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Federación Mexicana de Ginecología y Obstetricia, A.C.

2016, Número 09

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Ginecol Obstet Mex 2016; 84 (09)


Factores de riesgo de enfermedad cardiovascular en gestantes con estados hipertensivos. Experiencia de 10 años

Pérez-Adan M, Vázquez-Rodríguez M, Álvarez- Silvares E, Alvez-Pérez MT, Domínguez-Vigo P

Idioma: Español
Referencias bibliográficas: 49
Paginas: 573-585
Archivo PDF: 634.31 Kb.


RESUMEN

Antecedentes: los estados hipertensivos del embarazo afectan a 8-10% de las gestantes. Son la complicación obstétrica más frecuente, con elevadas morbilidad y mortalidad materna y perinatal. Estas afecciones trascienden más allá del embarazo porque en un grupo de mujeres incrementan el riesgo cardiovascular en la vida futura.
Objetivo: valorar si las mujeres con estados hipertensivos del embarazo tienen mayor riesgo de padecer diabetes mellitus tipo 2, síndrome metabólico, hipertensión arterial, dislipemia y, consecuentemente, enfermedad cardiovascular años después de la finalización del embarazo.
Material y Método: estudio de casos y controles efectuado con base en la información de mujeres embarazadas y que parieron entre los años 2000 y 2010. Casos: pacientes con diagnóstico de enfermedad hipertensiva del embarazo. Controles: muestra aleatoria de embarazadas normotensas durante la gestación (año 2000). Se aplicaron pruebas paramétricas (T-Student para muestras independientes) y para las variables sin cumplimiento de tal condición prueba U de Mann- Whitney; χ2 para comparar variables cualitativas, prueba exacta de Fisher y entre grupos un modelo de regresión logística univariado.
Resultados: la incidencia de hipertensión arterial fue de 41.3% en pacientes con antecedente de estado hipertensivo del embarazo, con riesgo relativo de 9.15. La incidencia de diabetes mellitus tipo 2 fue de 5.1%. La dislipemia se diagnosticó con posterioridad en 43.5% con un riesgo relativo de 3.7. El síndrome metabólico alcanzó 16.8% de la población de casos con un riesgo relativo de 2.6. La incidencia de hipotiroidismo fue de 8.1%. El seguimiento medio de ambos grupos fue de 10.7 años.
Conclusiones: las pacientes con diagnóstico de estado hipertensivo del embarazo son un grupo que en los siguientes años de vida tendrá más factores de riesgo cardiovascular.


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