title: [Association between risk pregnancy and route of delivery with maternal and neonatal outcomes].
abstract: OBJECTIVE
  To analyze the relationships among gestational risk, type of delivery and immediate maternal and neonatal repercussions.
  
  
  METHODS
  A retrospective cohort study based on secondary data was conducted in a university maternity hospital. A total of 1606 births were analyzed over a 9-month period. Epidemiological, clinical, obstetric and neonatal characteristics were compared according to the route of delivery and the gestational risk characterized on the basis of the eligibility criteria for high clinical risk. The occurrence of maternal and neonatal complications during hospitalization was analyzed according to gestational risk and cesarean section delivery using univariate and multivariate logistic analysis.
  
  
  RESULTS
  The overall rate of cesarean sections was 38.3%. High gestational risk was present in 50.2% of births, mainly represented by hypertensive disorders and fetal malformations. The total incidence of cesarean section, planned cesarean section or emergency cesarean section was more frequent in pregnant women at gestational high risk (p<0.001). Cesarean section alone did not influence maternal outcome, but was associated with poor neonatal outcome (OR 3.4; 95%CI 2.7-4.4). Gestational high risk was associated with poor maternal and neonatal outcome (OR 3.8; 95%CI 1.3-8.7 and OR 17.5; 95%CI 11.6-26.3, respectively). In multivariate analysis, the ratios were maintained, although the effect of gestational risk has determined a reduction in the OR of the type of delivery alone from 3.4 (95%CI 2.7-4.4) to 1.99 (95%CI 1.5-2.6) for adverse neonatal outcome.
  
  
  CONCLUSIONS
  Gestational risk was the main factor associated with poor maternal and neonatal outcome. Cesarean delivery was not directly associated with poor maternal outcome but increased the chances of unfavorable neonatal outcomes.
authors.affiliation: Departamento de Ginecologia e Obstetricia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
authors.forename: Zilma Silveira Nogueira
authors.initials: ZS
authors.lastname: Reis
authors.affiliation: Departamento de Ginecologia e Obstetricia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
authors.forename: Eura Martins
authors.initials: EM
authors.lastname: Lage
authors.affiliation: Departamento de Ginecologia e Obstetricia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
authors.forename: Regina Amelia Lopes Pessoa
authors.initials: RA
authors.lastname: Aguiar
authors.affiliation: Programa de Pos-Graduacao em Saude da Mulher, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
authors.forename: Juliano de Souza
authors.initials: Jde S
authors.lastname: Gaspar
authors.affiliation: Fundacao Centro de Hematologia e Hemoterapia do Estado de Minas Gerais, Belo Horizonte, MG, Brasil.
authors.forename: Gabriela Luiza Nogueira
authors.initials: GL
authors.lastname: Vitral
authors.affiliation: Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
authors.forename: Eliana Goncalves
authors.initials: EG
authors.lastname: Machado
mesh_terms: D000293:Adolescent; D000328:Adult; D002585:Cesarean Section; D015331:Cohort Studies; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012306:Risk; D055815:Young Adult