Parámetros hematológicos asociados a severidad de preeclampsia en gestantes del Hospital Regional de Loreto, Iquitos 2023

Abstract

Objective: To determine the association between hematological parameters and the severity of preeclampsia in pregnant women attended at the Regional Hospital of Loreto, Iquitos, during the year 2023. Methods: Analytical study with case- control correlational design. Results: 105 pregnant women with severe PE and 105 without severity were selected. The predominant group was women between 18 and 29 years of age (57.6%), followed by 28.6% aged 30 years or more, a group with a higher prevalence of severe PE (38.1% vs. 19.0%; p < 0.05). The mean gestational age was 36.2 weeks, and a higher percentage of preterm deliveries was observed in severe PE (53.3% vs. 28.6%). Systolic blood pressure ≥ 145.5 mmHg (76.2%) and diastolic blood pressure ≥ 94.7 mmHg (68.6%) were significantly more frequent in severe PE (p = 0.000). In hematologic analysis, elevated fibrinogen levels (6.67 ± 1.9 g/L; p = 0.005), leukocytes ≥ 12.0 x103 cél/uL (OR = 4.965), neutrophils ≥ 7.5 x103 cél/uL (OR = 4.332), hematocrit ≥ 35.1% (OR = 2.080) and plateletopenia (OR = 3.596; p = 0.016) were associated with increased risk of severe PE. The Neutrophil-Lymphocyte Index (NLI) ≥ 4.37 showed a high risk (OR = 5.887) and good predictive ability (AUC = 0.683; p = 0.000), with sensitivity of 67.9% and specificity of 56.2%, positioning it as a relevant marker in the identification of severe PE. Conclusions: Leukocytes, neutrophils and hematocrit were associated with severe preeclampsia; INL showed moderate capacity as a diagnostic tool.Objetivo: Determinar la asociación de los parámetros hematológicos y la severidad de la preeclampsia en gestantes atendidas en el Hospital Regional de Loreto, Iquitos, durante el año 2023. Métodos: Estudio tipo analítico con diseño correlacional de tipo caso y control. Resultados: Se seleccionaron 105 gestantes con PE severa y 105 sin severidad. El grupo predominante fueron mujeres entre 18 y 29 años (57,6%), seguido de un 28,6% con 30 años o más, grupo con mayor prevalencia de PE severa (38,1% vs. 19,0%; p < 0,05). La edad gestacional promedio fue de 36,2 semanas, y se observó un mayor porcentaje de partos pretérmino en PE severa (53,3% vs. 28,6%). La presión arterial sistólica ≥ 145,5 mmHg (76,2%) y la diastólica ≥ 94,7 mmHg (68,6%) fueron significativamente más frecuentes en PE severa (p = 0,000). En el análisis hematológico, niveles elevados de fibrinógeno (6,67 ± 1,9 g/L; p = 0,005), leucocitos ≥ 12.0 x103 cél/uL (OR = 4,965), neutrófilos ≥ 7.5 x103 cél/uL (OR = 4,332), hematocrito ≥ 35,1% (OR = 2,080) y plaquetopenia (OR = 3,596; p = 0,016) se asociaron con mayor riesgo de PE severa. El Índice Neutrófilo-Linfocito (INL) ≥ 4,37 mostró un riesgo elevado (OR = 5,887) y buena capacidad predictiva (AUC = 0,683; p = 0,000), con sensibilidad del 67,9% y especificidad del 56,2%. Conclusiones: Leucocitos, neutrófilos y hematocrito se asociaron con preeclampsia severa; el INL mostró capacidad moderada como herramienta diagnóstica.