found between the groups in podocyturia and serum angiogenic factors. Conclusion: Women who had pregnancy-induced hypertension syndrome were more obese, mainly by central obesity, higher incidence of metabolic syndrome and chronic arterial hypertension after pregnancy, with earlier onset after delivery. These findings reinforce the importance of investigating the history of hypertensive syndrome in pregnancy at postpartum follow-up.