EVALUATION OF EFFICACY AND EFFECTIVENESS OF PRENATAL NUTRITIONAL CARE ON PERINATAL OUTCOME OF PREGNANT WOMEN; RIO DE JANEIRO, BRAZIL.

AIM: to evaluate the impact of a prenatal nutritional assistance proposal (PNA) for adult pregnant women. METHODS: a study of the impact of an applied nutritional intervention throughout the prenatal on perinatal outcomes - adequacy of total gestational weight gain, gestational anemia frequency and pregnancy complications in a public maternity hospital in Rio de Janeiro. The data represent three groups of adult pregnant women, during 10 years: GI (1999-2001, n = 225), GII (2005-2006, n = 208) and GIII (2007-2008, n = 394). RESULTS: in GII (reference group) it was included a detailed nutritional assessment, an individualized eating plan and an attendance of at least four scheduled appointments with a nutritionist. PNA coverage occurred in only 20.4% of GI, 100% of GII and 42.1% in GIII (p < 0.001). Women in GI had a higher proportion of inadequate total weight gain (OR 1.82, 95% CI: 1.20 -2.75), anemia (OR 2.18, 95% CI: 1.35 - 3.55) and pregnancy complications (OR 1.57, 95% CI: 1.04 - 2.36), as well as those who joined GIII, - OR 1.68 (95% CI: 1.16 - 2.44), OR 2.45 (95% CI: 1.56 - 3.84), OR 2.07 (95% CI: 1.42 - 3.00) - when compared to women in GII. CONCLUSIONS: the model tested in GII PNA demonstrated to be effective in the outcomes studied.

Objetivo: evaluar el impacto de una propuesta de asistencia nutricional prenatal (ANP) para las mujeres embarazadas adultas. Métodos: estudio del impacto de una intervención nutricional prenatal en los resultados perinatales, adecuación de la ganancia total de peso durante la gestación, frecuencia de anemia gestacional y complicaciones en el embarazo en una maternidad pública de Río de Janeiro. Los datos representan tres grupos de mujeres embarazadas adultas, durante 10 años: GI (1999-2001, n = 225), GII (2005-2006, n = 208) y GIII (2007-2008, n = 394). Resultados: en el GII (grupo de referencia) se incluyó una evaluación nutricional detallada, un plan de alimentación individualizado y una asistencia de por lo menos cuatro citas programadas con un nutricionista. La cobertura PNA se produjo en solo el 20,4% en el GI, el 100% en el GII y el 42,1% en el GIII (p < 0,001). Las mujeres del GI tenían una mayor proporción de ganancia total de peso insuficiente (OR 1,82; IC 95%: 1,20 -2,75), anemia (OR 2,18; IC 95%: 1,35-3,55) y complicaciones del embarazo (OR 1.57, IC 95%: 1,04 - 2,36), así como aquellas que se unieron al GIII, - OR 1,68 (IC 95%: 1.16 - 2.44), OR 2,45 (IC 95%: 1,56-3,84), OR 2,07 (IC 95%:1,42- 3,00), en comparación con las mujeres del GII. Conclusiones: el modelo probado en el GII PNA demostró ser eficaz según los resultados estudiados.

Evaluation of efficacy and effectiveness of prenatal nutritional care on perinatal outcome of pregnant women; Rio de Janeiro, Brazil / Evaluación de la eficacia y efectividad de la atención nutricional prenatal sobre el resultado perinatal de las mujeres embarazadas; Río De Janeiro, Brasil

Aim: to evaluate the impact of a prenatal nutritional assistance proposal (PNA) for adult pregnant women. Methods: a study of the impact of an applied nutritional intervention throughout the prenatal on perinatal outcomes - adequacy of total gestational weight gain, gestational anemia frequency and pregnancy complications in a public maternity hospital in Rio de Janeiro. The data represent three groups of adult pregnant women, during 10 years: GI (1999-2001, n = 225), GII (2005-2006, n = 208) and GIII (2007-2008, n = 394). Results: in GII (reference group) it was included a detailed nutritional assessment, an individualized eating plan and an attendance of at least four scheduled appointments with a nutritionist. PNA coverage occurred in only 20.4% of GI, 100% of GII and 42.1% in GIII (p <0.001). Women in GI had a higher proportion of inadequate total weight gain (OR 1.82, 95% CI: 1.20 -2.75), anemia (OR 2.18, 95% CI: 1.35 - 3.55) and pregnancy complications (OR 1.57, 95% CI: 1.04 - 2.36), as well as those who joined GIII, - OR 1.68 (95% CI: 1.16 - 2.44), OR 2.45 (95% CI: 1.56 - 3.84), OR 2.07 (95% CI: 1.42 - 3.00) - when compared to women in GII. Conclusions: the model tested in GII PNA demonstrated to be effective in the outcomes studied (AU)

Objetivo: evaluar el impacto de una propuesta de asistencia nutricional prenatal (ANP) para las mujeres embarazadas adultas. Métodos: estudio del impacto de una intervención nutricional prenatal en los resultados perinatales, adecuación de la ganancia total de peso durante la gestación, frecuencia de anemia gestacional y complicaciones en el embarazo en una maternidad pública de Río de Janeiro. Los datos representan tres grupos de mujeres embarazadas adultas, durante 10 años: GI (1999-2001, n = 225), GII (2005-2006, n = 208) y GIII (2007-2008, n = 394). Resultados: en el GII (grupo de referencia) se incluyó una evaluación nutricional detallada, un plan de alimentación individualizado y una asistencia de por lo menos cuatro citas programadas con un nutricionista. La cobertura PNA se produjo en solo el 20,4% en el GI, el 100% en el GII y el 42,1% en el GIII (p <0,001). Las mujeres del GI tenían una mayor proporción de ganancia total de peso insuficiente (OR 1,82; IC 95%: 1,20 -2,75), anemia (OR 2,18; IC 95%: 1,35-3,55) y complicaciones del embarazo (OR 1.57, IC 95%: 1,04 - 2,36), así como aquellas que se unieron al GIII, - OR 1,68 (IC 95%: 1.16 - 2.44), OR 2,45 (IC 95%: 1,56-3,84), OR 2,07 (IC 95%:1,42- 3,00), en comparación con las mujeres del GII. Conclusiones: el modelo probado en el GII PNA demostró ser eficaz según los resultados estudiados (AU)

Use of multi-parameter flow cytometry as tool to monitor the impact of formic acid on Saccharomyces carlsbergensis batch ethanol fermentations.

The use of lignocellulosic materials as substrate for bioethanol production is considered a cost-effective approach to make the biofuel production process economically sustainable. However, lignocellulosic hydrolysis releases toxic compounds such as weak acids which inhibit microorganism growth and ethanol production. In order to understand the physiological response of Saccharomyces carlsbergensis when fermenting glucose in the presence of formic acid (HF), the yeast growth was monitored by multi-parameter flow cytometry. Cytoplasmic membrane potential decreased as the HF concentration increased and as the yeast culture reached the stationary phase. However, the proportion of cells with permeabilized membrane did not increase with the HF concentration increase. The accumulation of reactive oxygen species was also monitored. Control and fermentations at low HF concentrations (<1 g/L) resulted in a high proportion of highly oxidized cells at the stationary phase. The multi-parameter flow cytometry approach proved to be a useful tool to monitor the physiological stress response of S. carlsbergensis growth and ethanol production in the presence of HF, an inhibitor present in lignocellulosic hydrolysates. The information here obtained at near real time can be used to enhance second-generation bioethanol production process efficiency.

Effect of acetic acid on Saccharomyces carlsbergensis ATCC 6269 batch ethanol production monitored by flow cytometry.

Bioethanol produced from lignocellulosic materials has been considered a sustainable alternative fuel. Such type of raw materials have a huge potential, but their hydrolysis into mono-sugars releases toxic compounds such as weak acids, which affect the microorganisms' physiology, inhibiting the growth and ethanol production. Acetic acid (HAc) is the most abundant weak acid in the lignocellulosic materials hydrolysates. In order to understand the physiological changes of Saccharomyces carlsbergensis when fermenting in the presence of different acetic acid (HAc) concentrations, the yeast growth was monitored by multi-parameter flow cytometry at same time that the ethanol production was assessed. The membrane potential stain DiOC(6)(3) fluorescence intensity decreased as the HAc concentration increased, which was attributed to the plasmic membrane potential reduction as a result of the toxic effect of the HAc undissociated form. Nevertheless, the proportion of cells with permeabilized membrane did not increase with the HAc concentration increase. Fermentations ending at lower external pH and higher ethanol concentrations depicted the highest proportions of permeabilized cells and cells with increased reactive oxygen species levels. Flow cytometry allowed monitoring, near real time (at-line), the physiological states of the yeast during the fermentations. The information obtained can be used to optimize culture conditions to improve bioethanol production.

Pica em gestantes adolescentes / Pica in pregnant teenagers

Objetivo: Descrever a pica em gestantes adolescentes e o efeito desse comportamento no resultado perinatal. Métodos: Estudo longitudinal com 227 gestantes/puérperas adolescentes e seus recém-nascidos, realizado no período de 2007 a 2010. Os dados foram coletados por consulta aos prontuários e por entrevista padronizada para identificação do comportamento de pica. Resultados: A pica foi referida por 19.8% das adolescentes. Comparando-se as gestantes com e sem o comportamento de pica constatou-se, respectivamente, que a média do ganho de peso no terceiro trimestre (4.87 kg e 6.10 kg; p = 0.019), o ganho de peso no segundo e terceiro trimestres (10.07 kg e 11.58 kg; p = 0.039) e o ganho de peso semanal no terceiro trimestre (0.42 kg e 0.53 kg; p = 0.010) foram significativamente menores na presença desse comportamento. A pica foi mais prevalente nas adolescentes com menor idade (p = 0.000) e condições de saneamento inadequado na moradia (p = 0.007). A pica não associou-se à: adequação do ganho de peso gestacional, intercorrências gestacionais, anemia, peso e idade gestacional ao parto e intercorrências dos recém-natos. Conclusão: O comportamento de pica deve ser investigado no pré-natal e reconhecido como fator de risco para menor ganho de peso gestacional entre as gestantes adolescentes.

Pica em gestantes adolescentes / Pica in pregnant teenagers

Objetivo: Descrever a pica em gestantes adolescentes e o efeito desse comportamento no resultado perinatal. Métodos: Estudo longitudinal com 227 gestantes/puérperas adolescentes e seus recém-nascidos, realizado no período de 2007 a 2010. Os dados foram coletados por consulta aos prontuários e por entrevista padronizada para identificaþÒo do comportamento de pica. Resultados: A pica foi referida por 19.8% das adolescentes. Comparando-se as gestantes com e sem o comportamento de pica constatou-se, respectivamente, que a média do ganho de peso no terceiro trimestre (4.87 kg e 6.10 kg; p = 0.019), o ganho de peso no segundo e terceiro trimestres (10.07 kg e 11.58 kg; p = 0.039) e o ganho de peso semanal no terceiro trimestre (0.42 kg e 0.53 kg; p = 0.010) foram significativamente menores na presenþa desse comportamento. A pica foi mais prevalente nas adolescentes com menor idade (p = 0.000) e condiþ§es de saneamento inadequado na moradia (p = 0.007). A pica nÒo associou-se O: adequaþÒo do ganho de peso gestacional, intercorrÛncias gestacionais, anemia, peso e idade gestacional ao parto e intercorrÛncias dos recém-natos. ConclusÒo: O comportamento de pica deve ser investigado no pré-natal e reconhecido como fator de risco para menor ganho de peso gestacional entre as gestantes adolescentes.(AU)