{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T02:00:43Z","timestamp":1785463243003,"version":"3.56.0"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["88887.896655\/2023\u201000"],"award-info":[{"award-number":["88887.896655\/2023\u201000"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["2023\/13456\u20104"],"award-info":[{"award-number":["2023\/13456\u20104"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["2021\/09937\u20101"],"award-info":[{"award-number":["2021\/09937\u20101"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["408407\/2021\u20102"],"award-info":[{"award-number":["408407\/2021\u20102"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp;amp; Obste"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study describes maternal and perinatal outcomes of women with preeclampsia (PE) according to hospital admission characteristics: referral from lower complexity settings or directly admitted at the reference hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a cross\u2010sectional study considering women with PE who were admitted for childbirth between September 2019 and August 2021, at a Brazilian university hospital. Women were divided into hospitalized at the tertiary center or referred women (from facilities in the region). The main outcome measures were need for magnesium sulfate (proxy for severity), mean gestational age (GA) at childbirth, 5\u2010min Apgar score\u2009&lt;7, birthweight, and maternal and perinatal deaths.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were 3914 childbirths, with 428 with PE (10.9%). Among PE cases, 37 (8.6%) were referred cases. Magnesium sulfate was used in 89.2% of the referred women and 44.8% of non\u2010referred (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). The mean GA at childbirth differed significantly between groups (referred cases: 33.6\u2009\u00b1\u20093.27\u2009weeks vs. 36.1\u2009\u00b1\u20092.97\u2009weeks,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Five\u2010minute Apgar &lt;7 was more frequent among referred cases (13.9% vs. 4.1%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.03). There were no maternal deaths and no differences in perinatal deaths between groups. Newborns from referred mothers had lower mean birthweight (2150\u2009\u00b1\u2009946 vs. 2730\u2009\u00b1\u2009800\u2009g,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) and needed more intensive care (72.2 vs. 34.9%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Referred women with PE had worse maternal and perinatal outcomes than those who were directly hospitalized in the tertiary center, which highlights the importance of timely diagnosis and delays associated to referral of women with PE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70772","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T12:05:08Z","timestamp":1767614708000},"page":"1528-1536","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Direct versus referred admission to the maternity hospital due to preeclampsia: Does it influence pregnancy outcomes?"],"prefix":"10.1002","volume":"173","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2708-350X","authenticated-orcid":false,"given":"Juliana","family":"da\u2010Costa\u2010Santos","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medical Sciences Universidade Estadual de Campinas  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilherme F.","family":"Borges","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medical Sciences Universidade Estadual de Campinas  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vitor L. V.","family":"Reis","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medical Sciences Universidade Estadual de Campinas  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodolfo R.","family":"Japecanga","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medical Sciences Universidade Estadual de Campinas  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maykon A.","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medical Sciences Universidade Estadual de Campinas  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Julia G.","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medical Sciences Universidade Estadual de Campinas  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura C.","family":"Vinchi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medical Sciences Universidade Estadual de Campinas  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur B. P.","family":"Righi","sequence":"additional","affiliation":[{"name":"Pontifical Catholic University of Campinas  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jussara","family":"Mayrink","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine Federal University of Minas Gerais  Belo Horizonte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda G.","family":"Surita","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medical Sciences Universidade Estadual de Campinas  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Paulo de Siqueira","family":"Guida","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medical Sciences Universidade Estadual de Campinas  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renato T.","family":"Souza","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medical Sciences Universidade Estadual de Campinas  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 G.","family":"Cecatti","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medical Sciences Universidade Estadual de Campinas  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8280-3234","authenticated-orcid":false,"given":"Maria Laura","family":"Costa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medical Sciences Universidade Estadual de Campinas  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-1742680"},{"key":"e_1_2_11_3_1","unstructured":"Rede Brasileira de Estudos sobre Hipertens\u00e3o na Gravidez (RBEHG).Pr\u00e9\u2010ecl\u00e2mpsia \u2013 Protocolo 2023.2023."},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2109523"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2021.09.008"},{"key":"e_1_2_11_6_1","volume-title":"High\u2010Value Referrals: Learning from Challenges and Opportunities of the COVID\u201019 Pandemic. 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