Prevalência de morbidades gestacionais e fatores sociodemográficos e obstétricos associados em usuárias da atenção primária de Passo Fundo, RS.

Abstract

Objective: To assess the prevalence of gestational maternal morbidities and their relationship with sociodemographic, behavioral, and neonatal factors in women using the Unified Health System. Methods: This is a cross-sectional epidemiological study conducted between December 2022 and August 2023, involving women aged 12 years or older, who had children up to 2 years of age under pediatric care during the study period, in primary care in the municipality of Passo Fundo, RS. The main variables of interest were the presence of maternal morbidities such as gestational hypertension and gestational diabetes mellitus (GDM), preeclampsia, excessive weight gain, urinary tract infection (UTI), and HELLP syndrome. These were analyzed as outcomes when related to sociodemographic factors (maternal age, skin color, income, and education) and as exposures in the analysis with obstetric outcomes such as prematurity and fetal macrosomia. Descriptive statistics (n, %) were performed, and the distribution of outcomes according to independent variables was analyzed using the chi-square test, adopting a level of statistical significance of p<0.05. Results: The sample consisted of 272 women, of whom 53.3% self-identified as white, with a mean age of 26.6 years (± 6.0). Additionally, 37.1% completed high school, and 53% had a per capita income of 0 to 0.5 minimum wages. Among gestational morbidities, there was a prevalence of 28% (95% CI 22- 33) for UTI during pregnancy, 26.1% (95% CI 21-31) for gestational hypertension, 21.9% (95% CI 17-27) for excessive weight gain, 11.4% (95% CI 7-15) for preeclampsia, and 10.7% (95% CI 7-14) for gestational diabetes mellitus. Statistically significant associations were demonstrated between excessive weight gain and black, brown, and yellow skin color (p = 0.028), and the occurrence of GDM with maternal age above 35 years (p = 0.007) and white skin color (p = 0.029). Furthermore, women with gestational hypertension had a higher proportion of preterm birth (p = 0.014). Conclusion: The results indicate that more than half of the evaluated sample had some gestational maternal morbidity, with UTI, gestational hypertension, and excessive weight gain being the most prevalent. Additionally, a relationship was observed between a higher proportion of morbidities and sociodemographic factors, such as advanced age and black/brown/yellow skin color. Investigating the sociodemographic aspects of maternal morbidity is essential for understanding the health determinants that can impact the healthy process of pregnancy. Therefore, considering the need to expand and improve maternal care, studies with this focus are necessary and relevant. Key words: morbidity; prenatal care; women's health; public health.