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Federación Mexicana de Ginecología y Obstetricia, A.C.

2020, Número 02

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Ginecol Obstet Mex 2020; 88 (02)


Desenlaces maternos y neonatales relacionados con edad materna avanzada

Santa María-Ortiz J, Álvarez-Silvares E, Alves-Pérez MT, García-Lavandeira S

Idioma: Español
Referencias bibliográficas: 65
Paginas: 80-91
Archivo PDF: 217.82 Kb.


RESUMEN

Objetivo: Describir los desenlaces maternos y perinatales en embarazadas de edad avanzada.
Materiales y Métodos: Estudio de dos cohortes, prospectivo y retrospectivo efectuado con base en la información de expedientes clínicos de pacientes atendidas en el Complexo Hospitalario Universitario de Ourense entre 2017 y 2018. Se establecieron dos cohortes: la cohorte A con edad mayor o igual a 40 años y la cohorte B con edad menor de 40 años. Se realizaron pruebas paramétricas y no paramétricas para determinar la asociación potencial entre las variables de estudio ( χ2, t de Student, U de Mann-Whitney).
Resultados: Las pacientes de la cohorte A (n = 207) tuvieron significación estadística: índice de masa corporal mayor al inicio del embarazo (p = 0.028), mayor cantidad de embarazos previos (p = 0.001), a expensas de mayor cantidad de abortos (p ‹ 0.001), estados hipertensivos del embarazo (p = 0.03), prematurez (p = 0.009), retraso en el crecimiento intrauterino (p = 0.006), macrosomía fetal (p = 0.04), inducciones (p ‹ 0.001), cesáreas programadas o intraparto y hemorragia posparto (p = 0.001). No se encontraron diferencias en la paridad, amenorrea al parto, diabetes pregestacional-gestacional, peso fetal medio, Apgar, pH de la arteria umbilical y cantidad de recién nacidos con requerimiento de ingreso a la unidad de Neonatología.
Conclusiones: La edad materna avanzada es un factor de riesgo importante de morbilidad materna y perinatal. La mayor tasa de complicaciones descritas refleja la importancia del control exhaustivo del embarazo y vigilancia periparto minuciosa.


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