**6. Definitions of hypertensive states in pregnancy**

According to the American College of Obstetricians and Gynecologists (ACOG) [17–19], the classification of hypertensive disorders in pregnancy is as follows: Hypertensive disease induced by pregnancy:

	- Mild

*Prediction of Maternal and Fetal Syndrome of Preeclampsia*

adolescent. For example, preeclampsia or gestation-induced hypertension is more frequent in young pregnant women, from a low socioeconomic level, and specifically, in the first pregnancy, conditions all frequently met by a pregnant adolescent. When developing this clinical entity, a possible failure in the adaptive immune response has been posited, although it normally permits the development of a close interrelation between the maternal organism and its host. Since 50% of the fetal antigenic structure is of paternal origin, it acts like a graft and has been associated to factors such as immaturity of the maternal immune system or a functional abnormality that may be associated to maternal malnutrition, a very common condition in pregnant adolescents. Morbidity may be classified according to the gestational periods, whereby miscarriage, anemia, urinary tract infections, and asymptomatic bacteriuria are more common in the first half. In the second half, there are hypertensive manifestations, hemorrhage associated to placental pathology, scarce weight gain and associated maternal malnutrition, symptoms of premature delivery

(abnormal contractility), and premature membrane rupture [8, 9].

complications are summarized in **Table 1**.

**5. Frequency of preeclampsia in adolescents**

leads to severe maternal and perinatal complications.

women between the ages of 15 and 34 [14].

2.Obstetric hemorrhage (19%).

3.Sepsis (4.1%).

The main causes of death in pregnant women were:

1.Hypertensive disease induced by pregnancy (20.4%).

Several authors have suggested that there is a relation between hypertensive disorders and pregnancy, which will be further discussed in this chapter. Other

A strategy to confront these problems and adolescent pregnancy is to increase the availability of high-quality sexual and reproductive health services for adolescents [10].

Preeclampsia refers to a relatively common hypertensive disorder during pregnancy that develops progressively. Its cause remains unknown, and it frequently

Its incidence is broad since it depends on various aspects such as geographic location, race, nutritional or immunological factors, and associated comorbidities, and even a humid and cold climate has been related to a higher incidence of affected women. It is estimated that about 7% of pregnancies will develop preeclampsia. The incidence of preeclampsia is about 25% in primiparous women. In industrialized nations, the rate of maternal morbidity due to preeclampsia varies between 3.8 and 12 per 1000 births. In Latin America, there are few reports on the subject, so the real magnitude of the problem remains unknown; there are only some studies from Brazil and Cuba [11]. Throughout the world, 25% of all maternal deaths occur in adolescent women.

In Latin America, adolescent pregnancy is an independently associated factor conferring greater risk for adversities during pregnancy [12, 13]. In the United States, the maternal mortality rate due to preeclampsia-eclampsia is approximately 1 for every 100,000 live births. In Mexico, maternal mortality has decreased in the past six decades, whereby 1281 maternal deaths were registered in the year 2009, in

These percentages are five to ten times greater than those reported in industrial-

ized nations or in those with more developed national health systems [15, 16].

**128**


Chronic hypertension before pregnancy (any etiology). Chronic hypertension and pregnancy-induced hypertension:

