Foot length measurements of newborns of high and low risk pregnancies / Medida do comprimento hálux-calcâneo de recém-nascidos em gestações de alto e baixo risco / Medida de longitud hallux-calcáneo de recién nacidos en gestaciones de alto y bajo riesgo

Abstract OBJECTIVE Comparing foot length measurements of newborns in high and low risk pregnancies at a public hospital in Goiânia, GO, Brazil. METHOD A cross-sectional study carried out between April, 2013 and May, 2015, with a sample consisting of 180 newborns; 106 infants of women from high-risk pregnancies and 74 of women from low-risk pregnancies. Data were descriptively analyzed. Foot length measurement was performed using a stiff transparent plastic ruler, graduated in millimeters. The length of both feet was measured from the tip of the hallux (big toe) to the end of the heel. RESULTS A statistically significant relationship was found between the foot length and newborn’s weight, between the cephalic and thoracic perimeters in the high-risk group and between the cephalic perimeter in the control group. CONCLUSION There is a need for creating cut-off points to identify newborns with intrauterine growth disorders using foot length.

Resumo OBJETIVO Comparar as medidas do comprimento hálux-calcâneo de recém-nascidos em gestações de alto e baixo risco em um hospital público de Goiânia, GO. MÉTODO Estudo transversal, realizado no período de abril de 2013 a maio de 2015, cuja amostra constituiu-se de 180 recém-nascidos, 106 filhos de mulheres com gestação de alto risco e 74 de mulheres com gestação de baixo risco. Os dados foram analisados descritivamente. A medida do comprimento hálux-calcâneo foi realizada utilizando-se de régua plástica transparente rígida, graduada em milímetros. Foram medidos ambos os pés, aferindo-se o comprimento da ponta do hálux até a extremidade do calcâneo. RESULTADOS Foi encontrada relação estatisticamente significante entre o comprimento hálux-calcâneo e o peso do recém-nascido, entre os perímetros cefálico e torácico no grupo de alto risco e entre o perímetro cefálico no grupo controle. CONCLUSÃO Existe necessidade da criação de pontos de corte para identificar recém-nascidos com desvios de crescimento intrauterino utilizando-se do comprimento hálux-calcâneo.

Resumen OBJETIVO Comparar las mediciones de la longitud hallux-calcáneo de los recién nacidos en embarazos de alto y bajo riesgo en un hospital público de Goiânia, GO.MÉTODOSEstudio transversal realizado de abril 2013 a mayo 2015, cuya muestra estuvo constituida por 180 recién nacidos, 106 de mujeres con embarazos de alto riesgo y 74 de mujeres con embarazos de bajo riesgo. Los datos se analizaron de manera descriptiva. La medida de la longitud hallux-calcáneo se realizó mediante regla de plástico rígido transparente, graduada en milímetros. Se midieron en ambos pies, las longitudes de la punta del hallux hasta el final del calcáneo. RESULTADOS Se encontró una relación estadísticamente significativa entre la longitud hallux-calcáneo y el peso del recién nacido, entre las circunferencias cefálica y torácica en el grupo de alto riesgo y entre la circunferencia cefálica en el grupo control. CONCLUSIÓN Existe la necesidad de crear puntos de corte para identificar los recién nacidos con desviaciones de crecimiento intrauterino utilizando la longitud desde el hallux hasta el calcáneo.

Influence of a virtual reality-based exercise protocol on the sit-to-stand activity kinematic variables in pregnant women: a randomized controlled trial

AIMS: Changes resulting from the gestational period may lead to changes in the biomechanics of women, which can alter the performance of functional activities such as sit-to-stand. Thus, the objective of this study was to investigate the influence of a virtual reality-based exercise protocol on the kinematic variables of the sit-to-stand movement in women in their second and third gestational trimesters. METHODS: The sample consisted of 44 women selected according to the eligibility criteria, allocated into 4 groups: control group, 2nd trimester (CG2T); experimental group, 2nd trimester (EG2T); control group, 3rd trimester (CG3T); and experimental group, 3rd trimester (EG3T). All the volunteers answered the identification and evaluation form and were sent to the kinematic evaluation through the Qualisys Motion Capture System®. An intervention with game therapy was performed in 12 sessions of 30 minutes each, three times a week. RESULTS: No statistically significant differences were found intra- (P> 0.54) and inter-groups (P> 0.059) for kinematic variables. However, there was a tendency for improvement in the analyzed variables after the proposed protocol. CONCLUSIONS: The data obtained suggest that the use of the Nintendo Wii Fit Plus® was not able to influence sit-to-stand kinematic variables in the analyzed women.(AU)

Algunos factores de riesgo asociados al bajo peso al nacer en el Hospital General "Orlando Pantoja Tamayo" / Some risk factors associated with the low birth weight in "Orlando Pantoja Tamayo" General Hospital i: en

Introducción: cuando un recién nacido tiene un peso inferior a 2500 gramos, independientemente de su edad gestacional, se considera bajo peso. Objetivo: caracterizar algunos factores de riesgo asociados al bajo peso al nacer. Métodos: se realizó un estudio retrospectivo y longitudinal de 242 recién nacidos, atendidos en el Hospital General Docente "Orlando Pantoja Tamayo" de Contramaestre, en la provincia de Santiago de Cuba, desde enero hasta diciembre del 2012. Resultados: prevalecieron los recién nacidos con bajo peso al nacer pertenecientes al área de salud América I (41,3 %), las infecciones vaginales (74,8 %) y el periodo intergenésico menor de 2 años. De los neonatos con esa insuficiencia ponderal, 67,3 % fueron producto de partos pretérmino. Los hábitos tóxicos y la edad materna extrema constituyeron los factores de riesgo predominantes. Conclusiones: el bajo peso constituye un problema de salud que se acrecienta aún más cuando hay desnutrición, debido a la repercusión negativa que tiene para los padres, la familia y la sociedad.

Introduction: when a new born has an weight lower than 2500 grams, independently from its gestacional age, it is considered underweight. Objective: to characterize some risk factors associated with low birth weight. Methods: A retrospective and longitudinal study of 242 newborns, assisted in "Orlando Pantoja Tamayo" Teaching General Hospital from Contramaestre was carried out in Santiago de Cuba province, from January to December, 2012. Results: the underweight newborns who belonged to the health area América I (41.3%), the vaginal infections (74.8%) and the intergenesis period shorter than 2 years prevailed. Of the neonates with that ponderal deficit, 67.3% resulted from preterm childbirths. The toxic habits and the extreme maternal age constituted the predominant risk factors. Conclusions: the low birthweight constitutes a health problem that increases even more when there is malnutrition, due to the negative repercussion that has for the parents, the family and the society.

Epidemiología de la infección vaginal en gestantes diabéticas / Epidemiología de la infección vaginal en gestantes diabéticas i: en

Se realizó un estudio descriptivo y transversal de 37 gestantes diabéticas ingresadas en el Servicio de Perinatología del Hospital General "Orlando Pantoja Tamayo" de Contramaestre, provincia de Santiago de Cuba, desde enero hasta diciembre de 2012, con vistas a caracterizarles desde el punto de vista epidemiológico. La información fue procesada con el programa SPSS, versión 11.5 y se utilizó el porcentaje como medida de resumen. Entre los resultados principales predominaron el grupo de 26-30 años (35,1 %), el diagnóstico de infección vaginal a las 28-36 semanas de gestación (48,7 %), la técnica incorrecta para el aseo (67,6 %) y la moniliasis como principal causa de infección (62,2 %). Se impone intensificar estrategias para la prevención de dichas infecciones en las embarazadas con diabetes gestacional.

A descriptive and cross-sectional study of 37 diabetic pregnant women admitted in the Perinatology Service of "Orlando Pantoja Tamayo" General Hospital in Contramaestre, Santiago de Cuba province, was carried out from January to December, 2012, aimed at characterizing them from the epidemiological point of view. The information was processed with the program SPSS, version 11.5 and the percentage was used as summary measure. Among the main results the 26-30 year group (35.1%), the diagnosis of vaginal infection at 28-36 weeks (48.7%), the incorrect technique for the toilet (67.6%) and moniliasis as the main infection cause (62.2%) prevailed. It is imposed to intensify strategies for the prevention of these infections in this populational group.

Valor predictivo del urocultivo en el diagnóstico de las complicaciones obstétricas y neonatales, en gestantes adolescentes y añosas atendidas en el INMP, durante el 2011 / Predictive value of urine culture in the diagnosis of obstetric and neonatal complications in adolescents and old pregnant women treated at the Instituto Nacional Materno Perinatal

Objetivo: el presente estudio, busca determinar el valor predictivo del urocultivo en el diagnóstico de las complicaciones obstétricas y neonatales, en gestantes adolescentes y añosas. Material y Métodos: estudio retrospectivo, transversal, observacional, tipo caso y control. Se revisó, 453 historias clínicas y datos de recién nacidos de gestantes atendidas en el Instituto Nacional Materno Perinatal, durante el per¡odo Enero – Diciembre, 2011. Se redujo la muestra a 338 historias, para mantener una relación 1:2 para caso y control. Se excluyó, a las pacientes con patología crónica o gestacional, aquellas con edades entre 20 y 34 años, y las que no tuvieron un urocultivo en su control prenatal. Los casos fueron identificados a través del urocultivo patológico (grupo 1) y el grupo control (grupo 2) con urocultivo normal. Resultados: de las 338 pacientes estudiadas, 160 eran gestantes adolescentes y 178 gestantes añosas. Del total, 76 presentaron complicaciones obstétricas (Grupo 1: 61 y Grupo 2: 15; p≤0.001) y 46 presentaron complicaciones en el recién nacido (Grupo 1: 34 y Grupo 2: 12; p ≤0.001). Siendo, las más afectadas las gestantes adolescentes. Conclusiones: las pacientes con urocultivo patológico, especialmente en el segundo trimestre; presentaron con mayor probabilidad ruptura prematura de membranas, amenaza de parto pretérmino, recién nacido pequeño para edad gestacional, restricción del crecimiento intrauterino, depresión neonatal y parto pretérmino. Asimismo, la presencia de un urocultivo normal, se considera factor protector para las complicaciones antes mencionadas. Siendo las gestantes adolescentes las más afectadas.

Objective: this study aims to determine the predictive value of urine culture in the diagnosis of obstetric and neonatal complications in pregnant adolescents and aged pregnant women. Material and Methods. A retrospective, cross-sectional observational, case and control study. We reviewed 453 medical records and data of newborns of pregnant women at the National Perinatal Maternal Institute, during the period January to December 2011. The sample was reduced to 338 stories, to maintain a 1:2 ratio for cases and controls. Exclusion criteria were patients with chronic or gestational diseases, those aged between 20 and 34 years, and those who did not have a urine culture in prenatal care. Cases were identified through pathological urine culture (group 1) and control group (group 2) with standard urine culture. Results: of the 338 patients studied, 160 were pregnant adolescents and 178 aged pregnant women. Of the total, 76 had obstetric complications (Group 1: 61 and Group 2: 15, P ≤ 0.001) and 46 had complications in the newborn (Group 1: 34 and Group 2: 12, P ≤ 0.001). Pregnant teens were the most affected. Conclusions: Patients with pathological urine culture, especially in the second quarter, had more probability of premature rupture of membranes, preterm labor, a newborn small for gestational age, intrauterine growth restriction, preterm delivery and neonatal depression. Also, a normal urine culture is a protective factor for the above mentioned complications. Pregnant teens being the most affected.

Significance of background activity and positive sharp waves in neonatal electroencephalogram as prognostic of cerebral palsy / Valor do ritmo de base e da onda aguda positiva no eletrencefalograma neonatal como prognóstico da paralisia cerebral

OBJECTIVE: To study the significance of electroencephalographic background activity and positive sharp waves in neonatal electroencephalogram as prognostic of cerebral palsy. METHOD: We studied prospectively and sequentially 73 newborns who had severe neonatal complications (neonatal anoxia, seizures, respiratory distress, sepsis, and meningitis). Nineteen newborns were excluded and 54 children formed the object of our study and were followed for 2 years. We analyzed gestational age, conceptional age, electroencephalographic background activity and positive sharp waves, which were correlated with cerebral palsy. RESULTS: There were no statistically significant correlation between gestational age and conceptional age and cerebral palsy; the electroencephalographic background activity was correlated with cerebral palsy as well as the positive sharp waves. CONCLUSION: Children with electroencephalographic background activity markedly abnormal and accompanied by positive sharp waves were associated with a worse prognosis.

OBJETIVO: Estudar o valor do ritmo de base e das ondas agudas positivas no eletrencefalograma neonatal como prognóstico da paralisia cerebral. MÉTODO: Nós estudamos, prospectiva e sequencialmente, 73 recém-nascidos que apresentaram complicações neonatais graves (anoxia neonatal, crises convulsivas, desconforto respiratório, septicemia e meningite). Dezenove recém-nascidos foram excluídos e 54 crianças formaram o objeto do nosso estudo e foram seguidas por 2 anos. Nós analisamos a idade gestacional, a idade corrigida, o ritmo de base e as ondas agudas positivas, que foram correlacionadas com a paralisia cerebral. RESULTADOS: Não houve correlação estatisticamente significante entre as idades gestacional e corrigida com a paralisia cerebral; o ritmo de base foi correlacionado com a paralisia cerebral, tanto quanto as ondas agudas positivas. CONCLUSÃO: Crianças com o eletrencefalograma com o ritmo de base marcadamente anormal e ondas agudas positivas estão associadas com pior prognóstico neurológico.

Associação entre doença periodontal em gestantes e nascimentos prematuros e/ou de baixo peso: um estudo de revisão / Association between periodontal disease in pregnant women and preterm and/or low weight births: a review study

O nascimento de bebês prematuros (menos de 37 semanas de gestação) e de baixo peso (menos que 2.500g) está associado à elevada taxa de mortalidade no período pós-natal. Além do efeito significante na taxa de mortalidade infantil, há evidência crescente para ligar esses nascimentos a outros problemas de saúde que podem incapacitar estas crianças total ou parcialmente pelo resto da vida. Nos últimos anos, a hipótese de que a doença periodontal (DP) está associada ao nascimento de bebês prematuros e/ou de baixo peso tem recebido atenção considerável. Dessa forma, o objetivo deste estudo foi verificar, na literatura, se há evidência da associação entre DP na gestante e resultados adversos na evolução e desfecho da gestação e os possíveis mecanismos envolvidos nesta associação. Os estudos revisados parecem indicar que existe uma evidência de associação entre a DP em gestantes e um risco aumentado para nascimentos de bebês prematuros e/ou de baixo peso. A plausibilidade biológica da associação fundamenta-se na indução, pelos patógenos periodontais, da produção de mediadores inflamatórios (prostaglandinas e interleucinas) capazes de levar ao trabalho de parto e afetar o desenvolvimento fetal a distância. São necessários estudos de intervenção controlados para esclarecer a associação entre a doença e resultados adversos na gestação e estabelecer o benefício potencial do tratamento periodontal em reduzir estes nascimentos. Novos estudos poderiam, ainda, investigar os fatores locais e sistêmicos que podem predispor as gestantes ao estabelecimento e/ou agravamento da DP, bem como avaliar o impacto da prematuridade e/ou baixo peso ao nascimento em seus bebês.

Preterm (under 37 weeks of gestational age) and low weight infants (under 2.55g) have an elevated mortality rate in the postnatal period. Besides the significant effect on infant mortality rate, there is increasing evidence linking these births to other health problems that may disable a child totally or partially for the rest of his/her life. In the last years, the hypothesis that periodontal disease (PD) is related to preterm and/or low weight births has received considerable attention. According to this hypothesis, the objective of this study was to assess, the literature, for evidence of the association between PD in pregnant women and adverse results on the development and closing of the gestational period and possible mechanisms involved in this association. The revised studies seem to indicate that there is evidence of an association between PD in pregnant women and an increasing risk for preterm and/or low weight births. The biological rationale for this association is based on induction, periodontal pathogens, production of inflammatory mediators(prostaglandins and interleukins) able to induce labor and affect fetal development in the long run. Controlled intervention studies are necessary to clarify the association between the disease and adverse results during gestation and establish the beneficial potential of periodontal treatment at reducing these births. New studies could, still, investigate the local and systemic factors that may predispose the pregnant women to the establishment and/or severity of PD as well as evaluate the impact of preterm and/or low weight births of their infants.