Poster Presenter

Reduction Of Maternal Mortality By Pregnancy Hypertensive Disorders In A Developing Country
Julian A. Herrera
Spain

Background: Preeclampsia is the most important cause of maternal mortality in developing countries. This paper reports the national impact of a program to the reduction of maternal mortality by pregnancy induced hypertensive disorders (preeclampsia-eclampsia) six years after implementation. A new nutritional prophylactic intervention was tested (calcium and conjugated linoleic acid) and was developed by our research group in three previous international randomized clinical trials (Colombia, China, Bangladesh) and preliminary tested in an open population study (N=15.553). The model demonstrated decreases the endothelial dysfunction associated with severity and lethality of preeclampsia. Methods: The implementation of the model for the intervention of preeclampsia risk was evaluated in an observational national project. A government norms and regulations were launched and trained by the ministry of Social Protection. Maternal mortality rates (MM) were monitored during ten years (five years before and after implementation). Univariate and multivariate analysis was performed.

Results: The general maternal mortality had a reduction of 24.8% due to pregnancy-induced hypertensive disorders (48.7%) (p < 0.001). Multiple linear regression showed that standard antenatal care was not correlated with the incidence of preeclampsia (adjusted R2 = 0.64, IC 95% -0.26 - 0.93, P= 0.12) however after inclusion of nutritional intervention (calcium and CLA) was observed a significant correlation (R2 = 0.92, IC 95% 0.62-0.99, P=0.04).

Conclusion: Nutritional intervention in pregnant women of high risk to develop preeclampsia is critical determinant to reduce the maternal mortality by pregnancy-induced hypertensive disorders.