Desfecho materno e neonatal da pré-eclâmpsia grave no contexto gravídico puerperal em uma maternidade de referência

Abstract

Introduction: High-risk pregnant women are exposed to various obstetric complications that pose a substantial risk of morbidity and mortality to the mother–infant dyad. Preeclampsia is a hypertensive disorder of pregnancy characterized by elevated blood pressure, with or without proteinuria, and becomes severe when blood pressure levels continue to rise and clinical signs of systemic involvement emerge, leading to adverse repercussions during delivery and the postpartum period. Objectives: To evaluate maternal and neonatal outcomes of severe preeclampsia in the pregnancy–puerperal context at a referral maternity hospital. Methods: This was a retrospective, descriptive, observational, and quantitative study comprising a sample of 210 medical records of pregnant women diagnosed with severe preeclampsia, admitted to a public referral maternity hospital in Teresina, Piauí, for delivery management. Data collection was performed using a standardized form developed based on information retrieved from medical records between January and October 2024, with data gathered from May to July 2025. The data were organized in Microsoft Excel version 2019 spreadsheets and analyzed using a statistical analysis software package. Results: Most pregnant women were aged up to 30 years (54.8%), self-identified as mixed race (72.4%), lived with a partner (60.0%), had completed secondary education (51.0%), resided in rural municipalities of Piauí (61.4%), and identified themselves as homemakers (72.9%). Severe preeclampsia was the most frequent obstetric history (90 cases), and 78.1% had experienced two or more previous pregnancies. Cesarean section was the predominant mode of delivery (94.8%). The most common neonatal outcomes included newborns classified as appropriate for gestational age (66.4%) and full term (53.0%). Nevertheless, 10.6% required admission to the neonatal intensive care unit. The most frequently administered treatments were intravenous antihypertensive drugs (210 cases) and magnesium sulfate (209 cases). There was an association between maternal age group and postpartum admission to specific hospital care units, and maternal condition directly impacted both unit allocation and neonatal discharge outcomes. Conclusion: This study demonstrated that severe preeclampsia is a condition that can lead to multiple outcomes, and that the maternal profile and obstetric history influenced these results. The findings underscore the importance of early identification of risk factors and sociodemographic profiles to ensure high-quality prenatal care for high-risk pregnancies. The research highlights the need for further Brazilian studies on this topic.