Infant, newborn Archives - Revista Brasileira de Ginecologia e Obstetrícia

  • Original Article

    Incidence of small-for-gestational-age newborns in pregnant women with COVID-19

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo20
    04-30-2025

    Summary

    Original Article

    Incidence of small-for-gestational-age newborns in pregnant women with COVID-19

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo20
    04-30-2025

    DOI 10.61622/rbgo/2025rbgo20

    Views19

    Abstract

    Objective:

    This study aimed to assess the incidence of small for gestational age (SGA) newborns in pregnant women infected with COVID-19 and examine the associated neonatal outcomes.

    Methods:

    This study involved a secondary analysis of the REBRACO Network, a prospective cohort study conducted in 15 maternity hospitals in Brazil before the introduction of COVID-19 vaccination (February 2020 to February 2021). Demographic data of pregnant women tested for COVID-19 were analyzed, and fetal outcomes were compared between women with positive and negative COVID-19 results who had SGA fetuses.

    Results:

    A total of 729 symptomatic pregnant women with COVID-19 were included in the study. However, there were 248 participants with missing information regarding childbirth or loss of follow-up, and 107 participants without confirmatory tests for COVID-19. Among the remaining participants, 198 had confirmed COVID-19 and 176 tested negative. The incidence of SGA among women with COVID-19 was 22.4%, whereas the incidence among women who tested negative for COVID-19 was 14.8%. SGA newborns born to COVID-19 positive pregnant women were 1.6 times more likely to experience adverse outcomes (such as prematurity, stillbirth, neonatal death, and admission to a neonatal ICU) compared to non-SGA newborns [OR = 1.655 (1.145 – 2.394); P=0.017]. In SGA newborns of pregnant women with confirmed COVID-19 infection, mechanical ventilation use was found to be associated with the infection [OR = 0.692 (0.562 – 0.853); P=0.002].

    Conclusion:

    The higher incidence of SGA newborns and its stronger association with prematurity in pregnant women with confirmed COVID-19 infection suggest that COVID-19 infection is a significant factor contributing to neonatal morbidity and mortality.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
    Incidence of small-for-gestational-age newborns in pregnant women with COVID-19
  • Original Article

    Assessıng the predıctıve accuracy of blood-based bıomarkers ın neonatal outcomes for pregestatıonal dıabetes mellıtus

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo17
    04-30-2025

    Summary

    Original Article

    Assessıng the predıctıve accuracy of blood-based bıomarkers ın neonatal outcomes for pregestatıonal dıabetes mellıtus

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo17
    04-30-2025

    DOI 10.61622/rbgo/2025rbgo17

    Views19

    Abstract

    Objective:

    This retrospective study aimed to investigate blood-based immune-inflammatory biomarkers (IIBs) in predicting neonatal outcomes in pregnancies with pregestational diabetes mellitus (PGDM).PIV[(neutrophil×platelet×monocyte)/lymphocyte)], SII (neutrophil×platelet/lymphocyte), and NLR neutrophil/lymphocyte) values were evaluated in all three trimesters, and their correlation with neonatal outcomes was examined.

    Methods:

    We included 82 cases of PGDM pregnancies delivered after 32 weeks. Maternal age, gravidity, parity, types of diabetes, and route of delivery were noted. For neonatal outcomes, we recorded gestational age at birth, birth weight percentile, existence of fetal growth restriction, LGA, neonatal intensive care unit (NICU) requirement, Apgar Score <7 at 1, 5, or 10 minutes, need for positive pressure ventilation (PPV), need for mechanical ventilation, hypoglycaemia, hyperbilirubinemia and the need for phototherapy. PIV, SII and NLR values were calculated in each trimester and their association with adverse neonatal outcomes was analyzed.

    Results:

    We could not detect any consistent and significant correlation between SII and PIV values and adverse neonatal outcomes for each trimester. There was a correlation between 3rd trimester NLR and adverse neonatal outcomes, including APGAR <7, the requirement for PPV and mechanical ventilation (p=0.056, 0.013 and 0.060, respectively).

    Conclusion:

    While SII and PIV values did not consistently correlate with adverse neonatal outcomes throughout each trimester in PGDM pregnancies, 3rd-trimester NLR showed a notable association with the requirement for PPV with statistical significance and with Apgar Score <7 and the requirement for mechanical ventilation without statistical significance. NLR in the third trimester may hold potential as a predictive marker for specific adverse neonatal outcomes in PGDM pregnancies, warranting further investigation.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • 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 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

    DOI 10.61622/rbgo/2025rbgo6

    Views134

    Abstract

    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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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
    Effect of COVID-19 on Brazilian cesarean and prematurity rates: a cross-sectional study
  • 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 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

    DOI 10.61622/rbgo/2024rbgo69

    Views232

    Abstract

    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

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • Original Article

    Association between dietary patterns and infant birth weight in brazilian pregnancy women with gestational diabetes: a cross-sectional study

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo68
    09-06-2024

    Summary

    Original Article

    Association between dietary patterns and infant birth weight in brazilian pregnancy women with gestational diabetes: a cross-sectional study

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo68
    09-06-2024

    DOI 10.61622/rbgo/2024rbgo68

    Views166

    Abstract

    Objective

    To evaluate the association between the dietary patterns (DPs) of pregnant women with GDM (gestational diabetes mellitus) and the birth weight (BW) of the infants.

    Methods

    Cross-sectional study with 187 adult pregnant women with GDM attended at a maternity in Rio de Janeiro from 2011 to 2014. Dietary intake was assessed in the third trimester using a semiquantitative food frequency questionnaire (FFQ). The outcomes were BW and weight adequacy for gestational age (GA). Reduced Rank Regression (RRR) was used to explain the following response variables: density of carbohydrates, fibres, and saturated fatty acids. Statistical analyzes included multinomial logistic regression models.

    Results

    The mean BW was 3261.9 (± 424.5) g. Three DPs were identified, with DP 3 (high consumption of refined carbohydrates, fast foods/snacks, whole milk, sugars/sweets, and soft drinks and low consumption of beans, vegetables, and low-fat milk and derivatives) being the main pattern, explaining 48.37% of the response variables. In the multinomial logistic regression analysis no statistically significant association was found between the tertiles of DPs and BW or the adequacy of weight for GA, even after adjustments of confounding covariates.

    Conclusion

    No significant associations were found between maternal DPs in the third trimester of pregnancy and infant BW or adequacy of weight for GA.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • Original Article

    Mode of delivery according to Robson classification and perinatal outcomes in restricted and small for gestational age fetuses

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo30
    07-26-2024

    Summary

    Original Article

    Mode of delivery according to Robson classification and perinatal outcomes in restricted and small for gestational age fetuses

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo30
    07-26-2024

    DOI 10.61622/rbgo/2024rbgo30

    Views170

    Abstract

    Objective

    To evaluate the mode of delivery according to Robson classification (RC) and the perinatal outcomes in fetal growth restriction (FGR) and small for gestational age (SGA) fetuses.

    Methods

    Retrospective cohort study by analyzing medical records of singleton pregnancies from two consecutive years (2018 and 2019). FGR was defined according to Delphi Consensus. The Robson groups were divided into two intervals (1–5.1 and 5.2–10).

    Results

    Total of 852 cases were included: FGR (n = 85), SGA (n = 20) and control (n=747). FGR showed higher percentages of newborns < 1,500 grams (p<0.001) and higher overall cesarean section (CS) rates (p<0.001). FGR had the highest rates of neonatal resuscitation and neonatal intensive care unit admission (p<0.001). SGA and control presented higher percentage of patients classified in 1 - 5.1 RC groups, while FGR had higher percentage in 5.2 - 10 RC groups (p<0.001). FGR, SGA and control did not differ in the mode of delivery in the 1-5.1 RC groups as all groups showed a higher percentage of vaginal deliveries (p=0.476).

    Conclusion

    Fetuses with FGR had higher CS rates and worse perinatal outcomes than SGA and control fetuses. Most FGR fetuses were delivered by cesarean section and were allocated in 5.2 to 10 RC groups, while most SGA and control fetuses were allocated in 1 to 5.1 RC groups. Vaginal delivery occurred in nearly 60% of FGR allocated in 1-5.1 RC groups without a significant increase in perinatal morbidity. Therefore, the vaginal route should be considered in FGR fetuses.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • Original Article

    Factors associated with exclusive breastfeeding in “Near Miss” neonates in Brazil

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo59
    07-26-2024

    Summary

    Original Article

    Factors associated with exclusive breastfeeding in “Near Miss” neonates in Brazil

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo59
    07-26-2024

    DOI 10.61622/rbgo/2024rbgo59

    Views109

    Abstract

    Objective

    To assess the association between sociodemographic and perinatal factors and hospital practices to encourage exclusive breastfeeding in near miss neonates in maternity hospitals.

    Methods

    This is a prospective cohort of live births from the survey “To be born in Brazil” conducted between 2011 and 2012. The weighted number of newborns who met the neonatal near miss criteria was 832. Exclusive breastfeeding at hospital discharge and 45 days after delivery were dependent variables of the study. The sociodemographic and perinatal factors of the puerperal women and hospital practices to encourage breastfeeding were independent variables. The data were analyzed with Poisson regression and set with p value<0.05. Is exclusive breastfeeding in neonatal near misses associated with factors related to sociodemographic conditions, maternal characteristics and the organization of health services?

    Results

    Data from 498 women and their children were analyzed. Mothers with incomplete primary education were more likely (36%) to have exclusive breastfeeding (RR: 1.36; 95% CI: 1.06-1.74) at discharge. Women who did not offer the breast to the newborn in the joint accommodation (65%) were less likely to be breastfeeding exclusively (RR: 0.65; 95% CI: 0.56-0.75) at discharge. Variables that increased the probability of exclusive breastfeeding after 45 days of delivery were primiparity (RR: 1.36; 95% CI: 1.08-1.69) and having the newborn in the delivery room (RR: 1.90; 95% CI: 1.12-3.24).

    Conclusion

    Exclusive breastfeeding in neonatal near misses was associated with maternal characteristics and important hospital practices, such as being breastfed in the joint accommodation and the newborn being in the mother’s lap in the delivery room.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • Artigos Originais

    Obesity during pregnancy: gestational complications and birth outcomes

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(11):509-513
    11-01-2014

    Summary

    Artigos Originais

    Obesity during pregnancy: gestational complications and birth outcomes

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(11):509-513
    11-01-2014

    DOI 10.1590/S0100-720320140005024

    Views135

    PURPOSE:

    To evaluate the influence of maternal obesity on pregnancy, childbirth, and neonatal outcomes.

    METHODS:

    A cross-sectional study with 298 postpartum women. Information was obtained through interviews and access to patients' medical records. The patients were divided into three groups according to their pre-gestational body mass index: normal weight (18.5–24.9 kg/m2), overweight (25.0–29.9 kg/m2), and obese (≥30.0 kg/m2). Data are reported as adjusted odds ratios with 95% confidence interval (95%CI) following multinomial logistic regression analysis to account for confounding variables.

    RESULTS:

    Compared to pregnant women with normal body mass index, overweight women had greater chances of having cesarean delivery, odds ratio (OR) of 2.2 and 95%CI 1.3–3.9, and obese women even more (OR=4.2; 95%CI 2.1–8.1). The chances of gestational diabetes increased in the Overweight (OR=2.5; 95%CI 1.1–5.6) and Obese groups (OR=11.1; 95%CI 5.0–24.6). The occurrence of hypertensive syndrome was also higher in overweight (OR=3.2; 95%CI 1.2–8.1) and obese pregnant women (OR=7.5; 95%CI 2.9–19.1). Major postpartum hemorrhage only showed greater values in the obese women group (OR=4.1; 95%CI 1.1–15.8). Regarding the newborns, the probability of a low Apgar score at first minute was higher in the Obese Group (OR=5.5; 95%CI 1.2–23.7) and chances of macrosomia were higher in the Overweight Group (OR=2.9; 95%CI 1.3–6.3). Data regarding neonatal hypoglycemia were not conclusive.

    CONCLUSION:

    Excessive weight (overweight and obesity) during pregnancy increases the chance of maternal complications (gestational diabetes, hypertensive syndrome, and major postpartum hemorrhage) and neonatal outcomes (cesarean delivery, macrosomia, and low Apgar score).

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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