Made available in DSpace on 2014-12-17T14:13:51Z (GMT). No. of bitstreams: 1 AnaCAAG_TESE.pdf: 1218484 bytes, checksum: 515ab0b05a0c78a389b8ec33b20042ef (MD5) Previous issue date: 2013-11-27 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Preeclampsia is defined as an extremely serious complication of the pregnancy-puerperium cycle with delayed emergence of cardiovascular risk factors, including metabolic syndrome. The research aimed estimate the prevalences of metabolic syndrome and associated factors in women with preeclampsia and normal pregnancy followed five years after childbirth. This is a cross-sectional observational study using a quantitative approach, conducted at a maternity school in the city of Natal in Rio Grande do Norte state. The sample was composed of 70 women with previous preeclampsia and 75 normal selected by simple random probability sampling. Subjects were analyzed for sociodemographic, obstetric, clinical, anthropometric and biochemical parameters. International Diabetes Federation criteria were adopted to diagnose metabol ic syndrome. The Kolmogorov-Smirnov, Mann-Whitney, Student s t, Pearson s chi-squared, and Fisher s exact tests, in addition to simple logistic regression, were used for data analysis, at a 5% significance level (p &#8804; 0.05). Statistical tests demonstrated elevated body mass index (p = 0.001), predominance of family history of diabetes mellitus (p = 0.022) and significantly higher prevalence of metabolic syndrome in the preeclampsia group (37.1%) when compared to normal (22.7%) (p = 0.042). Intergroup comparison showed a high number of metabolic syndrome components in women with previous preeclampsia. Altered systolic and diastolic blood pressure (p < 0.001) was the most prevalent, followed by low concentrations of high-density lipoproteins (p = 0.049), and hyperglycemia (p=0.030). There was a predominance of the metabolic syndrome in women with schooling 0-9 years (42.4%) (p = 0.005), body mass index above 30Kg.m 2 (52.3%) (p < 0.001), uric acid high (62.5%) (p = 0.050 and family history of hypertension (38.5%) (p< 0.001). Multivariate analysis of the data showed that the body mass index above 30 kg.m2, education level less than 10 years of study (p < 0.001) and family history of hypertension (p = 0.002) remained associated with the metabolic syndrome after multivariate analysis of the data. It is considered Women with previous preeclampsia exhibited high prevalence of metabolic syndrome and their individual components in relation to normal, especially, altered systolic and diastolic blood pressure, low concentrations of high-density lipoproteins and hyperglycemia. The factors associated to this ou tcome were obesity, less than 10 years of schooling, and family history of hypertension. Overall, this study identified young women with a history of PE exposed to a higher cardiovascular risk than normal / A pr?-ecl?mpsia ? uma complica??o de extrema gravidade do ciclo grav?dico puerperal e contribui com o surgimento tardio de fatores de risco cardiovascular, dentre os quais a s?ndrome metab?lica. A pesquisa objetivou estimar as preval?ncias da s?ndrome metab?lica e fatores associados em mulheres que apresentaram pr?-ecl?mpsia e gravidez normal, acompanhadas cinco anos ap?s o parto. Trata-se de um estudo observacional transversal de abordagem quantitativa, realizado em uma maternidade escola no munic?pio de Natal, Rio Grande do Norte. A amostra foi constitu?da por 70 mulheres com pr?-ecl?mpsia pr?via e 75 normais selecionadas por meio do m?todo de amostragem probabil?stica aleat?ria simples, do banco de dados do grupo de pesquisa Sa?de da Mulher do Departamento de Tocoginecologia da Universidade Federal do Rio Grande do Norte, das quais foram analisados os par?metros sociodemogr?ficos, obst?tricos, cl?nicos, antropom?tricos e bioqu?micos. Para diagn?stico da s?ndrome metab?lica, adotou-se o crit?rio estabelecido pela International Diabetes Federation. Quanto ? an?lise dos dados, foram aplicados testes estat?sticos de Kolmogorov-Smirnov, Mann-Whitney, t de Student, Qui Quadrado de Pearson, exato de Fisher e modelo de regress?o log?stica simples com n?vel de signific?ncia estat?stica de 5% (p&#8804; 0,05). Ap?s aplica??o dos testes estat?sticos constatou-se um ?ndice de massa corp?rea elevado (p = 0,001), predom?nio de antecedentes familiares de diabetes mellitus (p = 0,022) e preval?ncia significativamente maior da s?ndrome metab?lica no grupo com pr?-ecl?mpsia (37,1%) em rela??o ?s normais (22,7%) (p = 0,042). Comparando os grupos, verificou-se um n?mero elevado de componentes da s?ndrome metab?lica nas mulheres com pr?-ecl?mpsia pr?via. A press?o arterial sist?lica e diast?lica alteradas (p < 0, 001) foi o mais prevalente, seguido da baixa concentra??o de lipoprote?nas de alta densidade (p = 0, 049) hiperglicemia (p = 0,030). Houve o predom?nio da s?ndrome metab?lica nas mulheres com escolaridade de 0 a 9 anos (42,4%) (p = 0,005), ?ndice de massa corp?rea acima de 30Kg.m 2 (52,3%) (p < 0,001), ?cido ?rico elevado (62,5%) (p = 0,050) e hist?rico familiar de hipertens?o arterial (38,5%) (p < 0,001). A an?lise multivariada dos dados apontou que o ?ndice de massa corp?rea acima de 30 kg.m 2 , grau de escolaridade menor que 10 anos de estudo (p < 0,001) e antecedentes familiares de hipertens?o arterial (p = 0,002) permaneceram associados ? s?ndrome metab?lica. Considera-se que as mulheres com PE pr?via apresentavam uma elevada preval?ncia da s?ndrome metab?lica e de seus componentes individuais em rela??o ?s normais, em particular, a press?o arterial sist?lica e diast?lica alteradas, os n?veis baixos da concentra??o de lipoprote?nas de alta densidade e a hiperglicemia. Os fatores independentemente associados a esse desfecho foram: obesidade, grau de escolaridade inferior a 10 anos e hist?rico familiar de hipertens?o arterial. De forma geral, este estudo identificou mulheres jovens com hist?rico de PE expostas a um risco cardiovascular mais elevado do que as normais

Heat shock proteins (Hsp) are highly conserved proteins that are part of the universal stress response of the cell. Their main function is to protect cells against structural and functional damage. Organisms exposed to different forms of stress, such as e.g. a lack of nutrients or water, hypoxia, infection or inflammation, demonstrated an increased gene expression of these proteins. Pregnancy complications cause stress conditions for maternal and fetal organism, which may result in an increased gene expression of Hsp. In my thesis, I examined the concentration of extracellular mRNA for five different heat shock proteins (Hsp27, Hsp60, Hsp70, Hsp90, HspBP1) in the plasma of pregnant women and wheather this concentration is affected by possible pregnancy complications (preeclampsia, fetal growth restriction and gestational hypertension). I also investigated a possible correlation between mRNA plasma concentration for Hsp and pulsatility index values (PI) obtained by Doppler ultrasound. This research should help to invent a new predictive method for pregnancy complications, based on a detection of specific biomarkers in the first trimester of pregnancy. The research was conducted on plasma samples obtained from peripheral blood of pregnant women, whose collection was performed during clinical manifestations of...