Objectives:

To identify and analyze the risk factors associated with the development of HELLP syndrome.

Method:

Systematic review of literature in PubMed and SciELO databases. Observational studies, systematic reviews, and case reports published between 2018 and 2024 in Spanish and English were included. The search strategy used MeSH terms: “HELLP syndrome,” “risk factors,” “preeclampsia,” and “pregnancy complications.” The PRISMA checklist was applied for methodological evaluation.

Results:

Forty-five studies were analyzed, including 125,847 cases of HELLP syndrome. The reported incidence was 0.5-0.9% of all pregnancies and 4-14% of pregnancies with preeclampsia (1,2). The most significant risk factors include: history of previous HELLP syndrome (RR 54.4; 95% CI 34.3-86.2) (28), family history of hypertension (80% of cases), maternal age ≥35 years (OR 2.3; 95% CI 1.8-2.9), pregestational obesity (BMI ≥30 kg/m²), gestational diabetes, and multiparity (1). Current maternal mortality is 1.1% with perinatal mortality of 7.3-11.9% (30).