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Original Article
The experience of pregnancy in the COVID-19 pandemic
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo8
03-18-2025
Summary
Original ArticleThe experience of pregnancy in the COVID-19 pandemic
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo8
03-18-2025Views76See moreAbstract
Objective:
To describe women's experience of pregnancy during the COVID-19 pandemic.
Methods:
A qualitative study conducted in a private maternity hospital, from May, 2020 to November, 2021, with women aged ≥ 18 years, gestational age ≥ 36 weeks at birth and ≥ 24 hours post-partum. Data collected through semi-structured interviews, recorded, transcribed, and analyzed adopting Krippendorff's Content Analysis as theoretical-methodological framework.
Results:
Four main themes emerged: Fear, Taking care and celebrating pregnancy: adjusting to the new reality, Harms of Isolation, and Benefits of Isolation. The fear of contamination and its impact on the health of mother and child resulted in the adoption of severe social isolation, including from those considered sources of support by the expecting mother. Overwhelmed, some of the participants reported loneliness and psychic suffering. The opportunity to focus on the pregnancy, the preparations for the arrival of the child, and the family made isolation a beneficial and positive period for other women.
Conclusion:
The experience of pregnancy in the Pandemic was an event outside of the ordinary and common. The expecting mother faced her worst fears on a daily basis and attended prenatal care, in order to ensure her child would be born healthy. The celebration of the baby's life, amid so many deaths, had to be adjusted to the virtual environment. It was a tense, solitary, and ambiguous period, which demanded a lot from the mental health of some participants, but to others, brought advantages that would not have been possible in different times.
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Original Article
Effect of COVID-19 on Brazilian cesarean and prematurity rates: a cross-sectional study
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo6
03-18-2025
Summary
Original ArticleEffect of COVID-19 on Brazilian cesarean and prematurity rates: a cross-sectional study
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo6
03-18-2025Views73See moreAbstract
Objective:
To investigate the relationship between prematurity and cesarean section rate in Brazil during the beginning of COVID-19 pandemic.
Methods:
Utilizing the Robson Classification, this study analyzed data from the Brazilian Ministry of Health's Live Births Panel, comparing CSR) and group 10 (preterm deliveries) between 2019 (pre-pandemic) and 2021 (pandemic) in each of Brazilian states and the overall country. The prematurity and CSR were compared using prevalence ratio and confidence interval, and p-value was obtained. The variation of prematurity and CSR were compared through the coefficient of determination (R2).
Results:
A total of 5,522,910 deliveries were evaluated during the period. The CSR increased from 56.34% to 57.05% (p<0.01), and the frequency of preterm deliveries rose from 8.99% to 9.13% (p<0.01). The CSR increased in 23 States and decreased in 4 States, while the prematurity rate increased in 16 States and decreased in 10 States. A positive relationship between the increase of CSR and prematurity was observed during COVID-19, with an R2 value of 0.3121, suggesting a moderate association between these two variables.
Conclusion:
Between 2019 (pre-COVID-19 pandemic) and 2021 (the first full year of the COVID-19 pandemic), there was an increase in prematurity and CSR in Brazil. These increases were observed in most Brazilian states and may be correlated. However, it is impossible to establish a cause-effect relationship given the design of this study.
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Original Article
Access and adequacy of antenatal care in a city in Brazil during two phases of the COVID-19 pandemic
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo87
10-23-2024
Summary
Original ArticleAccess and adequacy of antenatal care in a city in Brazil during two phases of the COVID-19 pandemic
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo87
10-23-2024Views148Abstract
Objective:
To compare access and suitability of antenatal care between years 2020 and 2022 among postpartum individuals at a Hospital in Florianopolis, and evaluate factors associated with antenatal suitability.
Methods:
Observational, cross-sectional, and quantitative study carried out in 2022. Collected data were compared with the database of a previous similar study carried out in the same setting in 2020. Data were extracted from medical records and prenatal booklets, in addition to a face-to-face questionnaire. Adequacy was measured using the Carvalho and Novaes index and health access was qualitatively evaluated. Socio-demographic and antenatal variables were analyzed. A statistical significance level of 0.05 was considered. Open-ended questions were categorized for analysis.
Results:
395 postpartum individuals were included. Antenatal care was adequate for 48.6% in 2020 and 69.1% in 2022. Among the barriers to access, 56% reported difficulty in scheduling appointments and/or exams and 23% complained of reduced healthcare staff due to strikes, COVID-19, among others. Adequate antenatal care was associated with being pregnant in 2022, being referred to high-risk units (PNAR), and not reporting difficulties in access. Also, it was associated with twice the chance of investigation for gestational diabetes (GDM) and syphilis.
Conclusion:
The 2022 post-vaccination period showed higher antenatal adequacy. The main difficulty for postpartum individuals was scheduling appointments and/or exams. Having antenatal care in 2022, no reports of difficulty in access, and follow-up at a high-risk unit were associated with antenatal adequacy.
Key-words COVID-19Delivery of health careDiabetesGestationalpandemicsPostpartum periodPregnancyPrenatal caresurveys and questionnairesVaccinationSee more -
Review Article
Neonatal and maternal outcomes of mRNA versus Non-mRNA COVID-19 vaccines in pregnant patients: a systematic review and meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo69
09-18-2024
Summary
Review ArticleNeonatal and maternal outcomes of mRNA versus Non-mRNA COVID-19 vaccines in pregnant patients: a systematic review and meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo69
09-18-2024Views202Abstract
Objective
To compare the effectiveness and safety of non-mRNA versus mRNA COVID-19 vaccines on pregnant women and their newborns in a systematic review with meta-analysis.
Data sources
We searched PubMed, Embase, and Cochrane Central in May 2023.
Study selection
The search strategy yielded 4451 results, 16 studies were fully reviewed. We selected case-control studies analysing non-mRNA versus mRNA vaccines. Data collection and analysis: we assessed the risk of bias using the Cochrane Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. Standardised mean differences were pooled using random-effect models.
Data synthesis
We identified 8 prospective and retrospective studies with a total of 32,153 patients. Non-mRNA vaccines were associated with a higher incidence of fever (OR 2.67; 95% CI 2.08-3.43; p<0.001), and a lower incidence of fetal or neonatal death (OR 0.16; 95% CI 0.08-0.33; p<0.001). In subgroup analyses, the Jansen vaccine (Ad26.COV2.S) was found to have a higher rate of premature labor/delivery (OR 4.48; 95% CI 1.45-13.83; p=0.009) and missed/spontaneous abortion (OR 1.90; 95% CI 1.09-3.30; p=0.02), as compared with the Pfizer (BNT162b2) vaccine.
Conclusion
non-mRNA vaccines are associated with a lower incidence of fetal or neonatal death among pregnant women who receive a Covid19 vaccine, although at an increased rate of pyrexia compared with mRNA vaccines. Other studies are required for better assessment.
PROSPERO
CRD42023421814
Key-words coronavirus infectionsCOVID-19COVID-19 vaccinesInfant, newbornmRNA vaccinesPregnancy complicationsPregnant womenSARS-CoV-2See more -
Original Article
Clinical, epidemiological characteristics and mortality of pregnant and postpartum women associated with COVID-19 in Brazil: cohort study
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo52
06-27-2024
Summary
Original ArticleClinical, epidemiological characteristics and mortality of pregnant and postpartum women associated with COVID-19 in Brazil: cohort study
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo52
06-27-2024Views151Abstract
Objective
To analyze the death of Brazilian pregnant and postpartum women due to COVID-19 or unspecific cause.
Methods
This is retrospective, descriptive-exploratory, population-based study carried out with the Sistema de Informação de Vigilância Epidemiológica da Gripe (SIVEP-Gripe) database, with pregnant and postpartum women of reproductive age who died from confirmed COVID-19 between 2020 and 2021. The chosen variables were: age, gestational period, type and number of comorbidities, skin color, using the statistical software R Foundation for Statistical Computing Platform, version 4.0.3 and Statistical Package for Social Science, version 29.0 for analysis.
Results
A total of 19,333 cases of pregnant and postpartum women aged between 10 and 55 years diagnosed with SARS were identified, whether due to confirmed COVID-19 or unspecific causes. Of these, 1,279 died, these cases were classified into two groups according to the cause of death: deaths from COVID-19 (n= 1,026) and deaths from SARS of unspecific cause (n= 253).
Conclusion
The risk of death increased among black and brown women, in the postpartum period and with the presence of comorbidities, mainly diabetes, cardiovascular diseases and obesity. The data presented here draw attention to the number of deaths from SARS, especially among sociodemographic profiles, precarious access to health, such as the black population. In addition, limitations in adequate access to health care are reinforced by even lower rates of ICU admissions among women who died from SARS of an unspecified cause.
Key-words coronavirus infectionsCOVID-19Health information systemsMaternal deathPostpartum periodPregnancySARS-CoV-2See more -
Original Article
Prevalence and factors associated with anxiety, depression and burnout in gynecology and obstetrics residents during the COVID-19 pandemic
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo17
00-00-2024
Summary
Original ArticlePrevalence and factors associated with anxiety, depression and burnout in gynecology and obstetrics residents during the COVID-19 pandemic
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo17
00-00-2024Views417Abstract
Objective:
To determine the prevalence of anxiety, depression and burnout in residents of Gynecology and Obstetrics during COVID-19 pandemic in Brazil and its associated factors.
Methods:
Cross-sectional study involving all regions of Brazil, through the application of a sociodemographic questionnaire, the Hospital Anxiety and Depression Scale (HAD) and the Maslach Burnout Inventory (MBI-HSS) instrument. Multivariate analysis was performed after adjusting the Poisson model.
Results:
Among the 719 participating medical residents, screening was positive for anxiety in 75.7% and for depression in 49.8% of cases. Burnout syndrome was evidenced in 41.3% of the physicians studied. Those with depression are more likely to have anxiety (OR 0.797; 95%CI 0.687 - 0.925) and burnout syndrome (OR 0.847 95%CI 0.74 - 0.97). Residents with anxiety (OR 0.805; 95%CI 0.699 - 0.928) and burnout (OR 0.841; 95%CI 0.734 - 0.963) are more likely to have depression.
Conclusion:
High prevalence of anxiety, depression and burnout were found in residents of Gynecology and Obstetrics in Brazil, in addition to important correlations between anxiety-depression and depression-burnout.
Key-words AnxietyBrazilBurnout, psychologicalCOVID-19DepressionGynecologyinternship and residencymedical residencyMental healthObstetricspandemicsSee more -
Original Article
Association of placental histopathological findings with COVID-19 and its predictive factors
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo3
00-00-2024
Summary
Original ArticleAssociation of placental histopathological findings with COVID-19 and its predictive factors
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo3
00-00-2024Views413See moreAbstract
Objective:
The aims of the study are to describe the association of coronavirus disease (COVID-19) with the abnormal histopathological findings in human placenta and to highlight the potential predictors of these histopathological findings.
Methods:
A retrospective cohort study, held in two obstetric units from January 2021- 2022, 34 patients who were confirmed cases of COVID- 19 were followed up till the time of delivery as their placenta were sent for histopathology. Patients diagnosed with other viral infections, chorioamnionitis, or were known case of as pre-term or term pre labour rupture of membrans (PROM) were excluded as well as pre exisiting diabetes mellitus or pre-eclampsia. Data analysis were performed using STATA software version 16.
Result:
Specific histopatological findings (fetal vascular malperfusion, maternal vascular malperfusion, inflammatory pathology and thrombotic finding) were significantly high among 13 (38.2%) of the study group who got infected earlier in pregnancy (P<0.001). The period between the diagnosis of COVID-19 and the delivery significantly increases the odds of the presence of pathological findings by 2.75 times for each week the patients getting infected earlier.
Conclusion:
Association of abnormal placental histopathological findings with COVID-19 infection in pregnancy and the potential predictor for the occurrence of placental findings is the longer duration between the diagnosis of the infection and the delivery.
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Review Article
Incidence and Outcomes Associated with Menopausal Status in COVID-19 Patients: A Systematic Review and Meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(12):796-807
01-11-2023
Summary
Review ArticleIncidence and Outcomes Associated with Menopausal Status in COVID-19 Patients: A Systematic Review and Meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(12):796-807
01-11-2023Views160See moreAbstract
Objective
Menopause causes several changes in the body that may affect the response to COVID-19. We aimed to investigate the possible association between menopausal status and incidence and outcomes in COVID-19 patients.
Methods
Combinations of keywordsCOVID-19, menopause, and estrogen were used to search the PubMed, Embase, Web-of-Science, and Scopus databases for articles reporting the incidence and outcomes of COVID-19 (discharge, length-of-admission, intensive care, or mortality) in premenopausal women, available through December 29, 2022. Data from studies comparing the incidence of COVID-19 infection with the age-matched male population were pooled and meta-analyzed using a random-effects model.
Results
Overall, 1,564 studies were retrieved, of which 12 were finally included in the systematic review to compare disease outcomes, and 6 were meta-analyzed for the incidence of COVID-19 in premenopausal and postmenopausal women. All studies reported better COVID-19-associated outcomes in premenopausal women compared with postmenopausal women. After adjusting for confounding factors, three studies found better outcomes in postmenopausal women, and two found no association between menopausal status and COVID-19 outcomes. Our meta-analysis found a higher incidence of COVID-19 infection among premenopausal women than postmenopausal women, when compared with age-matched men (odds ratio = 1.270; 95% confidence interval: 1.086–1.486; p = 0.003).
Conclusion
The incidence of COVID-19 was significantly higher in premenopausal women than in postmenopausal women when compared with age-matched men. Although premenopausal women may have more favorable COVID-19-associated outcomes, the presumed preventive effect of estrogens on the incidence and related outcomes of COVID-19 in premenopausal women cannot be proven at present. Further longitudinal studies comparing pre- and post-menopausal women are required to provide further insight into this matter.