Fatores de risco para o desenvolvimento da pré-eclâmpsia em gestantes

Abstract

Preeclampsia (PE) is one of the main hypertensive disorders of pregnancy, associated with high maternal and perinatal morbidity and mortality rates. In the North and Northeast regions of Brazil, especially in inland areas, it represents an important public health issue due to difficulties in early diagnosis and adequate prenatal follow-up. It is characterized by hypertension after the 20th week of gestation, often associated with proteinuria and systemic alterations that may compromise maternal and fetal health. The present study aimed to analyze the main risk factors related to the development of PE in pregnant women from the countryside of Ceará, Brazil. This is an observational, analytical, retrospective, and quantitative study conducted through the analysis of medical records from 95 pregnant women treated at Santa Casa de Misericórdia de Sobral between April 2025 and January 2026, including 57 women in the control group and 38 diagnosed with PE. Sociodemographic, obstetric, hemodynamic, and laboratory variables were evaluated. Data were analyzed using Student’s t-test, Mann-Whitney test, Pearson’s chi-square test, Spearman’s correlation, and ROC curve analysis, adopting a significance level of 5% (p<0.05). Patients with PE presented significantly higher body mass index values than the control group (p=0.0005), in addition to a higher frequency of alcohol consumption (p=0.0471). Significant positive correlations were also observed between systolic blood pressure and proteinuria (r=0.3570; p=0.0203), as well as between diastolic blood pressure and proteinuria (r=0.4645; p=0.0019). ROC curve analysis demonstrated a high discriminatory capacity of blood pressure levels for disease identification, with slightly superior performance of systolic blood pressure. Furthermore, obstetric and laboratory findings reinforced the association between hemodynamic alterations, metabolic overload, and clinical worsening of PE. The findings corroborate the multifactorial nature of the disease and highlight the importance of early identification of metabolic, behavioral, and hemodynamic risk factors during prenatal care, contributing to improved clinical stratification and prevention of maternal and fetal complications.