Resultados maternos y perinatales en gestantes nulíparas con preeclampsia de aparición tardía: estudio comparativo frente a gestantes sin preeclampsia / Maternal and perinatal outcomes in nulliparous gestations with late onset preeclampsia: Comparative study with gestations without preeclampsia

OBJETIVO: Evaluar los resultados obstétricos de una muestra de gestantes nulíparas con preeclampsia, en comparación con gestantes sin preeclampsia, asistidas en el Hospital Enrique C. Sotomayor de Guayaquil, Ecuador. MÉTODO: Este fue un estudio comparativo de los resultados maternos y perinatales de gestantes con preeclampsia de aparición tardía (n = 150; edad gestacional = 36,7 ± 3,3 semanas) frente a los de embarazos normales (n = 150; edad gestacional 38,7 ± 1,7 semanas). RESULTADOS: Un 73,3% de los casos de preeclampsia fueron formas graves. En comparación con los embarazos normales, los casos de preeclampsia tuvieron índices antropométricos (perímetro del cuello y del brazo) más altos y mayores tasas de oligoamnios, cesáreas, transfusiones, niños con distrés respiratorio y resultados perinatales adversos como test de Apgar bajo al nacer y mayores tasas de nacimientos pretérmino, nacidos de bajo peso, y niños pequeños para la edad gestacional. CONCLUSIÓN: Las embarazadas con preeclampsia tuvieron resultados maternos y perinatales negativos en comparación con las gestantes sin preeclampsia

OBJECTIVE: To assess obstetrical outcomes in a sample of nulliparous gestations with preeclampsia, as compared to gestations without preeclampsia, attended in the Enrique C. Sotomayor Hospital of Guayaquil, Ecuador. METHOD: This was a comparative study of maternal and perinatal outcome data of gestations with late onset preeclampsia (n = 150; gestational age = 36.7 ± 3.3 weeks) with that of normal gestations (n = 150; gestational age 38.7 ± 1.7 weeks). RESULTS: Almost three-quarters (73.3%) of preeclampsia cases were defined as severe. Compared to normal gestations, preeclampsia cases had higher anthropometric indices (neck and mid-arm circumference) and had more oligohydramnios, cesarean sections, transfusions, distressed fetuses, and adverse perinatal outcomes such as, lower Apgar scores at birth, and more preterm births, lower birth weight and small for gestational age infants. CONCLUSIÓN: Gestations with preeclampsia had a negative impact on maternal and perinatal outcomes compared to gestations without preeclampsia

[Maternal and perinatal outcomes in nulliparous gestations with late onset preeclampsia: Comparative study with gestations without preeclampsia]. / Resultados maternos y perinatales en gestantes nulíparas con preeclampsia de aparición tardía: estudio comparativo frente a gestantes sin preeclampsia.

OBJECTIVE: To assess obstetrical outcomes in a sample of nulliparous gestations with preeclampsia, as compared to gestations without preeclampsia, attended in the Enrique C. Sotomayor Hospital of Guayaquil, Ecuador. METHOD: This was a comparative study of maternal and perinatal outcome data of gestations with late onset preeclampsia (n=150; gestational age=36.7±3.3 weeks) with that of normal gestations (n=150; gestational age 38.7±1.7 weeks). RESULTS: Almost three-quarters (73.3%) of preeclampsia cases were defined as severe. Compared to normal gestations, preeclampsia cases had higher anthropometric indices (neck and mid-arm circumference) and had more oligohydramnios, cesarean sections, transfusions, distressed fetuses, and adverse perinatal outcomes such as, lower Apgar scores at birth, and more preterm births, lower birth weight and small for gestational age infants. CONCLUSION: Gestations with preeclampsia had a negative impact on maternal and perinatal outcomes compared to gestations without preeclampsia.

Polymorphisms of the methylenetetrahydrofolate reductase gene (C677T and A1298C) in nulliparous women complicated with preeclampsia.

OBJECTIVE: To determine the prevalence of C677T and A1298C Single-nucleotide polymorphisms (SNPs) of the MTHFR gene in nulliparous women complicated with preeclampsia (PE). METHODS: One hundred fifty gestations complicated with PE and their corresponding controls without the disease were recruited for the genotyping of C677T and A1298C polymorphisms of the MTHFR gene using restriction fragment length polymorphism polymerase chain reaction. Secondarily, homocysteine (HCy) plasma levels were measured in preeclamptic women displaying the CC genotype of the A1298C polymorphism (homozygous) and compared to HCy levels determined among controls with the normal AA genotype for the A1298C variant. RESULTS: Only the mutant CC genotype of the A1298C polymorphism was associated to higher risk of presenting PE, as frequency of this genotype was significantly higher among cases than controls (15.3% versus 0.7%, p < 0.05). All PE women with a neck circumference ≥32 cm presented the mutant CC A1298C polymorphism as compared to none among preeclamptics with a lower neck circumference (p = 0.0001). Women with the mutant CC A1298C SNP displayed higher plasma HCy levels as compared to controls with normal AA A1298C genotype (8.4 ± 2.6 versus 7.5 ± 2.7 mmoL/L p = 0.04). CONCLUSION: Prevalence of the CC mutant genotype of the A1298C polymorphism was higher among PE women. This mutation among PE women was related to increased neck circumference and higher HCy levels. Future research should aim at linking these gestational findings with obesity and cardiovascular risk.