Análise das correlações entre variáveis antropométricas, hemodinâmicas, hematológicas e bioquímicas relacionadas à pré-eclâmpsia e os desfechos gestacionais maternos e neonatais

Abstract

Preeclampsia is a multisystem syndrome with complex pathophysiology and unclear etiology, with a significant impact on global health. It is one of the leading causes of maternal and neonatal morbidity and mortality worldwide. Therefore, studies that help understand preeclampsia's pathophysiology and develop risk detection tools are essential to improve maternal and fetal prognosis. In this context, the present study aimed to investigate the correlations between parameters related to the pathophysiology of preeclampsia and maternal and neonatal outcomes. Based on these correlations, it was possible to select variables with the potential to be used in statistical risk stratification models to be developed later. For this purpose, moderation and mediation analyses were performed, contributing to a better understanding of the causal mechanisms inherent in the correlations between maternal, placental, and fetal parameters. The variables involved in moderation and mediation relationships can then serve as a starting point for constructing mathematical models that may contribute to gestational prognosis by identifying risks of adverse outcomes. Chapter 1 discusses the theoretical basis and describes the relevance of preeclampsia for global health, the pathophysiology of the syndrome, and the changes in the maternal organism most relevant to the progression of this disease. It also addresses the techniques used to obtain parameters, such as Doppler velocimetry, and the theoretical aspects of moderation and mediation analyses. Chapter 2 presents the initial population studies, with comparisons between normotensive and preeclamptic patients and correlation analyses that demonstrated associations between hemodynamic, hematological, and biochemical aspects, allowing the selection of variables to be used in the statistical models. Chapter 3 presents the moderation and mediation analyses that contributed to a better understanding of the correlations and the identification of more appropriate variables for the future construction of risk stratification models.