ABSTRACT
Objetivo: identificar el riesgo de depresión durante el embarazo en gestantes de riesgo habitual incluidas en el control prenatal y los factores asociados. Método: estudio transversal, realizado con 201 gestantes, en el consultorio de prenatal de riesgo habitual de una maternidad universitaria. Para la recolección de datos se utilizó un formulario electrónico que contenía un instrumento de caracterización y la Escala de Riesgo de Depresión del Embarazo. La variable dependiente fue el riesgo de depresión en el embarazo. El análisis estadístico se realizó mediante el cálculo de la razón de posibilidades (Odds Ratio) y utilizando las pruebas de Chi-cuadrado y exacta de Fischer. Resultados: entre las participantes, 68,2% tenían mayor riesgo de depresión durante el embarazo. Hubo asociación estadísticamente significativa entre mayor riesgo de depresión durante el embarazo y la variable ocupación (p=0,04), o sea, la ausencia del trabajo (OR = 2,00) duplicó la probabilidad de ocurrencia. Conclusión: la alta prevalencia de riesgo de depresión durante el embarazo destaca la necesidad de planificación, priorización e integración de la salud mental en los servicios de salud prenatal, especialmente en el ámbito de la Atención Primaria de Salud, por parte de los gestores de salud y de los formuladores de políticas.
Objective: to identify the risk of depression during pregnancy among pregnant women receiving routine prenatal care and the associated factors. Method: a cross-sectional study, carried out with 201 pregnant women, in a routine prenatal clinic of a university maternity hospital. Data were collected using an electronic form containing a characterization instrument and the Escala de Risco de Depressão na Gravidez (Depression during Pregnancy Scale). The dependent variable was the risk of depression during pregnancy. Statistical analysis was performed by calculating the Odds Ratio and using the Chi-square and Fischer's Exact tests. Results: among the participants, 68.2% had a higher risk of depression during pregnancy. There was a statistically significant association between a higher risk of depression during pregnancy and occupation (p=0.04), that is, unemployment (OR=2.00) doubled the risk of depression. Conclusion: the high prevalence of the risk of depression during pregnancy indicates the necessity of planning, prioritizing, and integrating mental health into prenatal health services, especially in the primary healthcare environment, by health managers and policymakers.
Objetivo: identificar o risco de depressão na gravidez entre gestantes inseridas na assistência pré-natal de risco habitual e os fatores associados. Método: estudo transversal, realizado com 201 gestantes, no ambulatório de pré-natal de risco habitual de uma maternidade universitária. A coleta de dados utilizou um formulário eletrônico contendo um instrumento de caracterização e a Escala de Risco de Depressão na Gravidez. A variável dependente foi o risco de depressão na gravidez. A análise estatística deu-se pelo cálculo da razão de chances (Odds Ratio) e pelos testes Qui-quadrado e Exato de Fischer. Resultados: entre as participantes, 68,2% apresentaram maior risco de depressão na gravidez. Houve associação estatisticamente significativa entre o maior risco de depressão na gravidez e a variável ocupação (p=0,04), ou seja, a ausência de emprego (OR = 2,00) aumentou em duas vezes a chance de ocorrência. Conclusão: a alta prevalência de risco de depressão na gravidez evidencia a necessidade de planejamento, priorização e integração da saúde mental nos serviços de saúde pré-natal, principalmente no ambiente da Atenção Primária à Saúde, por parte de gestores de saúde e formuladores de políticas.
Subject(s)
Humans , Female , Pregnancy , Pregnancy Complications/epidemiology , Prenatal Care , Cross-Sectional Studies , Risk Factors , Depression/epidemiologyABSTRACT
Abstract Objectives: measuring the prevalence of interventions and/or complications based on the Maternity Safety Thermometer (MST) criteria and verifying associations with sociodemographic, clinical, and obstetric factors. Methods: prospective observational study conducted with postpartum women admitted to the maternity ward of a tertiary hospital, from October 10th to December 30th, 2020. Data were collected from medical records and self-administered questionnaires from 260 patients. Results: harm-free care was detected in 17.7% of participants, 66.9% had low-temperature damage (one or less intervention/complication) and 33.1% of patients had elevated temperature damage (two or more intervention/complication). The most frequent intervention was the "scar", given that 38.5% had abdominal scarring (cesarean section) and 26.5% had perineal scarring (2nd-degree tear or greater - spontaneous or by episiotomy). The second most frequent MST item was related to the perception of safety (30%), followed by complications to the newborn (12.3%), infection (11.2%), and hemorrhage (9.2%). Factors related to high temperature were: being of social class A or B, having a previous cesarean section, and being hospitalized during pregnancy. Conclusions: one-third of the participating women had two or more complications/interventions (high temperature by the MST), factors that are related to this temperature were: being of social class A or B, having a previous cesarean section, and being hospitalized during pregnancy.
Resumo Objetivos: mensurar a prevalência de intervenções e/ou complicações a partir dos critérios estabelecidos pelo Termômetro de Segurança da Maternidade (TSM) e avaliar associações com fatores sociodemográficos, clínicos e obstétricos. Métodos: estudo observacional prospectivo realizado com puérperas internadas na maternidade de hospital terciário, de 10 de outubro a 30 de dezembro de 2020. Foram coletados dados do prontuário e de questionários autoaplicáveis de 260 pacientes. Resultados: um cuidado livre de intervenções/complicações foi detectado em 17,7% das participantes, 66,9% apresentaram baixa temperatura (até uma intervenção/complicação) e 33,1% tiveram alta temperatura de intervenções/complicações (2 ou mais). A intervenção mais frequente foi a denominada "cicatriz", sendo que 38,5% tiveram cicatriz abdominal (cesariana) e 26,5% tiveram "cicatriz" perineal (laceração de 2º grau ou mais - espontânea ou por episiotomia). O segundo dano mais frequente foi o relacionado à percepção de segurança (30%), seguido de complicações do recémnascido (12,3%), infecção (11,2%), e hemorragia (9,2%). Houve associação de ter alta temperatura com ser de classe social A ou B, ter cesárea anterior e ser internada na gestação. Conclusões: das mulheres participantes, um terço teve duas ou mais complicações/intervenções (alta temperatura no TSM), estiveram relacionados a essa temperatura: ser de classe social A ou B, ter cesárea anterior e ser internada ao longo da gestação.
Subject(s)
Humans , Female , Pregnancy , Pregnancy Complications/epidemiology , Maternal-Child Health Services , Patient Safety , COVID-19 , Hospitals, Maternity , Obstetric Labor Complications/epidemiology , Midwifery , Tertiary Healthcare , Brazil , Sociodemographic FactorsABSTRACT
Objetivo: Determinar o perfil epidemiológico da sífilis gestacional em um hospital público-privado localizado no município de Toledo, Paraná, no período de janeiro de 2017 a dezembro de 2019. Métodos: Estudo observacional, retrospectivo, com forma de abordagem quantitativa, descritiva e indireta, a partir de uma pesquisa documental em um hospital público-privado e na 20ª Regional de Saúde do Paraná, localizados no município de Toledo, Paraná, Brasil. Resultados: Foram avaliadas 163 gestantes com sífilis gestacional. A média de idade foi 24,42 anos. Entre as gestantes, 47,24% são mulheres brancas, 39,88% têm ensino médio completo, 66,26% residentes na cidade de Toledo, 98,16% realizaram pré-natal, 65,64% foram diagnosticadas no primeiro trimestre. O tratamento adequado ocorreu em 45,40% das gestantes e em 53,99% o parceiro foi tratado em conjunto. Conclusão: A sífilis gestacional apresentou predomínio em gestantes na faixa etária de 20 a 29 anos, mulheres brancas, com ensino médio completo, residentes em Toledo, Paraná. Retratou-se boa cobertura de pré-natal, assim como apontou-se o tratamento do parceiro sexual como o maior obstáculo para a gestante ser tratada adequadamente e indicou-se que a sífilis em gestantes pode ser considerada uma causa importante da ocorrência de desfechos perinatais desfavoráveis.
Objective: To determine the epidemiological profile of gestational syphilis in a public- private hospital, located in the city of Toledo, Paraná, from January 2017 to December 2019. Methods: Observational, retrospective study, with a quantitative, descriptive and indirect approach, based on a documentary research in a public-private hospital and in the 20th Regional Health of Paraná, located in the city of Toledo, Paraná, Brazil. Results: 163 pregnant women with gestational syphilis were evaluated. The average age was 24,42 years. 47,24% are white women, 39,88% have completed high school, 66,26% live in the city of Toledo. 98,16% had prenatal care, 65,64% were diagnosed in the 1st trimester. Appropriate treatment occurred in 45,40% of the pregnant women and in 53,99% the partner was treated together. Conclusion: Gestational syphilis was predominant in pregnant women aged 20 to 29 years, white women, with complete high school, living in Toledo, Paraná. It portrayed good prenatal coverage, as well as pointing out the treatment of the sexual partner as the biggest obstacle for the pregnant woman to be treated properly and indicated that syphilis in pregnant women can be considered an important cause of the occurrence of unfavorable perinatal outcomes.
Subject(s)
Humans , Female , Pregnancy , Pregnancy Complications/epidemiology , Syphilis/epidemiology , Pregnant Women , Health Profile , Brazil/epidemiology , Maternal and Child Health , Retrospective StudiesABSTRACT
Objetivo: Caracterizar a população das gestantes em diferentes faixas etárias; avaliar desfechos maternos e neonatais em pacientes com idade materna avançada; determinar a faixa etária a partir da qual os desfechos adversos foram mais prevalentes. Métodos: Parturientes atendidas no Hospital do Servidor Público Estadual de São Paulo entre junho/2019 e maio/2020 foram divididas em três grupos 20 a 34 anos; 35 a 39 anos; 40 anos ou mais e analisadas quanto a diversas variáveis. Resultados: Entre as gestantes do Serviço, 44,2% tinham idade materna avançada. A amostra foi composta por 927 pacientes, a maioria com relacionamento conjugal estável (75,2%) e ensino de nível superior (74,7%). Independentemente do grupo etário, foram observados elevados índices de obesidade (25,9%), sobrepeso (39,7%) e cesariana (76,4%). A frequência de iteratividade, diabetes gestacional e doença hipertensiva específica da gestação foi maior a partir dos 35 anos, e a frequência de hipertensão arterial crônica foi maior a partir dos 40 anos. Neonatos de pacientes com 40 anos ou mais tiveram maiores índices de baixo peso ao nascer, óbito neonatal, Apgar de quinto minuto < 7 e necessidade de reanimação neonatal. Conclusão: Pacientes com idade materna avançada representaram porcentagem expressiva da população e tiveram maior frequência de desfechos adversos. Complicações obstétricas foram mais prevalentes a partir dos 35 anos, com destaque para diabetes gestacional e distúrbios hipertensivos. Resultados neonatais desfavoráveis, como baixo peso ao nascer e óbito neonatal, foram mais prevalentes a partir de 40 anos.
Objective: Featuring the population of pregnant women in different age groups; assessing maternal and neonatal outcomes in patients at advanced maternal age; determining the threshold age for the potential prevalence of adverse outcomes. Methods: Women in labor assisted at Hospital do Servidor Público Estadual de São Paulo between June/2019 and May/2020 were divided into three age groups 20 to 34 years; 35 to 39 years; over 40 years , who were assessed for several variables. Results: 44.2% of pregnant women in this Service were at advanced maternal age. The sample counted on 927 patients, most of them declared stable marital relationships (75.2%) and College degree (74,7%). High obesity levels (25.9%), overweight (39.7%) and cesarean delivery (76.4%) were observed, regardless of age group. Maternal request was the main indication for cesarean surgery. Iteration frequency, gestational diabetes and pregnancy-specific hypertensive disease was higher from the age of 35 years, on. Chronical high blood pressure was higher in the age group over 40 years. Newborns from patients older than over 40 years presented higher low weight at birth index, neonatal death, 5th minute Apgar score < 7 and the need of neonatal resuscitation. Conclusion: Patients at advanced maternal age recorded higher obstetric adversity frequency in the age group over 35 years, with emphasis on gestational diabetes and high blood pressure. Unfavorable neonatal outcomes related to low weight at birth and neonatal death were more prevalent in the age group over 40 years.
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Pregnancy Complications/epidemiology , Diabetes, Gestational/epidemiology , Pregnant Women , Maternal Health , Hypertension/epidemiology , Obesity/epidemiology , Apgar Score , Prenatal Care , Comorbidity , Retrospective Studies , Maternal Age , Sociodemographic Factors , MidwiferyABSTRACT
Abstract Objective: In this present study, the authors evaluated the predictive factors for adverse maternal-fetal outcomes in pregnancies of women with cystic fibrosis (CF). Patients were followed up by a referral center for adults in southern Brazil. Methods: This is a retrospective cohort study that used data from electronic medical records regarding pregnancies of women diagnosed with CF. Results: The study included 39 pregnancies related to 20 different women. The main adverse outcomes were high prevalence rates of premature birth (38.5%) and maternal respiratory exacerbation (84.6%). Lower body mass index (BMI) values (< 20.8) and younger ages of CF diagnosis increased the risk of premature birth. The presence of methicillin-resistant and absence of methicillin-sensitive Staphylococcus aureus, as well as a younger age of diagnosis, increased the risk of maternal respiratory exacerbation during pregnancy. Conclusions: Conception in women with CF is often associated with maternal and fetal complications. Continuous monitoring by a multidisciplinary team should emphasize appropriate nutritional status, investigation of bacterial colonization, and immediate attention to respiratory exacerbations.
Subject(s)
Humans , Female , Pregnancy , Adult , Pregnancy Complications/epidemiology , Cystic Fibrosis/complications , Cystic Fibrosis/epidemiology , Premature Birth/etiology , Premature Birth/epidemiology , Pregnancy Outcome , Nutritional Status , Retrospective StudiesABSTRACT
Este estudo investigou os fatores associados à morbidade materna grave entre mulheres atendidas em maternidades públicas do Município de Ribeirão Preto, São Paulo, Brasil. Trata-se de um estudo quantitativo, analítico, transversal. Participaram 1.098 puérperas com parto em uma das quatro maternidades públicas do município. A coleta de dados ocorreu entre 3 de agosto de 2015 e 2 de fevereiro de 2016, a partir de entrevistas face a face, obtenção de informações dos prontuários e dos cartões da gestante. Para a análise de dados, considerou-se como variável dependente a ocorrência de morbidade materna grave, ou seja, quando a mulher era classificada como near miss materno ou condição potencialmente ameaçadora à vida a partir dos critérios de elegibilidade da Organização Mundial de Saúde. Calculou-se a razão do near miss materno, odds ratio (OR), intervalo de 95% de confiança (IC95%) e regressão logística múltipla. A razão do near miss materno foi de 3,6 casos por mil nascidos vivos. As complicações ocorreram principalmente na gravidez (53,8%) e os distúrbios hipertensivos foram os mais frequentes (49,4%). A análise de regressão múltipla mostrou associação entre morbidade materna grave e gestação de risco (OR = 4,5; IC95%: 2,7-7,7) e com trabalho de parto induzido (OR = 2,1; IC95%: 1,2-3,9). A ocorrência de morbidade materna grave, principalmente na gestação, com destaque para as síndromes hipertensivas, aponta para a necessidade de melhor rastreamento e manejo da elevação dos níveis pressóricos no pré-natal. A associação entre morbidade materna grave e gestação de risco também remonta ao pré-natal, para a demanda de uma maior atenção às mulheres classificadas como risco gestacional. A qualidade da assistência é ponto chave para o enfretamento da morbimortalidade materna no país.
This study investigated the factors associated with serious maternal morbidity (SMM) in women seen at public maternity hospitals in Ribeirão Preto, São Paulo State, Brazil. This was a cross-section analytical quantitative study. Participation included 1,098 postpartum women who had given birth at one of the four maternity hospitals in the municipality. Data were collected from August 3, 2015, to February 2, 2016, using face-to-face interviews and data obtained from patient records and prenatal cards. The dependent variable for data analysis was the serious maternal morbidity, that is, when the woman was classified as maternal near miss or potentially life-threatening condition based on WHO eligibility criteria. The study calculated the maternal near miss ratio, odds ratio (OR), 95% confidence interval (95%CI), and multiple logistic regression. The maternal near miss ratio was 3.6 cases per 1,000 live births. Complications occurred mainly during pregnancy (53.8%), and hypertensive disorders were the most frequent (49.4%). Multiple regression analysis showed an association between serious maternal morbidity and high-risk pregnancy (OR = 4.5, 95%CI: 2.7-7.7) and induced labor (OR = 2.1, 95%CI: 1.2-3.9). The occurrence of serious maternal morbidity mainly during pregnancy, featuring hypertensive syndromes, points to the need for better screening and management of high blood pressure in the prenatal period. The association between serious maternal morbidity and high-risk pregnancy also calls attention to prenatal care, for the demand for greater care for women classified as having gestational risk. Quality of care is a key point for dealing with maternal morbidity and mortality in Brazil.
Este estudio investigó los factores asociados a la morbilidad materna grave entre mujeres atendidas en maternidades públicas del municipio de Ribeirão Preto, São Paulo, Brasil. Se trata de un estudio cuantitativo, analítico, transversal. Participaron 1.098 puérperas con parto en una de las cuatro maternidades públicas del municipio. La recogida de datos se produjo entre el 3 de agosto de 2015 al 2 de febrero de 2016, mediante entrevistas cara a cara, obtención de información de los historiales y cartillas de las gestantes. Para el análisis de datos, se consideró como variable dependiente la ocurrencia de morbilidad materna grave, o sea, cuando la mujer era clasificada como near miss materno o condición potencialmente amenazadora para la vida, a partir de los criterios de elegibilidad de la Organización Mundial de Salud. Se calculó la razón del near miss materno, odds ratio (OR), intervalo de 95% de confianza (IC95%) y regresión logística múltiple. La razón de near miss materno fue de 3,6 casos por 1.000 nacidos vivos. Las complicaciones se produjeron principalmente en el embarazo (53,8%) y las alteraciones hipertensivas fueron las más frecuentes (49,4%). El análisis de regresión múltiple mostró asociación entre morbilidad materna grave y gestación de riesgo (OR = 4,5; IC95%: 2,7-7,7) y con trabajo de parto inducido (OR = 2,1; IC95%: 1,2-3,9). La ocurrencia de morbilidad materna grave, principalmente en la gestación, resaltando los síndromes hipertensivos, apunta la necesidad de un mejor rastreo y gestión de la elevación de los niveles presión arterial en el período prenatal. La asociación entre morbilidad materna grave y gestación de riesgo también se remonta al período prenatal, con el fin de que se preste una mayor atención a las mujeres clasificadas como de riesgo gestacional. La calidad de la asistencia es un punto clave para combatir la morbimortalidad materna en el país.
Subject(s)
Humans , Female , Pregnancy , Pregnancy Complications/epidemiology , Pregnancy, High-Risk , Brazil/epidemiology , Maternal Mortality , Cross-Sectional Studies , Cohort Studies , Hospitals, MaternityABSTRACT
The incidence of obstructive sleep apnea (OSA) is higher in pregnancy than in non-pregnancy,and obesity is a major risk factor.OSA in pregnancy can lead to multiple organ dysfunction and is associated with hypertensive disorders in pregnancy,gestational diabetes mellitus,premature birth,and fetal growth restriction. Therefore,early screening and diagnosis are essential for the prevention and treatment of OSA in pregnancy.
Subject(s)
Female , Humans , Pregnancy , Diabetes, Gestational , Obesity , Pregnancy Complications/epidemiology , Premature Birth , Risk Factors , Sleep Apnea, Obstructive/therapyABSTRACT
Objective: This study aims to investigate the sleep quality of pregnant women in Xuhui District, Shanghai, and the related factors of sleep disturbances during pregnancy. Methods: From February 2019 to February 2021, we used online integrated sleep questionnaire (including PSQI, BQ, ESS, AIS) in Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, The International Peace Maternity and Child Health Hospitals of China Welfare Institution, and Shanghai Eighth People's Hospital, to investigate the sleep quality across pregnancy. We also collected maternal physical examination results, childbearing history, sociodemographic, and other clinical data. The prevalences and related factors of various sleep disturbances in pregnant women were analyzed, including insufficient/excessive nighttime sleep, low sleep efficiency, difficulty falling asleep, poor sleep quality, insomnia, daytime sleepiness, and high risk of sleep-disordered breathing (SDB). Results: This study includes 1 898 cases in the first trimester (T1), 3 099 cases in the second trimester (T2), and 1 539 cases in the third trimester (T3). Poor sleep quality (38.6%), daytime sleepiness (mild 41.9%, moderate 17.7%, severe 2.1%), and suspicious insomnia (32.3%) are most prevalent among women in T1 (P<0.01). In comparison, short sleep time (2.7%), long sleep time (8.6%), difficulty falling asleep (12.2%), poor sleep efficiency (35.4%), very poor sleep quality (6.7%), clinical insomnia (21.8%), and high-risk SDB (6.4%) are most prevalent among women in T3 (P<0.05). During pregnancy, late gestation (OR=1.016, 95%CI: 1.006-1.025) and multiple induced/drug abortions (OR=1.329, 95%CI: 1.043-1.692) are risk factors for poor sleep quality (PSQI>5), while multiple full-term deliveries (OR=0.800, 95%CI: 0.675-0.949) is its protective factor. Advanced maternal age (OR=0.976, 95%CI: 0.956-0.997), multiple full-term deliveries (OR=0.808, 95%CI: 0.680-0.959), late gestation (OR=0.983, 95%CI: 0.974-0.992) and hypertension (OR=0.572, 95%CI: 0.401-0.814) are protective factors for daytime sleepiness (ESS>6). The high-risk pregnancy category (OR=9.312, 95%CI: 1.156-74.978) is a risk factor for insomnia (AIS≥4), while multiple full-term deliveries (OR=0.815, 95%CI: 0.691-0.961) is its protective factor. High BMI (OR=1.334, 95%CI: 1.270-1.402) and hypertension (OR=4.427, 95%CI: 2.539-7.719) are risk factors for high-risk SDB in pregnant women. Conclusions: The prevalences of various sleep disturbances are high throughout pregnancy. Noticeably, symptoms of maternal SDB develop along with pregnancy. Different types of sleep disturbances are associated with different factors. Women of high-risk pregnancy category, in late gestation, with high BMI, hypertension, a history of induced/drug abortion, or without a history of full-term delivery can be at high risk of sleep disturbances during pregnancy.
Subject(s)
Child , Female , Humans , Pregnancy , China/epidemiology , Cross-Sectional Studies , Pregnancy Complications/epidemiology , Pregnant Women , Sleep , Sleep QualityABSTRACT
Introducción: El embarazo en la adolescencia es el ocurrido en el lapso de vida entre los 10 y 19 años de edad; se presenta antes de que la madre haya alcanzado la suficiente madurez emocional para asumir la compleja tarea de la maternidad. A nivel mundial, se reconoce un aumento de la actividad sexual de los adolescentes, es un problema social que afecta, en mayor o menor proporción, a todas las regiones del mundo. Objetivo: Definir el alcance y la naturaleza de la literatura científica existente sobre el embarazo en la adolescencia, prevención y sus complicaciones. Métodos: Revisión bibliográfica sistemática para hacer un análisis crítico reflexivo de documentos, donde se incluyeron libros, tesis de doctorado, de maestría, artículos originales y de revisión. La estrategia de búsqueda utilizada en cada base de datos, SciELO y Google académico se reunió mediante la aceptación de los descriptores Adolescencia, Embarazo, Prevención y Complicaciones, con los operadores booleanos AND y OR. Conclusiones: Para la prevención del embarazo en la adolescencia, se necesita de una mayor divulgación de sus consecuencias y formas de evitarlo que podría lograrse con la puesta en práctica de estrategias educativas de forma didácticas y agradables, que puedan constituir interés para los adolescentes(AU)
Introduction: Pregnancy in adolescence is that one occurring in the period of life from the age of ten to nineteen years old. It occurs before the mother has reached enough emotional maturity to take on the complex task of motherhood. Worldwide, an increase in adolescent sexual activity is recognized; it is a social concern that affects, to a greater or lesser extent, all regions of the world. Objective: To define the scope and nature of the existing scientific literature on adolescent pregnancy, as well as its prevention and complications. Methods: Systematic bibliographic review carried out in view of a reflective-critical analysis of documents, which included books, doctoral and master's theses, as well as original and review articles. The search strategy used in each database, SciELO and Google Scholar, was designed by accepting the descriptors Adolescencia [Adolescence], Embarazo [Pregnancy], Prevención [Prevention] and Complicaciones [Complications], with the Boolean operators AND and OR. Conclusions: For the prevention of pregnancy in adolescence, greater spread of its consequences and ways for avoiding it is needed, which could be achieved with the implementation of educational strategies in a didactic and pleasant way, in order for it to become of interest to adolescents(AU)
Subject(s)
Humans , Male , Female , Adolescent , Pregnancy Complications/epidemiology , Pregnancy in Adolescence/prevention & control , Primary Health CareABSTRACT
Abstract Objectives: to describe the profile of women affected with premature childbirth and neonatal outcomes at a referral maternity in the city of Fortaleza-CE, Brazil. Methods: descriptive and retrospective documentary type study, with a quantitative approach, carried out from January to December, 2017, with 253 medical records of women who had premature childbirth in a referral maternity. Results: the average age was 28, with the prevalence of women living in a stable union, graduated from high school and without formal work. The gestational mean average was three pregnancies, gestational age of 34 weeks and three days, and six prenatal consultations, starting in the first trimester. The major intercurrence was pre-eclampsia. In relation to the neonatal data, there was a prevalence of male newborns, with an average of 2.251 kg and a score of seven on the 1-minute Apgar and eight on the 5-minute Apgar. Newborns in going to a hospital accommodation after childbirth and in room air, spending an average of 12.71 days in the hospital. Conclusion: in this case of this research, knowing the woman's profile and the outcomes in premature newborns is useful to encourage public policies and reduce the sequelae on mother and baby
Resumo Objetivos: descrever o perfil de mulheres acometidas por parto prematuro e os desfechos neonatais em maternidade de referência, na cidade de Fortaleza-CE, Brasil. Métodos: estudo do tipo documental, descritivo, retrospectivo, com abordagem quantitativa, realizadode janeiro a dezembro de 2017, com 253 prontuários de mulheres que tiveram parto prematuro em maternidade de referência. Resultados: média de idade de 28 anos, com prevalência de mulheres vivendo em união estável, ensino médio completo, sem trabalho formal. A média gestacional foi de três gravidezes, idade gestacional de 34 semanas e trêsdias e seis consultas de pré-natal, iniciando no primeiro trimestre. A maior intercorrência foi a pré-eclâmpsia. Relacionado aos dados neonatais, houve prevalência de recém-nascidos do sexo masculino, com média de 2,251 quilos e escore sete no Apgar do 1º minuto e oito, no Apgar do 5º minuto. Recémnascidos indo para alojamento conjunto após o parto e em ar ambiente, tendo passado, em média, 12,71 dias internados. Conclusões: no caso da pesquisa, conhecer o perfil dessa mulher e os desfechos do recém-nascido prematuro é útil para estimular as políticas públicas e diminuir as sequelas para mãe e bebê.
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Adult , Pregnancy Complications/epidemiology , Risk Factors , Obstetric Labor Complications/epidemiology , Obstetric Labor, Premature/epidemiology , Apgar Score , Prenatal Care , Brazil/epidemiology , Medical Records , Postpartum PeriodABSTRACT
Objetivo: Comparar la salud periodontal de embaraza- das y no embarazadas mediante la aplicación del Índice de Periodontal Comunitario (IPC). Materiales y métodos: Se realizó un estudio ob- servacional de corte transversal. Se reclutaron 100 mujeres embarazadas (EMB) y 50 no embarazadas (NoEMB) que concurrieron al Hospital Materno Provincial de la Ciudad de Córdoba, Dr. Raúl F. Lucini. En todas se registró el IPC con la sonda periodontal WHO 621 en los 6 sextantes de la boca. Los datos se analizaron con el software Infostat/SP; el nivel de significación establecido fue de P <0,05. Resultados: El 70% de las pacientes presentó edades de entre 18 y 25 años. En las EMB el código 3 del IPC fue el más frecuente presente en 240 sextantes (40,1%) y en las NoEMB el código 2 fue el más frecuente con 39 sextantes (43%). A ambos grupos de estudio les corresponde el trata- miento de instrucción de higiene bucal, instrumentación supra y/o subgingival, y/o regularización de obturaciones. Conclusiones: El código 3 fue el más frecuente entre las EMB, a quienes les corresponde un Código de tratamiento periodontal (CTP) 2; las NoEMB presentaron un IPC de 1 y 2 como los más frecuentes y se vinculan con un CTP 1 y 2. Nos encontramos frente a una situación clínica periodontal posible de resolver con terapia básica que puede ser realizada por odontólogos generalistas (AU)
Aim: To compare the periodontal health of pregnant and non-pregnant women by applying the Community Periodontal Index (CPI). Materials and methods: In an observational, cross-sec- tional study, 100 pregnant women (PREG) and 50 non-preg- nant women (NonPREG) were recruited at the Dr. Raúl F. Lu- cini Provincial Maternity Hospital in Córdoba City. The CPI was determined in the 6 sextants of the mouth using a WHO 621 periodontal probe. The data were analyzed with Infostat SP software. P <0.05 was considered significant. Results: 70% of the patients were 18 to 25 years old. In the PREG group, CPI Code 3 was the most frequent, present in 240 sextants (40.1%), while in the non-PREG group, CPI Code 2 was the most frequent, with 39 sextants (43%). Treat- ment needs in both study groups are oral hygiene instruction, supra- and/or subgingival instrumentation, and/or correction of plaque retentive margins. Conclusions: Code 3 was the most frequent among preg- nant women, which corresponded to Periodontal Treatment Code (CTP) 2. CPI 1 and 2 were the most frequent in non-pregnant women, corresponding to CTP 1 and 2. This periodontal clinical condition can be treated with initial dental hygiene therapy, which can be performed by general dentists (AU)
Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Young Adult , Periodontal Diseases/epidemiology , Pregnancy Complications/epidemiology , Periodontal Index , Oral Health , Health Services Needs and Demand , Oral Hygiene/education , Argentina/epidemiology , Cross-Sectional Studies , Health PromotionABSTRACT
Resumo Objetivou-se descrever as principais complicações clínicas em gestantes brasileiras relatadas na literatura, identificando os fatores de exposição mais relevantes e seus desfechos na saúde materno-infantil. Foi realizada uma revisão sistemática de artigos publicados entre 2010 e 2018. Foram incluídos três revisões e 36 artigos empíricos; transtornos mentais (n=9), doenças infecciosas (n=9) e morbidade materna grave (n=8) foram as principais complicações clínicas na gravidez. Ainda, quatro artigos enfocaram a determinação das principais afecções ou causas de internação, citando-se com maiores frequências a Infecção do Trato Urinário, a anemia e as doenças hipertensivas. Idade materna nos extremos reprodutivos, menor escolaridade, vulnerabilidade socioeconômica, características raciais e uso de serviços públicos de saúde foram os fatores de exposição mais relevantes. Resultados de saúde desfavoráveis associados a complicações clínicas na gravidez foram verificados nos oito artigos com esse perfil. A frequência de gestantes com complicações clínicas potenciais de ameaça à vida é elevada no país, evidenciando a importância da cobertura da atenção básica e a implantação de intervenções para sua redução e prevenção de desfechos maternos e infantis adversos.
Abstract The scope of this paper was to describe the main clinical complications among pregnant Brazilian women reported in the literature, identifying the most relevant exposure factors and their outcomes in maternal and child health. This is a systematic review of articles published between 2010 and 2018. Three reviews and 36 empirical articles were included; mental disorders (n=9), infectious diseases (n=9) and severe maternal morbidity (n=8) were the main clinical complications during pregnancy. In addition, four articles focused on determining the main conditions or causes of hospitalization, with a higher frequency of Urinary Tract Infection, anemia and hypertensive diseases. Maternal age at reproductive extremes, lower schooling, socioeconomic vulnerability, racial characteristics and the use of public health services were the most relevant exposure factors. Unfavorable health outcomes associated with clinical complications in pregnancy were verified in the eight articles with this profile. The frequency of pregnant women with potential life-threatening clinical complications is high in the country, highlighting the importance of primary care coverage and the implementation of interventions to reduce and prevent adverse maternal and child outcomes.
Subject(s)
Humans , Female , Pregnancy , Child , Pregnancy Complications/epidemiology , Pregnancy Complications, Infectious/epidemiology , Anemia , Pregnant Women , Educational Status , HospitalizationABSTRACT
Abstract Objective To determine the profile of maternal deaths occurred in the period between 2000 and 2019 in the Hospital de Clínicas de Porto Alegre (HCPA, in the Portuguese acronym) and to compare it with maternal deaths between 1980 and 1999 in the same institution. Methods Retrospective study that analyzed 2,481 medical records of women between 10 and 49 years old who died between 2000 and 2018. The present study was approved by the Ethics Committee (CAAE 78021417600005327). Results After reviewing 2,481 medical records of women who died in reproductive age, 43 deaths had occurred during pregnancy or in the postpartum period. Of these, 28 were considered maternal deaths. The maternal mortality ratio was 37.6 per 100,000 live births. Regarding causes, 16 deaths (57.1%) were directly associated with pregnancy, 10 (35.1%) were indirectly associated, and 2 (7.1%) were unrelated. The main cause of death was hypertension during pregnancy (31.2%) followed by acute liver steatosis during pregnancy (25%). In the previous study, published in 2003 in the same institution4, the mortality rate was 129 per 100,000 live births, and most deaths were related to direct obstetric causes (62%). The main causes of death in this period were due to hypertensive complications (17.2%), followed by postcesarean infection (16%). Conclusion Compared with data before the decade of 2000, there was an important reduction in maternal deaths due to infectious causes.
Resumo Objetivo Determinar o perfil dos óbitos maternos ocorridos no período de 2000 a 2019 no Hospital de Clínicas de Porto Alegre (HCPA) e comparar com os óbitos maternos entre 1980 e 1999 na mesma instituição. Métodos Estudo retrospectivo que analisou 2.400 prontuários de mulheres entre 10 e 49 anos que morreram entre 2000 e 2019. O presente estudo foi aprovado pelo Comitê de Ética (CAAE 78021417600005327). Resultados Após revisão de 2.481 prontuários de mulheres que morreram em idade reprodutiva, 43 mortes ocorreram durante a gravidez ou no período pós-parto. Destas, 28 foram considerados óbitos maternos. A taxa de mortalidade materna foi de 37.6 por 100.000 nascidos vivos. Em relação às causas, 16 óbitos (57.1%) estiveram diretamente associados à gravidez, 10 (35.1%) estiveram indiretamente associados e 2 (7.1%) não estiveram relacionados. A principal causa de morte foi hipertensão na gravidez (31.2%) seguida de esteatose hepática aguda da gravidez (25%). No estudo anterior, publicado em 2003 na mesma instituição4, a taxa de mortalidade foi de 129 por 100.000 nascidos vivos, e a maioria dos óbitos estava relacionada a causas obstétricas diretas (62%). As principais causas de óbito neste período foram por complicações hipertensivas (17.2%), seguidas de infecção pós-cesárea (16%). Conclusão Em comparação com os dados anteriores à década de 2000, houve uma redução importante das mortes maternas por causas infecciosas.
Subject(s)
Humans , Female , Pregnancy , Child , Adolescent , Adult , Young Adult , Pregnancy Complications/epidemiology , Maternal Death/etiology , Maternal Mortality , Retrospective Studies , Cause of Death , Postpartum Period , Live Birth , Middle AgedABSTRACT
SUMMARY OBJECTIVE: Routine follow-up of pregnancy is a comprehensive care process starting from planning of pregnancy that involves rational and careful use of medical, psychological, and social support. In this study, our objective was to compare the adherence rate to routine antenatal follow-up program during the COVID-19 pandemic with that of previous years among pregnant women, in an effort to shed light on health policies to be developed similar events in the future. METHODS: This retrospective cross-sectional study was carried out between March 11, 2019, when isolation measures were initiated in the context of precautionary steps taken in Turkey against the COVID-19 pandemic, and June 1, 2020, when the "normalization" was initiated. RESULTS: During the study period in 2020, the proportion of cesarean sections were higher, 61.1%, as compared to previous years (p=0.27). The stillbirths were numerically lower (1.2%, p=0.77), but the rate of spontaneous abortions was significantly higher (19.6%, p=0.009). The number of follow-up visits per pregnancy was lower than in previous years (3.8, p=0.02), although the proportion of patients visiting the outpatient units for regular controls to the overall patient group increased as compared to previous years (52.0%). CONCLUSION: During the flare-up of the COVID-19 pandemic (i.e. between March and June 2020), the rate of obstetric/neonatal morbidity and mortality except spontaneous abortion was not significantly higher as compared to the corresponding period in previous years. However, considering the potential increase in the risk of obstetric complications during a pandemic, specialized management programs targeting basic pregnancy follow-up services should be developed.
Subject(s)
Pregnancy Complications/epidemiology , Abortion, Spontaneous/epidemiology , COVID-19 , Prenatal Care , Cross-Sectional Studies , Retrospective Studies , Pandemics , SARS-CoV-2ABSTRACT
Abstract Objective To describe the obstetric outcomes of patients withmultiple sclerosis (MS) and the impact of pregnancy and the postpartum period on the progression of the disease. Methods A case series study performed between December 2019 and February 2020, reporting pregnancies occurred between 1996 and 2019. The subjects included were women with MS undergoing follow-up at an MS referral center in Northeastern Brazil, and who had at least one pregnancy after the onset of MS symptoms, or who had their first relapse in the first year after delivery. Results In total, 26 women and 38 pregnancies were analyzed - 32 of them resulted in delivery, and the remaining 6, in miscarriages. There was a significant increase in the prevalence of relapse during the postpartum period when compared with the gestational period. In 16 (42.1%) of the pregnancies, there was exposure to diseasemodifying therapies (DMTs) - 14 (36.8%), to interferon β, and 2 (5.3%), to fingolimod. Higher rates of abortion, prematurity and low birth weight were reported in the group was exposed to DMT when compared with the one who was not. Conclusion In the sample of the present study, there was a significant increase in the rate of MS relapse during the postpartum period when compared with the gestational period. Additionally, it seems that exposure to DMTs during pregnancy may affect the obstetric outcomes of the patients.
Resumo Objetivo Descrever os desfechos obstétricos de pacientes com esclerose múltipla (EM) e o impacto da gravidez e do período pós-parto na progressão da doença. Métodos Uma série de casos realizada entre dezembro de 2019 e fevereiro de 2020, que retrata gestações ocorridas entre 1996 e 2019. As pacientes incluídas neste estudo foram mulheres com EM, que realizam acompanhamento em um centro de referência em EM no Nordeste do Brasil, e que tiveram ao menos uma gestação após o início dos sintomas da EM, ou tiveram o primeiro surto da doença no ano posterior ao parto. Resultados No total, 26 mulheres e 38 gestações foram avaliadas - dentre as quais, 32 resultaram em partos, e 6, em abortamentos. Houve um aumento significativo na prevalência de surtos durante o pós-parto quando comparado com o período gestacional. Em 16 (42,1%) das gravidezes, houve exposição a terapias modificadoras da doença (TMDs) - 14 (36,8%) a β-interferona, e 2 (5,3%) a fingolimode. As taxas de abortamento, prematuridade e baixo peso ao nascer foram mais elevadas no grupo exposto às TMDs quando comparado com o não exposto. Conclusão Na amostra deste estudo, houve um aumento significativo na taxa de surtos da EM durante o período pós-parto quando comparado com o período gestacional. Além disso, a exposição às TMDs durante a gestação pode afetar os desfechos obstétricos das pacientes.
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Adult , Young Adult , Pregnancy Complications/epidemiology , Multiple Sclerosis/epidemiology , Referral and Consultation , Brazil/epidemiology , Pregnancy Outcome , Disease ProgressionABSTRACT
En Guatemala, el embarazo en la adolescencia es un problema social, que repercute seriamente en el desarrollo de los adolescentes. El fenómeno se vincula, directamente, con los factores económicos y, sobre todo, con el acceso a la educación y la información, aspectos que de ser accesibles ayudarían a promover un cambio favorable entre las personas con menos recursos. La edad avanzada en el embarazo representa un factor de riesgo de morbimortalidad materna, perinatal e infantil. Se realizo un Estudio descriptivo retrospectivo, se revisaron las papeletas médicas de todas las pacientes embarazadas que cumplieron con los criterios de inclusión. Dentro del estudio se incluyeron 289 pacientes, se observó mayor prevalencia de pacientes >35 años, respecto a los antecedentes prenatales, la edad gestacional más prevalente fue 37 a 41 semanas, el promedio de número de citas de control prenatal fue de 2.98, las complicaciones más frecuentes fueron infección y trabajo de parto pretérmino. En cuanto a los antecedentes natales, la Cesárea trans peritoneal fue la vía de resolución más prevalente y la asfixia perinatal fue la complicación más frecuente. Se observó asociación estadísticamente significativa entre complicaciones pre, natales y post natales edad materna mayor a 35 años. El hallazgo de sobrepeso y obesidad en pacientes mayores a 35 años se puede asociar con la prevalencia de complicaciones y el bajo promedio del número de controles prenatal. La falta de asociación entre edad materna menor a 15 años y complicaciones puede ser atribuida a que estas pacientes llevan un mejor control prenatal, debido al seguimiento especializado que se cuenta por parte del MSPAS. (AU)
In Guatemala, teenage pregnancy is a social problem, which seriously affects the development of adolescents. The phenomenon is directly linked to economic factors and, above all, to access to education and information, aspects that if accessible would help promote a favorable change among people with fewer resources. Advanced age in pregnancy represents a risk factor for maternal, perinatal and infant morbidity and mortality. A retrospective descriptive study was carried out, the medical records of all pregnant patients who met the inclusion criteria were reviewed. The study included 289 patients, a higher prevalence of patients> 35 years of age was observed, with respect to prenatal history, the most prevalent gestational age was 37 to 41 weeks, the average number of prenatal control appointments was 2.98, complications the most frequent were infection and preterm labor. Regarding the natal history, trans peritoneal caesarean section was the most prevalent means of resolution and perinatal asphyxia was the most frequent complication. A statistically significant association was observed between prenatal and postnatal complications, maternal age greater than 35 years. The finding of overweight and obesity in patients older than 35 years can be associated with the prevalence of complications and the low average number of prenatal check-ups. The lack of association be-tween maternal age less than 15 years and complications can be attributed to the fact that these patients have better prenatal control, due to the specialized follow-up provided by the MSPAS. (AU)
Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Pregnancy Complications/etiology , Pregnancy Complications/epidemiology , Pregnancy in Adolescence , Asphyxia Neonatorum/complications , Perinatal Care/methods , Socioeconomic Factors , Pregnancy/physiology , Cesarean Section/methods , Adolescent , Vaginosis, Bacterial/diagnosis , Observational Studies as TopicABSTRACT
Abstract Cases of maternal near miss are those in which women survive severe maternal complications during pregnancy or the puerperium. This ecological study aimed to identify the temporal trend of near-miss cases in different regions of Brazil between 2010 and 2018, using data fromtheHospital Information System(HIS) of theUnified BrazilianHealth System (SUS, in the Portuguese acronym). Hospital admission records of women between 10 and 49 years old with diagnosis included in the 10th Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) and codes indicating nearmiss events were selected. From 20,891,040 admissions due to obstetric causes, 766,249 (3.66%) near-miss cases were identified, and 31,475 women needed admission to the intensive care unit (ICU). The cases were found to be more predominant in black women over 35 years old from the North and Northeast regions. There was a trend of increase in near-miss rates of ~ 13.5% a year during the period of the study. The trend presented a different behavior depending on the level of development of the region studied. The main causes of near miss were preeclampsia (47%), hemorrhage (24%), and sepsis (18%).
Resumo Casos de near miss materna são aqueles em que as mulheres sobrevivem a graves complicações maternas durante a gravidez ou o puerpério. Este estudo ecológico teve comoobjetivo identificar a tendência temporal de casos de near missemdiferentes regiões do Brasil entre 2010 e 2018, utilizando dados do Sistema de Informações Hospitalares (SIH) do Sistema Único de Saúde (SUS). Foram selecionados registros de internação demulheres entre 10 e 49 anos comdiagnóstico incluído na 10ª revisão daClassificação Internacional de Doenças e Problemas Relacionados à Saúde (CID-10) e códigos indicando eventos de near miss. Das 20.891.040 internações por causas obstétricas, 766.249 (3,66%) casos de near miss foram identificados, e 31.475mulheres necessitaramde internação na unidade de terapia intensive (UTI). Constatou-sequeos casos sãomaispredominantesemmulheres negras commais de 35 anos da região Norte e Nordeste. Houve uma tendência de aumento nas taxas de near miss de aproximadamente 13,5% ao ano durante o período do estudo. A tendência apresentou um comportamento diferente, dependendo do nível de desenvolvimento da região estudada. As principais causas de near miss foram pré-eclâmpsia (47%), hemorragia (24%), e sepse (18%).
Subject(s)
Humans , Male , Female , Pregnancy , Adolescent , Adult , Young Adult , Pregnancy Complications/epidemiology , Prenatal Care , Near Miss, Healthcare/statistics & numerical data , Obstetric Labor Complications/epidemiology , Patient Admission , Pregnancy Complications/prevention & control , Brazil/epidemiology , Demography , Maternal Mortality , Hospital Information Systems , Diagnosis-Related Groups , Near Miss, Healthcare/trends , Obstetric Labor Complications/prevention & control , Middle AgedABSTRACT
OBJETIVO: Analizar si los casos positivos de cribado combinado de trisomía 21 (t21) o trisomía 18 (t18) en ausencia de aneuploidía (falsos positivos- FP) se relacionan con complicaciones de la gestación, ajustando por factores demográficos y clínicos de riesgo. MATERIAL Y MÉTODOS: Estudio retrospectivo de casos y controles anidado en una cohorte de pacientes que acudieron para cribado del primer trimestre. Los casos fueron las pacientes con FP de riesgo combinado de t21 superior a 1/270 o riesgo de t18 superior a 1/100. Se consideraron complicaciones de la gestación: óbito fetal, parto prematuro menor de 34 semanas o prematuro menor de 37 semanas, preeclampsia, retrasos de crecimiento, pequeño para la edad gestacional (CIR, PEG) y diabetes gestacional (DG). Se ajustó por obesidad, edad, paridad, tabaquismo, y técnicas de reproducción asistida. RESULTADO: Se obtuvieron 204 casos de FP, 149 FP para trisomía 21, 41 para trisomía 18, y 14 FP para ambos riesgos. Se encontró asociación estadísticamente significativa de FP t21 con óbito fetal (OR=3,5; ic95% 1,4-8,7; p=0,01), parto prematuro menor de 37 semanas (OR=2,2; IC95% 1,4-3,4; p=0,001), preeclampsia (OR =2,6; IC95% 1,17-6,1; p=0,02), PEG (OR =2,2; IC95% 1,2-4,1; p=0,02), CIR (OR=2,8; IC95% 1,6-5,1; p=0,001), y DG (OR=2,1; IC95% 1,2-3,7; p=0,01). Los FP t18 se asociaron con óbito (OR=8,9; IC95% 2,9-27; p=0,002). CONCLUSIÓN: Los FP del cribado del primer trimestre, para trisomía 21 y trisomía 18, se asocian con resultados obstétricos adversos.
We have studied whether positive cases of combined trisomy 21 (t21) or 18 (t18) screening in the absence of aneuploidy (false positives -FP-) are related to pregnancy complications adjusting for demographic and clinical risk factors. METHODS: Retrospective case-control study nested in a cohort of patients who came for first trimester aneuploidy screening. The cases were patients with FP combined risk of t21 (greater than 1/270) or t18 risk (greater than 1/100). The control group was a sample of patients with low-risk screening. We considered pregnancy complications: stillbirth, premature delivery before 34 and 37 weeks, preeclampsia, growth retardation, small for gestational age (FGR, SGA), and gestational diabetes (GD). Or were adjusted for obesity, age, parity, smoking, and assisted reproduction techniques. RESULTS: 204 cases of FP were obtained, 149 FP for trisomy 21, 41 for trisomy 18, and 14 FP for both risks. A statistically significant association between t21 FP was found with stillbirth (OR = 3.5; 95% CI 1.4-8.7; p = 0.01), preterm delivery less than 37 weeks (OR = 2.2; 95% CI 1.4-3.4; p = 0.001), preeclampsia (OR = 2.6; 95% CI 1.17-6.1; p = 0.02), SGA (OR = 2.2; 95% CI 1, 2-4.1; p = 0.02), FGR (OR = 2.8; 95% CI 1.6-5.1; p = 0.001), and GD (OR = 2.1; 95% CI 1.2 −3.7; p = 0.01). FP t18s were associated with fetal loss (OR= 8.9 (95% CI 2.9-27) p = 0.002. CONCLUSION: FP from first trimester screening for t21 and t18 are associated with adverse obstetric outcomes.
Subject(s)
Humans , Female , Pregnancy , Down Syndrome/diagnosis , Trisomy 18 Syndrome/diagnosis , Pregnancy Complications/diagnosis , Pregnancy Complications/epidemiology , Pregnancy Trimester, First , Trisomy/diagnosis , Case-Control Studies , Mass Screening , Predictive Value of Tests , Risk Factors , Down Syndrome/epidemiology , False Positive Reactions , Trisomy 18 Syndrome/epidemiologyABSTRACT
Objetivo: Este estudo teve como principal objetivo estimar a prevalência de sífilis gestacional e fatores associados à infecção em uma Maternidade no Sul do Brasil no ano de 2018. Métodos: Trata-se de estudo descritivo, transversal, retrospectivo, no qual foram avaliados os testes rápidos para sífilis de todas as gestantes internadas para atenção ao parto ou ao abortamento na Maternidade Carmela Dutra no ano de 2018. Nos casos confirmados de sífilis, foram obtidos dados epidemiológicos, adequação do tratamento, coinfecção pelo HIV e resultados gestacionais. Resultados: Entre os prontuários analisados, 161 (3,6%) foram considerados casos de sífilis materna. A média de idade das gestantes foi de 27,98 (±6,65), 54 (33,5%) eram primigestas, 114 (70,8%) se declararam brancas, 125 (77,5%) estavam em uma união estável e 85 (52,7%) tinham escolaridade até o ensino médio. Quanto ao tratamento, 71 (44%) trataram de maneira adequada e 90 (56%), de maneira inadequada, e 44 (27,3%) delas realizaram o diagnóstico apenas no momento da internação hospitalar. Entre as pacientes que realizaram tratamento inadequado de sífilis, 28 (53,4%) apresentaram títulos iguais ou superiores a 1:8. Entre as pacientes que realizaram teste rápido para HIV na internação, 5 (3,7%) apresentaram coinfecção com a doença. Com relação ao tratamento dos parceiros no pré-natal, 11,8% não realizaram nenhum tipo de tratamento, porém em 66 (41%) prontuários não constava essa informação. Com relação ao desfecho neonatal, 5 (7,4%) pacientes com tratamento inadequado para sífilis tiveram parto prematuro, 5 (7,4%) recém- -nascidos foram de baixo peso e 22 (24,5%) pacientes apresentaram abortamento da gestação. Conclusão: A alta taxa de tratamentos inadequados sugere falhas na assistência pré-natal e indica serem necessárias novas estratégias para reduzir a transmissão de sífilis na gestação.(AU)
Objective: The aim of this study is to estimate the prevalence of maternal syphilis and factors associated with the infection in Carmela Dutra Maternity in 2018. Methods: This is a descriptive, cross-sectional and retrospective study. All of the syphilis rapid- tests on pregnant women admitted for childbirth or miscarriage assistance at Carmela Dutra Maternity in 2018 were avaluated. In the cases of confirmed syphilis infection, the variables were epidemiological data, adequacy of treatment, HIV coinfection and gestational outcomes. Results: Out of all the medical records analyzed, 161 (3.6%) were considered maternal syphilis (MS). The average age of the pregnant women was 27.98 (± 6.65), 54 (33.5%) were primigestae, 114 (70.8%) declared themselves white, 125 (77.5%) were in a stable relationship and 85 (52.7%) had a high school education. Regarding treatment, 71 (44%) were treated adequately and 90 (56%) inadequately. Forty-four (27.3%) were diagnosed only at the time of hospitalization. Amongst patients who had inadequate syphilis treatment, 28 (53.4%) had titers equal to or greater than 1:8. Amongst patients who underwent rapid HIV testing during hospitalization, 5 (3.7%) had HIV coinfection. Regarding the partners treatment during prenatal, 11.8% did not receive any treatment, but 66 (41%) of the medical records did not contain this information. Regarding neonatal outcome, 5 (7.4%) of patients with inadequate treatment for syphilis had premature birth, 5 (7.4%) of newborns were underweight and 22 (24.5%) had miscarriages. Conclusion: The high rate of inadequate treatment suggests failure in prenatal care and indicates that new strategies are necessary to reduce syphilis transmission during pregnancy.(AU)